NCT07839988Not yet recruitingPhase 4
De-escalation Strategy of Tyrosine Kinase Inhibitors Before Treatment Discontinuation in Patients With Chronic Myeloid Leukemia
De-escalation Strategy of Tyrosine Kinase Inhibitors Before Treatment Discontinuation in Patients With Chronic Myeloid Leukemia: Dose Reduction Versus Discontinuation - a Multicenter, Prospective, Randomized Controlled Study
Source: ClinicalTrials.gov · Last updated 24 Sept 2026
Brief summary (registry, in English)
The goal of this clinical trial is to learn if a 1-year dose-reduction strategy with tyrosine kinase inhibitors (TKIs) - before complete discontinuation - works to improve treatment-free remission in adults with chronic-phase chronic myeloid leukaemia (CML) who have already achieved stable deep molecular response and are eligible to stop therapy. It will also learn about the safety of this gradual reduction approach. The main questions it aims to answer are: Does the dose-reduction strategy lead to a higher 2-year molecular relapse-free survival rate (maintaining major molecular response, BCR-ABL1 ≤0.1%) compared with immediate TKI discontinuation? What medical problems (adverse events) do participants experience during and after dose reduction, and how do they differ from those in the direct-stop group? Researchers will compare the dose-reduction group (reduced daily TKI for 12 months, then 1-year follow-up) with the direct-discontinuation group (immediate stop, 2-year follow-up) to see whether gradual reduction is superior in preserving molecular remission. In addition, they will compare the changes in T-cell subsets between the two groups to explore immune mechanisms that may influence treatment-free remission. Participants will: Be randomly assigned to either dose reduction or immediate discontinuation; Take reduced TKI (or no drug) daily for 1 year, followed by 1-year observation (total 24 months); Visit the clinic every 2 months for the first 6 months, then every 3 months thereafter, for physical exams, blood tests, molecular monitoring (BCR-ABL1 PCR), and ECG; Have T-cell subsets measured by flow cytometry at months 3, 6, 12, and 24; Complete quality-of-life questionnaires (EORTC QLQ-CML24) at baseline and at months 3, 6, 12, and 24; Report all adverse events; if MMR is lost, they must restart full-dose TKI and be monitored monthly until remission is regained;
- Status (registry)
- Not yet recruiting
- Phase (registry)
- Phase 4
- Study type
- Interventional
- Enrollment
- 280 (estimated)
- First submitted
- 9 Sept 2026
- Start date
- 9 Sept 2026
- Primary completion date
- 31 Jul 2030
- Lead sponsor
- Nanfang Hospital, Southern Medical University
- Diseases
- Chronic myeloid leukaemia
- NCT number
- NCT07839988
What you commit to
- Study type: Interventional · Phase 4
- Planned participants: 280
- From 9 Sept 2026 to the primary completion date, 31 Jul 2030
- 1 site in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Received stem cell transplantation before study entry.
- Concurrent participation in other clinical studies.
- Major surgery within 4 weeks, or not recovered from a previous surgery.
Other illness
- Presence of diseases associated with immunodeficiency, such as syphilis, hepatitis C, or HIV.
- Having another malignant disease, unless the other primary malignancy is currently of no clinical significance or does not require active intervention.
- Known allergy or contraindication to the study drug (active pharmaceutical ingredient and/or excipients).
- Any other condition that the investigator considers makes the patient unsuitable for enrolment.
Other
- Pregnancy, lactation, or women planning to become pregnant.
- Eastern Cooperative Oncology Group performance status (ECOG PS) ≥3.
- Inability to comply with protocol procedures or to attend follow-up visits on time.
Who the study is looking for
- Age ≥ 18 years.
- Patients in chronic phase, with no history of accelerated phase (AP-CML) or blast phase (BP-CML).
- Treatment with a first-generation TKI for ≥5 years; treatment with a second-generation TKI for ≥3 years; for resistant patients, treatment with an effective TKI for ≥5 years.
- Prior evidence of detectable BCR::ABL1 transcripts. Stable deep molecular response (DMR) for \>2 years (MR⁴, BCR::ABL1¹⁵ ≤0.01%), with at least 4 test results meeting the criterion and each test at least 3 months apart.
- Availability of reliable qPCR testing with a sensitivity of at least MR⁴·⁵ (BCR::ABL1¹⁵ ≤0.0032%), and test results available within 2 weeks.
Age in the registry: 18 years to 80 years · Sex: All · Does not accept healthy volunteers
Sites (1)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Nanfang Hospital, Southern Medical University Coordinator of this site? Confirm its status | Guangzhou | China | Unknown status |
This page is information, not medical advice. Discuss any trial with your doctor.