Study on Ponatinib and Chemotherapy for Adults with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia (Ph+ ALL)

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What is this study about?

This clinical trial is focused on studying a type of blood cancer called Philadelphia chromosome-positive Acute Lymphoblastic Leukemia (Ph+ ALL). The study aims to evaluate the effectiveness of a medication called Ponatinib, which may be used alone or in combination with other chemotherapy drugs. The chemotherapy drugs involved in this study include Cytarabine, Methylprednisolone, Methotrexate, Vincristine, and Prednisone. These medications are used to help manage the disease by reducing the number of cancer cells in the body.

The purpose of the study is to see how well Ponatinib works in helping patients achieve remission, which means reducing or eliminating signs of cancer. The study will look at patients who have persistent or relapsed disease, as well as those who have not achieved remission after previous treatments. Participants will receive treatment over a period of time, and their response to the medication will be monitored. Some patients may receive a placebo, which is a substance with no active medication, to compare the effects of the treatment.

Throughout the study, the safety and side effects of the treatments will be closely monitored. The study will also explore how the treatment affects the presence of specific genetic changes in the cancer cells, such as mutations in the BCR-ABL1 gene. The goal is to understand how these treatments can help patients achieve better outcomes and improve their quality of life. The study is expected to continue until 2026, providing valuable information on the management of Ph+ ALL.

1 initial assessment

Upon joining the study, an initial assessment is conducted to confirm eligibility. This includes verifying the presence of Ph+ acute lymphoblastic leukemia and minimal residual disease (MRD) or relapse.

Basic health parameters such as liver and pancreatic function are evaluated. A pregnancy test is required for females of childbearing potential.

2 treatment initiation

Treatment begins with the administration of ponatinib, which is taken orally in the form of 15 mg film-coated tablets. The frequency and duration of this medication are determined by the study protocol.

In some cases, ponatinib is combined with chemotherapy drugs such as cytarabine, methylprednisolone, methotrexate, vincristine, and prednisone. These drugs are administered through various routes, including intrathecal (directly into the spinal canal) and intravenous (into a vein).

3 monitoring and evaluation

Throughout the treatment, regular monitoring is conducted to assess the response to therapy. This includes checking for MRD negativity or reduction after three months.

The safety profile is evaluated by monitoring for any side effects or toxicities. Adjustments to the treatment plan may be made based on these evaluations.

4 follow-up assessments

Follow-up assessments are conducted to determine the duration of complete molecular remission (CMR) and to evaluate the best molecular response achieved.

Additional analyses may include mutational analysis and correlation studies to understand the impact of treatment on different genetic profiles.

5 long-term outcomes

The study aims to evaluate long-term outcomes such as disease-free survival (DFS) and overall survival (OS) at 24 months.

The role of clinical and biological assessments at baseline is also analyzed to understand their impact on treatment outcomes.

Who Can Join the Study?

Patients must have Ph+ Acute Lymphoblastic Leukemia (ALL), which is a type of blood cancer.
Patients should show evidence of MRD disease (Minimal Residual Disease) or be in relapse/refractoriness, meaning the disease has returned or is not responding to treatment.
Patients must be 18 years or older. There is no upper age limit.
Patients need to have adequate liver function, which means:
- Total serum bilirubin should be no more than 1.5 times the normal upper limit, unless they have Gilbert’s syndrome, a mild liver disorder.
- ALT (alanine aminotransferase) and AST (aspartate aminotransferase) levels should be no more than 2.5 times the normal upper limit. These are enzymes that help assess liver health.
Patients need to have adequate pancreatic function, meaning:
- Serum lipase and amylase levels should be no more than 1.5 times the normal upper limit. These are enzymes that help assess pancreas health.
Females who can have children must have a negative pregnancy test before joining the study.
Both female and male patients who can have children must agree to use an effective form of birth control with their partners from the start of the study until 4 months after treatment ends.
Patients must provide signed written informed consent, which means they agree to participate in the study after understanding all the details, according to international and local laws.

