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Trial registered on ANZCTR
Registration number
ACTRN12607000410459
Ethics application status
Approved
Date submitted
3/08/2007
Date registered
13/08/2007
Date last updated
31/08/2023
Date data sharing statement initially provided
31/08/2023
Date results provided
31/08/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
A phase II trial in patients with acute promyelocytic leukaemia (APML) to evaluate the effects of: all-trans retinoic acid combined with intensive idarubicin during induction and consolidation; subsequent intermittent all-trans retinoic acid; and molecular monitorting for evidence of minimal residual leukaemia and for evidence of incipient relapse.
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Scientific title
A phase II trial in patients with acute promyelocytic leukaemia (APML) to evaluate the effects of: all-trans retinoic acid (ATRA) combined with intensive idarubicin during induction and consolidation; subsequent intermittent all-trans retinoic acid; and molecular monitoring for evidence of minimal residual leukaemia and for evidence of incipient relapse, as measured by remission rate, relapse rate and overall survival.
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Secondary ID [1]
451
0
Australasian Leukaemia and Lymphoma Group (ALLG): APML3
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute promyelocytic leukaemia
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Condition category
Condition code
Cancer
2308
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0
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Leukaemia - Acute leukaemia
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Induction therapy: Two cycles of intensive idarubicin 12mg /m2 intravenously (IV) on days 2, 4, 6 and 8, (9mg/m2 for age 61-70, and 6mg/m2 for age > 70), together with continuous ATRA 45mg/m2/day orally starting on day 1 and Prednisone 50mg/day orally.
Consolidation: 3 cycles of ATRA (45mg/m2/day orally) for 2 weeks out of every 4-week cycle.
Maintenance (for a total of 2 years): ATRA 45mg/m2/d orally for 15 days every 3 months plus 6-mercaptopurine (6MP) 90mg/m^2/d orally plus Methotrexate 15mg/m^2 once weekly orally.
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Intervention code [1]
1928
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Treatment: Drugs
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Comparator / control treatment
Uncontrolled
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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1. To maximise the complete remission rate (number of patients achieving remission) by combining all-trans retinoic acid (ATRA) with intensive idarubicin chemotherapy, assessed after induction cycle 1 and after induction cycle 2.
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Assessment method [1]
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Timepoint [1]
3203
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Assessed after induction cycle 1 and after induction cycle 2.
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Primary outcome [2]
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2. To minimise the relapse rate by employing a second course of idarubicin followed by intermittent ATRA for eradication of minimal residual leukaemia as measured by the actuarial relapse free survival (measured from date of remission to date of relapse). This is measured annually, starting from one year after closure of trial to study close-out date
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Assessment method [2]
3204
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Timepoint [2]
3204
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This is measured annually, starting from one year after closure of trial to study close-out date
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Primary outcome [3]
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3. To maximise overall survival (measured from day 1 to death) through an intensive program of molecular monitoring for the detection of incipient relapse, combined with an aggressive therapeutic intervention strategy aimed at eradication of low levels of recurrent leukaemia. Overall survival is measured annually, starting from one year after closure of trial to study close-out date
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Assessment method [3]
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Timepoint [3]
3205
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Overall survival is measured annually, starting from one year after closure of trial to study close-out date
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Secondary outcome [1]
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There are no secondary outcomes.
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Assessment method [1]
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Timepoint [1]
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Not applicable.
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Eligibility
Key inclusion criteria
1. Morphological diagnosis of de novo acute promyelocytic leukaemia
2. Demonstration of PML-RAR fusion transcripts by reverse transcriptase-polymerase chain reaction (RT-PCR)
3. Eastern Cooperative Oncology Group performance status 0-3, and absence of previous history of serious cardiac, pulmonary, hepatic or renal disease. A serum creatinine >200 micro mol/L or serum bilirubin
>80µmol/L precludes entry into the study, unless medically correctable.
4. A left ventricular ejection fraction of at least 50% as demonstrated by gated heart pool scan (preferably) or by cardiac ultrasound.
5. No previous treatment for APL, or history of cancer (other than basal cell skin cancer, or carcinoma of cervix in situ).
6. No contra-indication to use of any of the study drugs.
7. Treatment will be carried out at an affiliated ALLG centre, with approval of the protocol by the Institutional Human Ethics Committee or equivalent.
8. A negative pregnancy test in females of child-bearing age.
9. Written informed consent will be given by each patient.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
There are no specified exclusion criteria. All patients who met the inclusion criteria were eligible for the trial.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/1997
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Actual
19/08/1997
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Date of last participant enrolment
Anticipated
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Actual
22/10/2002
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Date of last data collection
Anticipated
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Actual
31/03/2007
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Sample size
Target
100
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Accrual to date
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Final
107
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Pharmacia
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Address [1]
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NSW
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Country [1]
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Australasian Leukaemia and Lymphoma Group
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Address
C/- Peter MacCallum Cancer Centre
10 St Andrews Place
East Melbourne VIC 3002
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Nil.
