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Trial registered on ANZCTR
Registration number
ACTRN12607000614493
Ethics application status
Approved
Date submitted
28/11/2007
Date registered
29/11/2007
Date last updated
17/09/2023
Date data sharing statement initially provided
4/08/2023
Date results provided
4/08/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
A Phase II study in adult patients with newly-diagnosed chronic myeloid leukaemia of initial intensified Glivec® therapy, and sequential combination therapy for non-responders. With Protocol Amendments October 2004: to include an Extension Phase of the Study
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Scientific title
A Phase II study in adult patients with newly-diagnosed chronic myeloid leukaemia of initial intensified Glivec® therapy, and sequential combination therapy for non-responders, in order to assess response and survival
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Secondary ID [1]
501
0
Australasian Leukaemia and Lymphoma Group CML6
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Universal Trial Number (UTN)
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Trial acronym
TIDEL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic myeloid leukaemia (CML)
2594
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Condition category
Condition code
Cancer
2705
2705
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0
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Leukaemia - Chronic leukaemia
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
1. All patients receive higher dose imatinib – 600 mg/day
2. in eligible patients dose increased to 800 mg based on time dependent response targets
3. In eligible patients cytosine arabinoside added to imatinib if response targets are not reached
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Intervention code [1]
2326
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Treatment: Drugs
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
3605
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To assess overall rates and duration of complete cytogenetic response (CCR) and molecular response (MR) achieved using a schedule of intensive, escalated and combination therapy with Glivec, in association with filgrastim support, in adults with newly-diagnosed chronic-phase CML over the 2 year study period.
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Assessment method [1]
3605
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Timepoint [1]
3605
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Every 3 months for 8 years
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Secondary outcome [1]
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1. To assess overall rates and duration of response, Quality of Life using European Quality of Life 5 Dimension (EQ-5D) Health Questionnaire and overall survival.
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Assessment method [1]
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Timepoint [1]
6037
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Every 3 months for 8 years
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Secondary outcome [2]
6038
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2. To determine the safety and efficacy of filgrastim
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Assessment method [2]
6038
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Timepoint [2]
6038
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Every 3 months for 2 years
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Secondary outcome [3]
6039
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3. To determine the patterns of change of CML disease load in blood and/or bone marrow over time
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Assessment method [3]
6039
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Timepoint [3]
6039
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Every 3 months for 8 years
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Secondary outcome [4]
6040
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4. To determine the tolerability, quality of life, and safety of initial therapy with Glivec? 600mg daily, and escalated therapy with Glivec 800mg daily, and subsequent combined sequential therapy with Glivec and Cytosine arabinoside
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Assessment method [4]
6040
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Timepoint [4]
6040
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Every 3 months for 8 years
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Secondary outcome [5]
6041
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5. To assess subsequent levels of response to imatinib in patients who show continuing response at 24 months on Study, by Quantitative Polymerase Chain Reaction (Q-PCR) analysis of 3-monthly blood samples for the ratio of BCR-ABL/BCRL transcripts, for up to six further years of an Extension Phase to this Study.
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Assessment method [5]
6041
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Timepoint [5]
6041
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Every 3 months for 8 years
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Secondary outcome [6]
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6. To evaluate reasons for loss of response to imatinib in patients on the Extension Phase of this Study, if and when Q-PCR analysis of 3-monthly blood samples (for up to six further years) shows a 2-fold increase in bcr-abl transcripts, by mutation analyses of BCR-ABL genes.
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Assessment method [6]
6042
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Timepoint [6]
6042
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Every 3 months for 8 years
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Eligibility
Key inclusion criteria
1.Male or female patients between 16 and 75 years of age inclusive. Patients must have all of the following:
2.i.be enrolled within 6 months of initial diagnosis of CML-CP
ii.be previously untreated for CML with the exception of hydroxyurea and/or anagrelide,
iii.cytogenetic confirmation of Philadelphia chromosome or variants of (9;22) translocations; OR molecular (PCR) confirmation of bcr-abl gene rearrangement(s);
iv.(a) < 15% blasts in peripheral blood and bone marrow;
(b) < 30% blasts plus promyelocytes in peripheral blood and bone marrow;
(c) < 20% basophils in peripheral blood,
(d) > 100 x 109/L platelets
v.no evidence of extramedullary leukemic involvement, with the exception of the spleen and liver,
3.Written voluntary informed consent.
