NCT04175587

Brief Summary

Acute Promyelocytic Leukaemia (APL) has been known as a type of cancer, which is of great significance to improve its eradication rate. Recent clinical trials show that ATRA plus ATO treatment regimen can result in complete response (CR) in 90-94% of patients and 5-year disease-free survival (DFS) in more than 90% of patients. However, the ATRA plus ATO treatment regimen can achieve considerate survival rate, patients still need to receive infusion therapy in hospital. If oral arsenic can replace intravenous ATO without reduction of the efficacy, patients would not need to be administered to receive treatment, which would highly increase their quality of lives. Phase I, II Clinical trials have verified the security and efficacy of the Compound Realgar-Indigo Naturalis Formula. Compound Realgar-Indigo Naturalis Formula was approved by the China Food and Drug Administration in 2009. Investergators have done a multi-centre, randomized, controlled, non-inferiority phase 3 clinical trial in China. And the result showed that oral arsenic plus retinoic acid has an anti-leukaemic efficacy similar to the intravenous arsenic treatment. So Investigators performed an international multi-center, Randomized controlled clinical trialsto compare the efficacy of oral RIF plus ATRA with intravenous arsenic trioxide plus ATRA in patients with non-high-risk APL in different racial types.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
109

participants targeted

Target at P25-P50 for phase_3

Timeline
Completed

Started Dec 2019

Typical duration for phase_3

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 21, 2019

Completed
4 days until next milestone

First Posted

Study publicly available on registry

November 25, 2019

Completed
6 days until next milestone

Study Start

First participant enrolled

December 1, 2019

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2021

Completed
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2023

Completed
Last Updated

November 29, 2019

Status Verified

November 1, 2019

Enrollment Period

1.8 years

First QC Date

November 21, 2019

Last Update Submit

November 26, 2019

Conditions

Keywords

Realgar-Indigo Naturalis Formula, Retinoic Acid

Outcome Measures

Primary Outcomes (1)

  • 2-year Event-free Survival (EFS) rate

    treatment failure (no CR after 45-day induction therapy, or no molecular complete remission after 3-month consolidation therapy), relapse (molecular relapse, or haematological relapse); or death from any cause.

    2 year after diagnosis

Study Arms (2)

Compound Realgar-Indigo Naturalis Formula Plus Retinoic Acid

EXPERIMENTAL

Induction: a) RIF: 60 mg/kg daily until CR, b) ATRA: 25 mg/m² daily until CR; Consolidation: a) RIF: 60 mg/kg daily, in a 4-week on 4-week off regimen for four cycles in a 4-week on 4-week off regimen for four cycles b) ATRA: 25 mg/m² daily, in a 2-week on 2-week off regimen for seven cycles

Drug: Compound Realgar-Indigo Naturalis Formula Plus Retinoic Acid

Arsenic trioxide Plus Retinoic Acid

OTHER

Induction: a) Arsenic trioxide: 0·15 mg/kg daily until CR, b) ATRA: 25 mg/m² daily until CR Consolidation: a) Arsenic trioxide: 0.15mg/kg daily, in a 4-week on 4-week off regimen for four cycles b) ATRA: 25 mg/m² daily, in a 2-week on 2-week off regimen for seven cycles Expected Efficacy: Oral RIF plus ATRA is not inferior to intravenous arsenic trioxide plus ATRA for achieving 2-year EFS.

Drug: Compound Realgar-Indigo Naturalis Formula Plus Retinoic Acid

Interventions

Randomization is done centrally according to trial centers Eligible patients are randomly assigned (2:1) to the Treatment Group or the Control Group, with a 24-month follow-up.

Also known as: intravenous arsenic trioxide plus Retinoic Acid
Arsenic trioxide Plus Retinoic AcidCompound Realgar-Indigo Naturalis Formula Plus Retinoic Acid

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Newly diagnosed APL patient (with WHO performance status)
  • Age 18-70
  • ALT and AST of maximum 2·5 times the ULN, and bilirubin concentration of maximum two times the ULN
  • Creatinine concentration of maximum three times the ULN
  • Performance status of 0-2 grade (ECOG)
  • WBC ≤ 10 x 109/L before the treatment
  • Informed Consent Paper signed

You may not qualify if:

  • Cerebral hemorrhage
  • Pregnancy
  • Concomitant severe psychiatric condition or anything else against the fulfillment of the plan
  • Clinically significant arrhythmias or electrocardiogram abnormalities (QT\>500ms)
  • Refusal to sign off the Informed Consent Paper

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Leukemia, Promyelocytic, Acute

Interventions

Tretinoin

Condition Hierarchy (Ancestors)

Leukemia, Myeloid, AcuteLeukemia, MyeloidLeukemiaNeoplasms by Histologic TypeNeoplasmsHematologic DiseasesHemic and Lymphatic Diseases

Intervention Hierarchy (Ancestors)

Vitamin ARetinoidsCarotenoidsPolyenesAlkenesHydrocarbons, AcyclicHydrocarbonsOrganic ChemicalsCyclohexenesCyclohexanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicTerpenesDiterpenesPigments, BiologicalBiological Factors

Study Officials

  • Xiao-Jun Huang, MD

    Peking University People's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Hao Jiang, MD

CONTACT

Sheng ye Lu, PhD & MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This study is a prospective, non-inferiority, randomized controlled clinical trial. The non-inferiority is concluded if the lower limit of the 95% CI for the difference in proportion of patients achieving EFS is greater than the -10% non-inferiority margin. The survival curves are estimated by using the Kaplan-Meier method and will be compared by using the log-rank test.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director of Hematology Department

Study Record Dates

First Submitted

November 21, 2019

First Posted

November 25, 2019

Study Start

December 1, 2019

Primary Completion

August 31, 2021

Study Completion

August 31, 2023

Last Updated

November 29, 2019

Record last verified: 2019-11

Data Sharing

IPD Sharing
Will not share