ClinicalTrials.gg
Active, not recruitingNCT03906292CMLXIUpdated Aug 18, 2026

Frontline Asciminib Combination in Chronic Phase CML

A Phase 2 interventional study of Imatinib and Nilotinib 300 mg in Chronic Myeloid Leukemia, sponsored by University of Jena. Active, not recruiting at 21 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-18.

Sponsored by University of Jena · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
125
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

Adult male and female patients with newly diagnosed Philadelphia chromosome positive (Ph+) and/or BCR-ABL1 positive CML can be included in the study until 3 months after diagnosis. A \<4 week pretreatment with hydroxyurea is permitted. Patients treated for \<6 weeks with nilotinib 300 mg BID, imatinib 400 mg QD, dasatinib 100 mg QD or without any therapy are eligible for recruitment and will be allocated to the respective cohort. All patients must provide written informed consent to be enrolled in the trial. Cohorts were designed to allow assessment of QD and BID asciminib based combinations to optimize quality of life and compliance. Patients will not be randomized. In general, cohorts will be filled consecutively. Asciminib therapy will be commenced 12 weeks after start of nilotinib, imatinib or dasatinib and after recovery of hematopoiesis or in case of no therapy so far 6 weeks after diagnosis as first line treatment. Referred patients already treated with imatinib, nilotinib or dasatinib will remain on the initial drug and will be allocated to the respective cohort.

Read the detailed description

Despite the dramatic progress made over the past decade with TKIs in the treatment of CML, allogeneic stem cell transplant remains the only proven curative therapy. To achieve cure or benefit from treatment-free remissions with pharmacologically-based therapies, it is estimated that patients will likely need to achieve a sustained reduction in tumor burden corresponding to a deep molecular response of at least 4 logs (MR4). Currently, only 30.8% of patients achieve a deep molecular response after 12 months of treatment with single agent nilotinib.

The development of the novel and potent BCR-ABL1 allosteric inhibitor, asciminib, presents an opportunity to assess the effect of a different mechanism of inhibition of BCR-ABL1 in the first-line treatment of CML to enhance speed of response and to increase the patient population benefitting from deep molecular response. Dosing a combination of asciminib with an ATP-site inhibitor also has the potential to prevent the emergence of resistance due to point mutations being acquired in one of the binding sites.

The safety, tolerability and pharmacokinetic profile of asciminib as a single agent and in combination with either nilotinib or imatinib or dasatinib was assessed in a phase-I study. At the doses chosen here, all three combination treatments were well tolerated.

Since in all patient cohorts the standard of care therapy will remain the backbone of initial therapy, there is no reason to expect an efficacy problem with the combination therapies.

02

Conditions studied

  • Chronic Myeloid Leukemia
03

In context

Leukemia, Myelogenous, Chronic, BCR-ABL Positive

894 studies on the registry are indexed under Leukemia, Myelogenous, Chronic, BCR-ABL Positive; 109 are open to participants now.

This study's enrollment of 125 is above the median of 44 across 681 interventional studies indexed under Leukemia, Myelogenous, Chronic, BCR-ABL Positive.

Browse Leukemia, Myelogenous, Chronic, BCR-ABL Positive studies →

Lead sponsor

University of Jena is the lead sponsor of 89 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female patients with diagnosis of CP-CML with cytogenetic confirmation of the Ph+ chromosome [t(9;22)(q34;q11)].
  • Ph-negative cases or patients with variant translocations who are BCR-ABL1 positive in multiplex PCR 35 will be also considered eligible.
  • performance status of ≤2.
  • Age ≥ 18 years old (no upper age limit is given)
  • Serum levels of potassium, magnesium, total calcium within the normal limits (≥LLN [lower limit of normal] and ≤ [upper limit of normal]). Correction of electrolytes levels with supplements to fulfil enrolment criteria is allowed.
  • and ALT ≤2.5 x ULN or 5.0 x ULN if considered due to leukemia
  • Alkaline phosphatase ≤2.5 x ULN unless considered due to leukemia
  • Total ≤1.5 x ULN, except known Gilbert disease
  • Serum creatinine ≤2 x ULN
  • Written prior to any study procedures being performed.