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Address [1]
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Not applicable.
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Country [1]
2247
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
4351
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Royal Adelaide Hospital
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Ethics committee address [1]
4351
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SA
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Ethics committee country [1]
4351
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Australia
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Date submitted for ethics approval [1]
4351
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Approval date [1]
4351
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Ethics approval number [1]
4351
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Ethics committee name [2]
4352
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Alfred Hospital
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Ethics committee address [2]
4352
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Ethics committee country [2]
4352
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Australia
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Date submitted for ethics approval [2]
4352
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Approval date [2]
4352
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Ethics approval number [2]
4352
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Ethics committee name [3]
4353
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Auckland Hospital
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Ethics committee address [3]
4353
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Ethics committee country [3]
4353
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New Zealand
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Date submitted for ethics approval [3]
4353
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Approval date [3]
4353
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Ethics approval number [3]
4353
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Ethics committee name [4]
4354
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Austin Hospital
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Ethics committee address [4]
4354
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Ethics committee country [4]
4354
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Australia
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Date submitted for ethics approval [4]
4354
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Approval date [4]
4354
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Ethics approval number [4]
4354
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Ethics committee name [5]
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Ballarat Base Hospital
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Ethics committee address [5]
4355
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VIC
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Ethics committee country [5]
4355
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Australia
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Date submitted for ethics approval [5]
4355
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Approval date [5]
4355
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Ethics approval number [5]
4355
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Ethics committee name [6]
4356
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Canberra Hospital
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Ethics committee address [6]
4356
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ACT
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Ethics committee country [6]
4356
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Australia
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Date submitted for ethics approval [6]
4356
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Approval date [6]
4356
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Ethics approval number [6]
4356
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Ethics committee name [7]
4357
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Fremantle Hospital
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Ethics committee address [7]
4357
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WA
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Ethics committee country [7]
4357
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Australia
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Date submitted for ethics approval [7]
4357
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Approval date [7]
4357
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Ethics approval number [7]
4357
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Ethics committee name [8]
4358
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Geelong Hospital
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Ethics committee address [8]
4358
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VIC
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Ethics committee country [8]
4358
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Australia
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Date submitted for ethics approval [8]
4358
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Approval date [8]
4358
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Ethics approval number [8]
4358
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Ethics committee name [9]
4359
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Royal Hobart Hospital
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Ethics committee address [9]
4359
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TAS
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Ethics committee country [9]
4359
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Australia
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Date submitted for ethics approval [9]
4359
0
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Approval date [9]
4359
0
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Ethics approval number [9]
4359
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Ethics committee name [10]
4360
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Liverpool Hospital
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Ethics committee address [10]
4360
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Ethics committee country [10]
4360
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Australia
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Date submitted for ethics approval [10]
4360
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Approval date [10]
4360
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Ethics approval number [10]
4360
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Ethics committee name [11]
4361
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Mater Private Hospital
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Ethics committee address [11]
4361
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Ethics committee country [11]
4361
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Australia
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Date submitted for ethics approval [11]
4361
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Approval date [11]
4361
0
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Ethics approval number [11]
4361
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Ethics committee name [12]
4362
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Mater Hospital Brisbane
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Ethics committee address [12]
4362
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Ethics committee country [12]
4362
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Australia
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Date submitted for ethics approval [12]
4362
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Approval date [12]
4362
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Ethics approval number [12]
4362
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Ethics committee name [13]
4363
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Mater Hospital Newcastle
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Ethics committee address [13]
4363
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Ethics committee country [13]
4363
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Australia
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Date submitted for ethics approval [13]
4363
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Approval date [13]
4363
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Ethics approval number [13]
4363
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Ethics committee name [14]
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Monash Medical Centre
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Ethics committee address [14]
4364
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Ethics committee country [14]
4364
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Australia
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Date submitted for ethics approval [14]
4364
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Approval date [14]
4364
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Ethics approval number [14]
4364
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Ethics committee name [15]
4365
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Peter MacCallum Cancer Centre
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Ethics committee address [15]
4365
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Ethics committee country [15]
4365
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Australia
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Date submitted for ethics approval [15]
4365
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Approval date [15]
4365
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Ethics approval number [15]
4365
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Ethics committee name [16]
4366
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Princess Alexandra Hospital
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Ethics committee address [16]
4366
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Ethics committee country [16]
4366
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Australia
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Date submitted for ethics approval [16]
4366