4.Patients with an Eastern Cooperative Oncology Group performance status score of 2 or less.
5.Patients with serum bilirubin, Serum glutamic oxaloacetic transaminase, Serum glutamic pyruvic transaminase and creatinine concentrations <1.5x the institutional upper limits of normal (ULN).
6.Patients with a coagulation international normalised ratio (INR) and a partial thromboplastin time (PTT) <1.5x the institutional ULN, with the exception of allowing inclusion of patients on oral anticoagulant therapy.
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Minimum age
16
Years
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Maximum age
75
Years
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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
1.Patients who have received other investigational agents.
2.Patients with secondary chromosomal abnormalities in their CML cells.
3.Patients who received prior chemotherapy. Previous treatment with hydroxyurea is allowed.
4.Patients with uncontrolled medical disease
5.Patients with a positive test for human immunodeficiency virus
6.Patients who have undergone major surgery within 4 weeks of Study Day 1, or who have not recovered from prior major surgery.
7.Patients who are: (a) pregnant, (b) breast feeding, (c) of childbearing potential without a negative pregnancy test prior to Study Day 1, and (d) male or female of childbearing potential unwilling to use barrier contraceptive precautions throughout the trial (postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential).
8.Patients with a history of another malignancy within the past five years, with the exception of adequately-treated basal or squamous cell skin carcinoma or cervical carcinoma in situ.
9.Patients with a history of non-compliance to medical regimens or who are considered potentially unreliable.
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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
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
21/10/2002
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Actual
21/10/2002
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Date of last participant enrolment
Anticipated
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Actual
27/08/2003
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Date of last data collection
Anticipated
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Actual
16/02/2006
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Sample size
Target
100
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Accrual to date
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Final
103
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,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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Novartis Australia
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Address [1]
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PO Box 101
North Ryde NSW 2113
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Country [1]
2837
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Australia
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Funding source category [2]
2838
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Commercial sector/Industry
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Name [2]
2838
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Amgen Australia
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Address [2]
2838
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Level 1
801 Glenferrie Rd
Hawthorn VIC 3122
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Country [2]
2838
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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/- Centre for Biostatistics and Clinical Trials
Peter MacCallum Cancer Centre
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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Address [1]
2560
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Country [1]
2560
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
4769
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Royal Adelaide Hospital
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Ethics committee address [1]
4769
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Port Rd, Adelaide SA 5000
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Ethics committee country [1]
4769
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Australia
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Date submitted for ethics approval [1]
4769
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Approval date [1]
4769
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09/10/2002
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Ethics approval number [1]
4769
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Ethics committee name [2]
4770
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Albury Base Hospital/Murray Valley Private Hospital
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Ethics committee address [2]
4770
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201 Borella Rd, East Albury NSW 2640
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Ethics committee country [2]
4770
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Australia
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Date submitted for ethics approval [2]
4770
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Approval date [2]
4770
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Ethics approval number [2]
4770
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Ethics committee name [3]
4771
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Alfred Hospital
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Ethics committee address [3]
4771
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55 Commercial Rd, Melbourne VIC 3004
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Ethics committee country [3]
4771
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Australia
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Date submitted for ethics approval [3]
4771
0
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Approval date [3]
4771
0
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Ethics approval number [3]
4771
0
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Ethics committee name [4]
4772
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Fremantle Hospital
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Ethics committee address [4]
4772
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Alma St, Fremantle WA 6160
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Ethics committee country [4]
4772
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Australia
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Date submitted for ethics approval [4]
4772
0
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Approval date [4]
4772
0
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Ethics approval number [4]
4772
0
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Ethics committee name [5]
4773
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Newcastle Mater Hospital
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Ethics committee address [5]
4773
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Edith &, Platt St, Waratah NSW 2298
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Ethics committee country [5]
4773
0
Australia
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Date submitted for ethics approval [5]
4773
0
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Approval date [5]
4773
0