Exclusion criteria

Exclusion Criteria:

  • stem cell transplantation
  • Known impaired cardiac function, including any of the following:

    • Congenital long syndrome
    • History of or presence of ventricular or atrial tachyarrhythmia
    • QTc >450 msec on screening
    • Myocardial infarction within 12 months prior to starting therapy
  • Other clinical significant heart disease (e.g. unstable angina, congestive heart failure)
  • Acute or chronic viral hepatitis with moderate or severe hepatic impairment ( scores >6), even if controlled
  • Other concurrent uncontrolled medical conditions (e.g., active or uncontrolled infections, acute or chronic liver and renal disease) that could cause unacceptable safety risks or compromise compliance with the protocol
  • Impaired gastrointestinal function or disease that may alter the absorption of study drug (e.g., ulcerative disease, uncontrolled nausea, vomiting and diarrhea, malabsorption syndrome, small bowel resection or gastric by-pass surgery)
  • Concomitant medications known to be strong inducers or inhibitors of the CYP450 isoenzyme
  • Patients who have undergone major surgery ≤2 weeks prior to starting study drug or who have not recovered from side effects of such therapy
  • Patients who are pregnant or breastfeeding or women of not employing an effective method of . Women of must have a negative serum pregnancy test within 14 days of study start. women must be amenorrheic for at least 12 months in order to be considered of non-childbearing potential. Male and female patients must agree to employ an effective method of birth control throughout the study and for up to 2 weeks following discontinuation of study drug
  • Known diagnosis of (HIV) infection (HIV testing is not mandatory)
  • Known serious reactions to asciminib, imatinib, nilotinib or dasatinib
  • Patients with a history of another primary that is currently clinically significant or currently requires active intervention
  • Patients unwilling or unable to comply with the protocol.
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
125 participants (actual)

Study arms

  • Experimental
    Asciminib 60mg QD

    Standard therapy of Imatinib 400 mg QD and asciminib 60 mg QD

    Drug: Imatinib · Drug: Asciminib

  • Experimental
    Asciminb 20 mg BID

    Standard therapy of Nilotinib 300 mg BID and asciminib 20 mg BID

    Drug: Nilotinib 300 mg · Drug: Asciminib

  • Experimental
    Asciminib 40 mg QD

    Standard therapy of Nilotinib 300 mg BID and asciminib 40 mg QD

    Drug: Nilotinib 300 mg · Drug: Asciminib

  • Experimental
    Asciminib 80 mg QD

    Standard therapy of Dasatinib 100 mg QD and asciminib 80 mg QD

    Drug: Dasatinib · Drug: Asciminib

  • Experimental
    Asciminib 80 mg QD monotherapy

    Asciminib 80 mg QD as a single agent

    Drug: Asciminib

Interventions

  • Imatinib 400 mg QD and asciminib 60 mg QD

    Also known as: Imatinib 400 mg QD and asciminib 60 mg QD

  • Nilotinib 300 mg BID and asciminib 20 mg BID or 40 mg QD

    Also known as: Nilotinib 300 mg BID and asciminib 20 mg BID or 40 mg QD

  • Dasatinib 100 mg QD and asciminib 80 mg QD

    Also known as: Dasatinib 100 mg QD and asciminib 80 mg QD

  • Asciminib 80 mg QD Monotherapy

06

What researchers measure

Primary outcomes

  1. deep molecular response (Rate of MR4)

    Achievement of deep molecular response (MR4) throught standardized testing of BCR-ABL-transcript Levels

    Time frame: at month 12 after Start of Standard-Therapy

  2. deep molecular Response (Rate of MR4.5)

    Achievement of deep molecular response (MR4.5) throught standardized testing of BCR-ABL-transcript Levels

    Time frame: at month 36 after Start of Standard-Therapy

Secondary outcomes

  1. molecular response (MMR and MR4.5)

    Achievement of deep molecular response throught standardized testing of BCR-ABL-transcript levels

    Time frame: at and by 6, 12, 18, 24, 36 and 60 months after Start of Therapy

  2. Adverse Events

    Incidence of adverse events grade 1-5 and 3-5

    Time frame: at and by baseline, 3, 6, 12, 15, 18, 21, 24, 36 and 60 months after Start of Therapy

  3. Progression free survival

    Progression free survival at the end of the study

    Time frame: at month 60 after Start of Therapy

  4. Overall survival

    Overall survival at the end of the study

    Time frame: at month 60 after Start of Therapy

  5. Maintenance of MR4.5 during Asciminib-monotherapy

    Achievement of deep molecular response (MR4.5) throught standardized testing of BCR-ABL-transcript Levels

    Time frame: at month 36 and 60 after Start of Therapy

  6. Achievement and durability of treatment-free remission

    Achievement of deep molecular response (MR4) throught standardized testing of BCR-ABL-transcript Levels

    Time frame: months 37 and 60 after Start of Therapy

07

Study locations

21 sites
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 18, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03906292
Lead sponsor
University of Jena
Responsible party
Thomas Ernst, PD Dr. med. (Principal Investigator, University of Jena) — Principal investigator
First posted
Apr 8, 2019
Start date
Aug 19, 2019
Primary completion
Mar 2027 (estimated)
Completion
Dec 2027 (estimated)
Last update
Aug 18, 2026

Study contacts

Thomas Ernst, Prof. Dr.
principal investigator · University Hospital Jena

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Asciminib

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