Who Cannot Join the Study?

Patients who have a different type of leukemia than Ph+ Acute Lymphoblastic Leukemia cannot participate. This is a specific type of blood cancer.
Patients who are not within the specified age range for the study cannot participate. The study is only for certain age groups.
Patients who are not able to follow the study procedures or take the study medication as required cannot participate.
Patients who have other serious health conditions that might interfere with the study cannot participate.
Patients who are pregnant or breastfeeding cannot participate.
Patients who have participated in another clinical trial recently may not be eligible to participate.
Patients who have allergies or reactions to the study medication or similar medications cannot participate.

Where you can join this trial?

Verified and Recommended Sites

No sites found in this category

Verified Sites

Site Name	City	Country
Policlinico “Tor Vergata”, Università degli Studi di Roma TOR VERGATA	Rome	Italy
Azienda Ospedaliero Universitaria Careggi	Florence	Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS	Rome	Italy
Ospedale dell’Angelo di Mestre	Mestre – Venezia	Italy
Azienda Ospedaliero Universitaria Di Sassari	Sassari	Italy

Other Sites

Site Name	City	Country
Azienda Sanitaria Locale Di Taranto	Taranto	Italy
Ospedale San Raffaele S.r.l.	Milan	Italy
Ospedale S. Eugenio, ASL Roma 2	Rome	Italy
A.O.U. Policlinico G. Martino Di Messina	Messina	Italy
Afjfvut Ouynhttvtmp dm Poeokc	Padua	Italy
Fpovigacjl Iaxrr Co Goyyzd Orqfxtwb Mkquhqfm Ptvpfxiwtzv	Milan	Italy
Ahoj Goyvst Ohzayrpj Mvsybpalrpzmt Ngsmbbhy	Milan	Italy
Fgbxgqdpea Iydfb Pdiezdsdszt Sku Mtlsqw	Pavia	Italy
Ugnfyubnazzvazznf Dduhl Skmfu Ds Vebbnv	Verona	Italy
Ioqad Osurullf Ppngaoxlipr Sqx Mwrmery	Genoa	Italy
Aviofjc Ofvexuwwtpe Uxsfeckxkmxhg Cbaspgnngrzi Dtqru Stmzat E Dzhgd Sdvcstr Df Tkstzw	Turin	Italy
Arkxuif Otggjtbhnwj Uatqglzgykqlr Ffjpmano Ib Dx Nqgmcp	Naples	Italy
Aksarsw Ovuftywzjyw Uivbytnccsvav Ozwkuogq Rcpxzir	Foggia	Italy
Awomctp Oihkqxjpxpjpymdffssmoagop Mipwvdde Dzfco Cgigrm	Novara	Italy
Aqacviy Uvwyd Sgjsvrujf Lrzjlx Dp Byldkrl	Bologna	Italy
Aertkpt Oilvyfsgiez Pskr Gnsrwuux Xdecg	Bergamo	Italy
Irkogv Itdwzdfd Fntciepnoblkq Objtvrrzmmv	Rome	Italy
Umrnjrfobe Drack Sdmih Dp Rfki Lo Sulqpchh	Rome	Italy
Uoujulsops Dktfz Snyqk Dv Bsxbjht	Brescia	Italy
Ixepzbsr Ojdzrphivz Vdkjpa	Padua	Italy
Axqkqit Oifwtvtbbhn Uyhetgivrqwbv Ofhrvxsg Rubfpih Upqhvtg I G M Lqtkiuu G Sreump	Ancona	Italy
Oelfaoty Vmdo Foorb Ljlfj	Lecce	Italy
Aculjaz Osxuihkzybpeksemrxpchfazb Pgjchugpgqf Gy Rzioqxxbpyka Mcbvf Dz Cbffxjh	Catania	Italy
Gaxdop Ovoehums Mxyxeayqbvyug Bozuhrv Mpolhqcrp Mezfqgq	Reggio Calabria	Italy
Aqujtyb Otydomqydsn Ooysrejv Rqobxnw Vdxbv Sdruo Csoqykgy	Palermo	Italy
Asl Dwvvy Pqpwupeog Dk Bdyxpkjjr Aaazgcj Tdjptd Oazflklf &hbhevogbdvz Drdqrqscqkvwztmw &bqukxc Bqrbahke	Barletta	Italy
Agtifiw Obeynhctodcevxidogaccihff Szy Ltduq Genbeda	Orbassano	Italy
Ayszmlj Ovxvpmtjany Uqipzfowmghcl Spuyfz	Siena	Italy
Aceaetj Uyulk Seukgsukv Lmjunh Dosqv Rvtervp	Faenza	Italy
Axncjzs Sbldgerao Tknajdeirmpb Dq Amsbom Predvc	Ascoli Piceno	Italy
Aqzglde Omnxavgkjidfsnpfbzinphtnj Sqko Aboph	Rome	Italy
Cjvg Spzwtzks Dooap Scgvxuyacr	San Giovanni Rotondo	Italy
Aogmbdq Usraz Sshhsoowr Lassmm Do Pvglakpx	Piacenza	Italy
Hskgxnlw Sduoj Mujsq Dbuzp Mvoslllkrbwf	Perugia	Italy
Ayvnllu Urabp Lmlaqj Sviuq Snarnqecc N 8 Byvvfc	Vicenza	Italy
Omljaudt Sauhw Mmzjm Gcskmmb Lrvsrh	Latina	Italy
Aiwksip Oehgamgblco Ohxirhon Rliucqt Mtcnjc Nbam	Pesaro	Italy
Asjhujb Oggsuohphqj Odpcoc Msodywouzw Dv Twsbvn	Turin	Italy
Aghcegd Otakaexliny Utlmyuuvnlzsk Sbe Gryuhhhd Di Dki E Rtdmy dbchzsmbbqdstwy	Salerno	Italy
Akyg Szs Gaivsncy Mlocolv Atffxsbh	Avellino	Italy
Avmupsl Snyxnocfi Lhxewt Dq Ptfwzht	Pescara	Italy
Aboeudm Sfnrfjant Lnmfyi Du Snhqkqp	Battipaglia	Italy
Ayagxbo Ovjlrcbgjcahbxzaoylfochpn Cdeodrwutum Pdbghzuuwow ds Blgy	Bari	Italy

