NCT05832320

Brief Summary

Despite the high cure probability for acute promyelocytic leukemia (APL), a minority of patients will relapse and the risk factors for relapse are unclear. The goal of this clinical trial is to compare the effectiveness and safety of induction of oral all-trans retinoic acid (ATRA) and realgar-indigo naturalis formula (RIF) combined with oral etoposide or daunorubicin as cytoreductive therapies in low-risk APL. The present study was to explored a cytoreduction of an oral etoposide for low-risk APL with dual induction of ATRA and RIF as a high efficacy, low recurrence, and more convenient all-oral regimen.

Trial Health

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Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
74

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2023

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2023

Completed
3 months until next milestone

First Submitted

Initial submission to the registry

April 2, 2023

Completed
25 days until next milestone

First Posted

Study publicly available on registry

April 27, 2023

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2024

Completed
Last Updated

May 10, 2024

Status Verified

May 1, 2024

Enrollment Period

2 years

First QC Date

April 2, 2023

Last Update Submit

May 9, 2024

Conditions

Keywords

Acute Promyelocytic Leukemialow riskinduction therapyetoposide

Outcome Measures

Primary Outcomes (2)

  • Complete remission

    Haematological CR was defined as a proportion of BM blasts of \<5%, the absence of blasts in Auer rods, the absence of extramedullary disease, an absolute neutrophil count of \>1×10⁹/L and a platelet count of \>100×109/L, with no red-cell transfusions

    At the end of induction therapy within 45 days after diagnosis

  • Promyelocytic leukaemia-retinoic acid receptor alpha (PML-RARA) transcript levels of ≥6.5% at the end of induction therapy

    PML-RARA transcripts using Abelson tyrosine-protein kinase (ABL) as an internal control by quantitative RT-PCR

    At the end of induction therapy within 45 days after diagnosis

Secondary Outcomes (4)

  • Early death (ED)

    During the induction therapy within 30 days after diagnosis

  • Cumulative recurrence rate

    From date of randomization until the date of last documented progression or date of death from any cause, whichever came first, assessed up to 2 years

  • 2-year event-free survival rate

    From the time of randomization to the time of last follow-up within 2 years after diagnosis

  • Satefy. Common haematological and non-haematological adverse events were monitored twice per week during induction and twice per month during consolidation.

    From the time of randomization to the time of last follow-up within 2years after diagnosis

Study Arms (2)

Oral etoposide with dual induction of ATRA and RIF

EXPERIMENTAL

RIF: 60mg/kg qd, ATRA: 25mg/m2 qd, till CR. When WBC\>4.0×109/L, patients will be given oral etoposide (50mg qd to 50mg tid). Cumulative dosage of etoposide during induction ≤1500mg.

Drug: Etoposide

Daunorubicin with dual induction of ATRA and RIF

ACTIVE COMPARATOR

RIF: 60mg/kg qd, ATRA: 25mg/m2 qd, till CR. When WBC\>4.0×109/L, patients will be given daunorubicin (20 to 40mg per dose).

Drug: Daunorubicin

Interventions

Introduction: RIF: 60mg/kg qd, ATRA: 25mg/m2 qd, till CR. When WBC\>4.0×109/L, patients will be given oral etoposide (50mg qd to 50mg tid). Cumulative dosage of etoposide during induction ≤1500mg.

Also known as: all-trans retinoic acid, realgar-indigo naturalis formula
Oral etoposide with dual induction of ATRA and RIF

Introduction: RIF: 60mg/kg qd, ATRA: 25mg/m2 qd, till CR. When WBC\>4.0×109/L, patients will be given daunorubicin (20 to 40mg per dose).

Also known as: all-trans retinoic acid, realgar-indigo naturalis formula
Daunorubicin with dual induction of ATRA and RIF

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Newly diagnosed APL patients (WHO 2008 diagnostic classification);
  • years old;
  • Liver function: propionate hydrogentransferase (ALT) and aspartate hydrogentransferase (AST) ≤ 2.5 times the upper limit of normal value, bilirubin ≤ 2 times the upper limit of normal value;
  • Renal function: muscle salt ≤ 3 times the upper limit of normal value;
  • The physical strength score is 0-2 (ECOG);
  • White blood cells ≤ 10×109/L;
  • Subjects must sign an informed consent form.

You may not qualify if:

  • Subjects who have participated in other clinical trials within 30 days;
  • Pregnant and lactating subjects;
  • Subjects who are known to be HIV-positive in serological tests;
  • Subjects who have viral hepatitis serological test positive;
  • Subjects who have severe arrhythmia, abnormal electrocardiogram (QT\>500ms);
  • Subjects who suffer from mental illness or unable to cooperate with the research treatment and monitoring requirements due to other diseases;
  • Subjects who participate in other clinical research at the same time;
  • Subjects who fail to sign the informed consent form;

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Peking University Institute of Hematology

Beijing, Beijing Municipality, 100044, China

RECRUITING

MeSH Terms

Conditions

Leukemia, Promyelocytic, Acute

Interventions

EtoposideTretinoinDaunorubicin

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

PodophyllotoxinTetrahydronaphthalenesNaphthalenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsPolycyclic CompoundsGlucosidesGlycosidesCarbohydratesVitamin ARetinoidsCarotenoidsPolyenesAlkenesHydrocarbons, AcyclicCyclohexenesCyclohexanesCycloparaffinsHydrocarbons, AlicyclicTerpenesDiterpenesPigments, BiologicalBiological FactorsAnthracyclinesNaphthacenesAminoglycosides

Study Officials

  • Xiaolu Zhu, Doctor

    Peking University People's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Xiaolu Zhu, Doctor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Physician-in-charge

Study Record Dates

First Submitted

April 2, 2023

First Posted

April 27, 2023

Study Start

January 1, 2023

Primary Completion

December 31, 2024

Study Completion

December 31, 2024

Last Updated

May 10, 2024

Record last verified: 2024-05

Data Sharing

IPD Sharing
Will not share

Locations