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Ethics approval number [5]
4773
0
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Ethics committee name [6]
4774
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Brisbane Mater Hospital
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Ethics committee address [6]
4774
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Raymond Terrace, South Brisbane QLD 4101
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Ethics committee country [6]
4774
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Australia
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Date submitted for ethics approval [6]
4774
0
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Approval date [6]
4774
0
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Ethics approval number [6]
4774
0
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Ethics committee name [7]
4775
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Monash Medical Centre
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Ethics committee address [7]
4775
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246 Clayton Rd, Clayton VIC 3168
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Ethics committee country [7]
4775
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Australia
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Date submitted for ethics approval [7]
4775
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Approval date [7]
4775
0
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Ethics approval number [7]
4775
0
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Ethics committee name [8]
4776
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Peter MacCallum Cancer Centre
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Ethics committee address [8]
4776
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305 Grattan St, Melbourne VIC 3000
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Ethics committee country [8]
4776
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Australia
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Date submitted for ethics approval [8]
4776
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Approval date [8]
4776
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Ethics approval number [8]
4776
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Ethics committee name [9]
4777
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Prince of Wales Hospital
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Ethics committee address [9]
4777
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320-346 Barker St, Randwick NSW 2031
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Ethics committee country [9]
4777
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Australia
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Date submitted for ethics approval [9]
4777
0
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Approval date [9]
4777
0
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Ethics approval number [9]
4777
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Ethics committee name [10]
4778
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Princess Alexandra Hospital
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Ethics committee address [10]
4778
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199 Ipswich Rd, Woolloongabba QLD 4102
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Ethics committee country [10]
4778
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Australia
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Date submitted for ethics approval [10]
4778
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Approval date [10]
4778
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Ethics approval number [10]
4778
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Ethics committee name [11]
4779
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Royal Brisbane Hospital
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Ethics committee address [11]
4779
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Butterfield St, Herston QLD 4029
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Ethics committee country [11]
4779
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Australia
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Date submitted for ethics approval [11]
4779
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Approval date [11]
4779
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22/11/2002
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Ethics approval number [11]
4779
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Ethics committee name [12]
4780
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Royal Melbourne Hospital
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Ethics committee address [12]
4780
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300 Grattan St, Parkville VIC 3050
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Ethics committee country [12]
4780
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Australia
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Date submitted for ethics approval [12]
4780
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Approval date [12]
4780
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Ethics approval number [12]
4780
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Ethics committee name [13]
4781
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Royal North Shore Hospital
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Ethics committee address [13]
4781
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Reserve Rd, St Leonards NSW 2065
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Ethics committee country [13]
4781
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Australia
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Date submitted for ethics approval [13]
4781
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Approval date [13]
4781
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14/10/2002
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Ethics approval number [13]
4781
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Ethics committee name [14]
4782
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Royal Perth Hospital
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Ethics committee address [14]
4782
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197 Wellington St, Perth WA 6000
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Ethics committee country [14]
4782
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Australia
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Date submitted for ethics approval [14]
4782
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Approval date [14]
4782
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21/11/2002
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Ethics approval number [14]
4782
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Ethics committee name [15]
4783
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Sir Charles Gairdner Hospital
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Ethics committee address [15]
4783
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Hospital Ave, Nedlands WA 6009
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Ethics committee country [15]
4783
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Australia
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Date submitted for ethics approval [15]
4783
0
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Approval date [15]
