Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Tyrosine kinase inhibitors (TKI) have revolutionized the management and prognosis of chronic myeloid leukemia (CML). Daily treatment with TKI, which is necessary due to lack of cure, is frequently associated with moderate, chronic and sometimes severe adverse effects. The ability to permanently stop treatment with TKI has thus become a major goal in CML to prevent the occurrence of adverse events, improve quality of life and reduce the general cost of the treatment; we talk about Treatment Free Remission (TFR). It now remains to be demonstrated in a comparative prospective study that a strategy of de-escalation of the TKI treatment dose before treatment discontinuation optimizes TFR results. At the same time, it is possible to reduce adverse reactions and improve the quality of life of patients. In this context, the investigator propose to conduct a randomized clinical trial including CML patients, allowing to compare the results of TFR at 24 months between a sudden stop of treatment after a maintenance phase of dosage for 12 months and a de-escalation arm of dose (dosage reduced by 50%) for 12 months before stopping. A secondary immunological translational objective of this project will be to compare the quantitative and qualitative evolution of innate CD8 T cells between the 2 arms (abrupt cessation of ITK treatment versus progressive withdrawal) and look for a predictive innate CD8 T cells blood signature at the time of stopping treatment of a successful TFR in both arms.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| continued treatment with TKI at 50% dose reduction | Experimental | continued treatment with TKI at 50% dose reduction compared to dosing received at randomization and then stopped treatment 12 months after randomization |
|
| continuation of TKI treatment without dose change | Active Comparator | continued treatment with TKI at same dose compared to dosing received at randomization and then stopped treatment 12 months after randomization |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| treatment of TKI in CML | Drug | continued treatment with TKI at randomization a then stopped treatment 12 months after randomization |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients in treatment free Remission (TFR) 24 months after treatment discontinuation in patients.Treatment-Free Remission (TFR) is defined as patients with Major Molecular Response (MMR) or better (BCR-ABL level ≤ 0.1% IS). | Percentage of patients in treatment free Remission (TFR) 24 months after treatment discontinuation in patients is calculated by dividing the number of patients with no loss of MMR-Major Molecular Response (BCR-ABL level ≤ 0.1% IS) on the total number of patients. | 24 months after treatment discontinuation |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in proportions (%) at randomization and 12 months post randomization, of innate CD8 T cells among total CD8 T cells | 12 months |
Not provided
Inclusion Criteria:
Imatinib (≥ 300 mg/j) Dasatinib (≥ 50 mg/j) Nilotinib (≥ 300 mg/j) Bosutinib (≥ 200 mg/j)
Non-Inclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chu Angers | Angers | France | ||||
| Ch Annecy |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Annecy |
| France |
| Ch Bayonne | Bayonne | France |
| Chu Brest | Brest | France |
| CH Brive la Gaillarde | Brive-la-Gaillarde | France |
| Ch Chambery | Chambéry | France |
| CHI Creteil | Créteil | France |
| Ch La Rochelle | La Rochelle | France |
| Chu Lille | Lille | France |
| CHU Limoges | Limoges | France |
| Centre Léon Bérard | Lyon | France |
| Ch Mont de Marsan | Mont-de-Marsan | France |
| Chu Nancy | Nancy | France |
| Chu Nantes | Nantes | France |
| Hopital Prive Du Confluent | Nantes | France |
| Ch Perigueux | Périgueux | France |
| Chu Poitiers | Poitiers | France |
| Oncopole Toulouse | Toulouse | France |
| Chu Tours | Tours | France |
| CH Versailles | Versailles | France |
| ID | Term |
|---|---|
| D015464 | Leukemia, Myelogenous, Chronic, BCR-ABL Positive |
| ID | Term |
|---|---|
| D007951 | Leukemia, Myeloid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009196 | Myeloproliferative Disorders |
| D001855 | Bone Marrow Diseases |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
Not provided