Asciminib Prospective Non Interventional Study as 3rd Line Therapy or More to Treat Adult Patients With CML- CP in Real World Setting in France

Study Overview
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Brief Summary
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The purpose of this study is to enhance the knowledge on asciminib treatment in a broader and real-life population by collecting additional data to characterize the treatment patterns of patients treated with asciminib, with a primary objective represented by maintenance on treatment at 12 months.

Detailed Description
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The ASSURE-3 study is a national, multicentric, non-interventional, prospective study in real-life conditions with primary data collection in adult patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Ph+ CML-CP) previously treated with two or more Tyrosine Kinase Inhibitors (TKIs). It will be conducted in France with hematologists, onco-hematologists, physicians with documented involvement in managing Ph+ CML-CP patients in routine practice, practicing in public or private health care institutions. Each patient will be followed during 15 months at M0, M1 and then every 3 months (rhythm of visits according to the routine clinical care), or until premature discontinuation of asciminib treatment. Historical data will be abstracted retrospectively by the participating physicians from patient files, to collect information using an electronic case report form (eCRF). Primary data will be collected during inclusion and follow-up visits

Official Title
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Scemblix® (Asciminib): Prospective Non Interventional Study as 3rd Line Therapy or More to Treat Adult Patients With CML-CP in Real World Setting in France

Conditions
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Chronic Myeloid Leukemia

Intervention / Treatment
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* Other: Asciminib


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient aged ≥ 18 years at inclusion, Patient with Ph+ CML-CP previously treated with two or more TKIs, Patient for whom a decision has been taken by the treating physician (investigator) to initiate treatment with asciminib according to his own practice, the drug label / Summary of Product Characteristics (SmPC), and regardless of study participation, Patient having given their non objection to participate to the study Exclusion Criteria: Patient with CML in accelerated phase (AP) or blastic phase (BP) at enrolment, Patient with known history of T315I mutation, Patient who previously received asciminib treatment, Patient currently participating to an interventional clinical trial, Patient with known contra-indication to asciminib according to the SmPC.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Asciminib<br>Adult patients with Ph+ CML-CP previously treated with two or more tyrosine kinase inhibitors | Other: Asciminib<br>* There is no treatment allocation. Patients administered Asciminib by prescription will be enrolled<br>* Other names: Scemblix;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients remaining on asciminib at 12 months | Proportion of patients remaining on asciminib treatment at 12 months to be provided | Month 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients in major molecular response (MMR) - for patients not in MMR at treatment initiation | Molecular response to treatment: Response to treatment (MMR, BCR::ABL1 ≤ 0.1% on the International Scale, IS) at 12 months (+/- 1 month) for patients not in MMR at treatment initiation | 12 months | 
| Proportion of patients in MMR - for patients in MMR at treatment initiation | Molecular response to treatment: Maintenance of molecular response (MMR, BCR::ABL1 ≤ 0.1% on the International Scale, IS) at 12 months (+/- 1 month) for patients in MMR at treatment initiation | 12 months | 
| Proportion of patients in MR2, MMR, MR4.0, MR4.5, uMR4.5 - for all patients | Molecular response to treatment: Kinetics of response: MR2, MMR, MR4.0, MR4.5, undetectable MR4.5 for all patients. MR2, MR4, MR4.5 are defined as the transcript ratio of BCR-ABL1/ABL1 being 1% or less, 0.01% or less and 0.0032% or less respectively | 3 months, 6 months, 9 months, 12 months and 15 months | 
| BCR::ABL1 on the International Scale (IS) kinetics along treatment - for all patients | Kinetics of response: BCR::ABL1 on the International Scale (IS) for all patients | 15 months | 
| Time to MMR from the index date - for patients not in MMR at treatment initiation | Kinetics of response: Time to MMR for patients not in MMR at treatment initiation | Up to 15 months | 
| Time from the first MMR to the first loss of MMR - for patients not in MMR at treatment initiation | Molecular response to treatment: Duration of MMR for patients not in MMR at treatment initiation | Up to 15 months | 
| Event-Free Surviva (EFS) | EFS: time from index date to occurrence of one the events listed among variables: lack of efficacy, i.e., BRC::ABL1>1% or loss of CCyR if assessed disease progression (CML-AP/BP, CML death) death from any cause definitive treatment discontinuation due to any reason | Up to 15 months | 
| Progression-Free Survival (PFS) | PFS: time from index date to occurrence of one of the progression markers listed among variables: disease progression (CML-AP/BP, CML death), death from any cause, definitive treatment discontinuation due to any reason | Up to 15 months | 
| Comorbidity profile | Charlson comorbidity index (CCI) at index date | Baseline | 
| Disease characteristics | Disease characteristics to be provided | Baseline | 
| History of TKI treatment | History of TKI treatment to be provided | Baseline | 
| Management of patients in real-life | Concomitant medications | 15 months | 
| Exposure patterns to asciminib | Exposure patterns to be provided | 15 months | 
| EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30) | The EORTC QLQ-C30 contains 30 questions assessed by the participant. There are 9 multiple-item scales: 5 scales that assess aspects of functioning (physical, role functioning, cognitive, emotional, and social); 3 symptom scales (Fatigue, Pain, and Nausea and Vomiting); and a global health status/Quality of Life (QOL) scale. There are 5 single-item measures assessing additional symptoms (i.e., dyspnea, loss of appetite, insomnia, constipation, and diarrhea) and a single item concerning perceived financial impact of the disease. All but two questions have 4-point scales ranging from Not at all to Very much. The two questions concerning global health status/ QOL have 7 point scales with ratings ranging from Very poor to Excellent. For each of the 14 domains, final scores are transformed such that they range from 0-100, where higher scores indicate improvement. | Baseline, 3months, 6months, 9months, 12months, 15months | 
| EORTC QLQ-CML24 questionnaire | The EORTC QLQ-CML24 was designed to supplement the QLQ-C30 - the QLQ-CML24 is not a stand-alone instrument but is to be used in conjunction with the QLQ-C30. The EORTC QLQ-CML 24 is composed of four multi-item scales and two single-item scales. The module consists of 24 items assessing symptoms burden (13 items), impact on worry/mood (4 items), impact on daily life (3 items), satisfaction with care and information (2 items) body image problems (1 item) and satisfaction with social life (1 item). The items were measured on four levels: 1=not at all, 2=a little, 3=quite a bit, 4=very much. For each domain, scores were averaged and transformed to 0 to 100. A higher score in satisfaction with social life domain indicates a higher level of satisfaction. A positive change from baseline indicates increasing satisfaction. | Baseline, 3months, 6months, 9months, 12months, 15months | 
| Emergence of mutations | If available at end of treatment: mutational analysis, methods and results | Up to 15 months | 
| Proportion of patient with an AE described during asciminib treatment among patient reporting the same AE which led to discontinuation with previous TKI treatments | Cross intolerance with previous TKI treatments | Up to 15 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic myeloid leukemia, CML, asciminib, France