4783
0
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Ethics approval number [15]
4783
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Ethics committee name [16]
4784
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St Vincent's Hospital Melbourne
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Ethics committee address [16]
4784
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41 Victoria Parade, Fitzroy VIC 3065
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Ethics committee country [16]
4784
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Australia
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Date submitted for ethics approval [16]
4784
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Approval date [16]
4784
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18/11/2004
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Ethics approval number [16]
4784
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Ethics committee name [17]
4785
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St Vincent's Hospital Sydney
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Ethics committee address [17]
4785
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390 Victoria St, Darlinghurst NSW 2010
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Ethics committee country [17]
4785
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Australia
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Date submitted for ethics approval [17]
4785
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Approval date [17]
4785
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Ethics approval number [17]
4785
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Ethics committee name [18]
4786
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Westmead Hospital
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Ethics committee address [18]
4786
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Hawkesbury Rd, Westmead NSW 2145
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Ethics committee country [18]
4786
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Australia
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Date submitted for ethics approval [18]
4786
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Approval date [18]
4786
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02/03/2005
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Ethics approval number [18]
4786
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Summary
Brief summary
We conducted a trial in 103 de-novo chronic phase CML patients using imatinib 600 mg/day initially, increasing to 800 mg for suboptimal response. Ten patients not achieving major cytogenetic response (MCR) at 6 months and 13 with no complete cytogenetic response (CCR) at 9 months were eligible for dose increase, but this was only possible in 7/23 patients due mainly to non-hematologic toxicities. CCR was achieved in 90% and 95% of patients by 12 and 24 months, compared to rates of 69% and 80% in the IRIS trial. Major molecular response (MMR) was achieved in 47% and 72% of patients by 12 and 24 months compared to estimated frequencies of 40% and 55% in the IRIS trial. In the group averaging 600 mg throughout the first 12 months (n=51) 89% achieved MMR by 24 months compared to 50% in those averaging 500-599 mg in the first 6 months and 600mg in the second (n=18) (p=0.009). The superior molecular responses achieved in imatinib-treated patients who averaged 600 mg/day, compared to patients who were dose modified, suggest that early dose intensity of imatinib therapy may be critical to optimise response in CML.
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Trial website
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Trial related presentations / publications
Branford S, Rudzki Z, Walsh S, Grigg A, Arthur C, Taylor K, Herrmann R, Lynch KP, Hughes TP. Detection of BCR-ABL mutations in patients with CML treated with imatinib is virtually always accompanied by clinical resistance, and mutations in the ATP phosphate-binding loop (P-loop) are associated with a poor prognosis. Blood 2003; 102: 276- 283.
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Public notes
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Contacts
Principal investigator
Name
28219
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A/Prof A.Prof. T Hughes, A.Prof. A Grigg
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Address
28219
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:Institute of Medical and Veterinary Science,
Frome Road, Adelaide SA 5000. Postal address: PO Box 14 Rundle Mall SA 5000
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Country
28219
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Australia
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Phone
28219
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+61 08 82223330
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Fax
28219
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Email
28219
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[email protected]
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Contact person for public queries
Name
11376
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Timothy Hughes
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Address
11376
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Division of Haematology
Institute of Medical and Veterinary Science
Frome Road
Adelaide SA 5000
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Country
11376
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Australia
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Phone
11376
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+61 8 82223330
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Fax
11376
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+61 8 82223139
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Email
11376
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[email protected]
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Contact person for scientific queries
Name
2304
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Timothy Hughes
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Address
2304
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Division of Haematology
Institute of Medical and Veterinary Science
Frome Road
Adelaide SA 5000
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Country
2304
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Australia
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Phone
2304
0
+61 8 82223330
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Fax
2304
0
+61 8 82223139
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Email
2304
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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 primary sponsor 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
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
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Impact of early dose intensity on cytogenetic and molecular responses in chronic- phase CML patients receiving 600 mg/day of imatinib as initial therapy
2008
https://doi.org/10.1182/blood-2008-06-161737
Dimensions AI
Early molecular response and female sex strongly predict stable undetectable BCR-ABL1, the criteria for imatinib discontinuation in patients with CML
2013
https://doi.org/10.1182/blood-2012-10-462291
N.B. These documents automatically identified may not have been verified by the study sponsor.
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