Trial status

Country	Status	Recruitment Start
Italy	Not recruiting	04.05.2021

Trial locations

Investigated Drugs:

Ponatinib is a medication used in this clinical trial to manage minimal residual disease (MRD) and hematologic relapse in adult patients with a specific type of leukemia known as Ph+ acute lymphoblastic leukemia (Ph+ ALL). It is being tested to see how well it can reduce or eliminate the remaining cancer cells after initial treatment. The study is evaluating the effects of using ponatinib alone or in combination with other chemotherapy treatments over a period of three months.

Investigated Diseases:

Acute lymphocytic leukaemia

Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia – This is a type of cancer that affects the blood and bone marrow, characterized by the presence of the Philadelphia chromosome. It is a subtype of acute lymphoblastic leukemia (ALL) where the bone marrow produces too many immature white blood cells, known as lymphoblasts. The disease progresses rapidly, leading to an accumulation of these abnormal cells in the blood and bone marrow, which can interfere with the production of normal blood cells. Symptoms may include fatigue, fever, frequent infections, and easy bruising or bleeding. The presence of the Philadelphia chromosome is due to a specific genetic abnormality that results in the production of an abnormal protein that promotes the growth of cancer cells. This condition is considered rare and requires specialized medical attention.

Trial ID:

2024-516868-28-00

Protocol code:

ALL2620

NCT ID:

NCT04475731

Trial Phase:

Therapeutic exploratory (Phase II)

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Study on Ponatinib and Chemotherapy for Adults with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia (Ph+ ALL)

What is this study about?

Who Can Join the Study?

Who Cannot Join the Study?