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Approval date [16]
4366
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Ethics approval number [16]
4366
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Ethics committee name [17]
4367
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Queen Elizabeth Hospital
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Ethics committee address [17]
4367
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Ethics committee country [17]
4367
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Australia
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Date submitted for ethics approval [17]
4367
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Approval date [17]
4367
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Ethics approval number [17]
4367
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Ethics committee name [18]
4368
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Royal Melbourne Hospital
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Ethics committee address [18]
4368
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VIC
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Ethics committee country [18]
4368
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Australia
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Date submitted for ethics approval [18]
4368
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Approval date [18]
4368
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Ethics approval number [18]
4368
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Ethics committee name [19]
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Royal Perth Hospital
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Ethics committee address [19]
4369
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WA
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Ethics committee country [19]
4369
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Australia
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Date submitted for ethics approval [19]
4369
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Approval date [19]
4369
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Ethics approval number [19]
4369
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Ethics committee name [20]
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Royal Prince Alfred Hospital
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Ethics committee address [20]
4370
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NSW
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Ethics committee country [20]
4370
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Australia
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Date submitted for ethics approval [20]
4370
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Approval date [20]
4370
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Ethics approval number [20]
4370
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Ethics committee name [21]
4371
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St George Hospital
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Ethics committee address [21]
4371
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Ethics committee country [21]
4371
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Australia
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Date submitted for ethics approval [21]
4371
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Approval date [21]
4371
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Ethics approval number [21]
4371
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Ethics committee name [22]
4372
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St Vincent's Hospital Sydney
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Ethics committee address [22]
4372
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NSW
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Ethics committee country [22]
4372
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Australia
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Date submitted for ethics approval [22]
4372
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Approval date [22]
4372
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Ethics approval number [22]
4372
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Ethics committee name [23]
4373
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Townsville Hospital
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Ethics committee address [23]
4373
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QLD
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Ethics committee country [23]
4373
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Australia
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Date submitted for ethics approval [23]
4373
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Approval date [23]
4373
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Ethics approval number [23]
4373
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Ethics committee name [24]
4374
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Wesley Medical Centre
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4374
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Ethics committee country [24]
4374
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Australia
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Date submitted for ethics approval [24]
4374
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Approval date [24]
4374
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Ethics approval number [24]
4374
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Ethics committee name [25]
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Westmead Hospital
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4375
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NSW
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4375
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Australia
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Date submitted for ethics approval [25]
4375
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Approval date [25]
4375
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4375
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Ethics committee name [26]
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Woolongong Hospital
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Ethics committee address [26]
4376
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NSW
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Ethics committee country [26]
4376
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Australia
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4376
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Approval date [26]
4376
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Ethics approval number [26]
4376
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Summary
Brief summary
An Italian clinical trials group demonstrated excellent outcomes for the majority of APL patients when intensive idarubicin was added to ATRA for remission induction therapy. Their patients were then treated with conventional consolidation chemotherapy. In the APML3 trial, intensive idarubicin and ATRA are used for both induction and consolidation in order to exploit the unique sensitivity of APL to this combination. In addition, frequent molecular monitoring is used to determine post-remission therapy.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Harry Iland
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Address
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Institute of Haematology Royal Prince Alfred Hospital Missenden Road Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 95157451
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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A/Prof Harry Iland
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Address
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Institute of Haematology
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 95157451
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Fax
11117
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+61 2 95156698
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Email
11117
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[email protected]
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Contact person for scientific queries
Name
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A/Prof Harry Iland
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Address
2045
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Institute of Haematology
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050
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Country
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Australia
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Phone
2045
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+61 2 95157451
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Fax
2045
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+61 2 95156698
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified IPD data for all data collected during the trial
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When will data be available (start and end dates)?
Data available 3 months following publication, for an indefinite period
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Available to whom?
Data are potentially available to:
• Researchers from not-for-profit organisations
• Commercial organisations
• Other
Based in:
• Any location
Further information:
All data requests will be considered by the sponsor ALLG on a case by case basis. Requests must include a methodologically sound proposal. Specific conditions of use may apply and will be specified in a data sharing agreement (or similar) that the requester must agree to before access is granted.
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Available for what types of analyses?
Any type of analysis. Proposals will be assessed on a case-by-case basis
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How or where can data be obtained?
Access can be requested via the Health Data Australia catalogue (https://researchdata.edu.au/health/). Search for the ACTRN number in the catalogue to find datasets associated with this trial or email enquiries to
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
20192
Study protocol
[email protected]
Access can be requested via the Health Data Austra...
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Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
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No additional documents have been identified.
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