Clinical Trial of Consolidation Treatment With Iodine I 131 Tositumomab for Multiple Myeloma
Multiple Myeloma
About this trial
This is an interventional treatment trial for Multiple Myeloma
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Expected survival ≥ 6 months Pre-study performance status of 0, 1, or 2 according to the World Health Organization (WHO) Newly diagnosed or relapsed/refractory myeloma with histologic confirmation of multiple myeloma by the Department of Pathology at University of Michigan Cancer Center (UMCC) Not more than 3 lines of therapy for myeloma for patients with relapsed disease Documented Stage II or III multiple myeloma (Durie and Salmon, 1975) prior to initiation of first line therapy At least 4 cycles of first line (for newly diagnosed patients) or salvage (for relapsed/refractory patients) prior therapy and in a plateau of at least partial response (Blade et al, 1999) for at least 2 determinations 6 weeks apart At least 21 days from day 1 of the last cycle and fully recovered from all toxicities associated with prior surgery, radiation treatments, chemotherapy, or immunotherapy Measurable M-proteins with greater than 1 g/dl serum monoclonal protein and/or greater than 0.5 g/24 hour urine light chain excretion Acceptable hematologic status within two weeks prior to patient registration, including: Absolute neutrophil count ([segmented neutrophils + bands] x total white blood cell [WBC]) ≥ 1,500/mm3; Platelet counts ≥ 150,000/mm3; these patients will receive total body dose of 75 cGy of Bexxar; or Platelet counts from 100,000/mm3 to 149,000/mm3; these patients will receive a 65 cGy total body dose of Bexxar; In patients previously treated with ASCT, total body dose will be 55 cGy in patients with platelet count > 150,000 and 45 cGy in patients with platelets 100,000-149,000. Female patients who are not pregnant or lactating Men and women of reproductive potential who are following accepted birth control methods (as determined by the treating physician) Patients previously on Phase II drugs if no long-term toxicity is expected, and the patient has been off the drug for three or more weeks with no significant post treatment toxicities observed Patients determined to have < 25% bone marrow involvement with myeloma within six weeks of registration (based on bilateral core biopsy). Exclusion Criteria: Patients with impaired bone marrow reserve, as indicated by one or more of the following: Platelet count < 100,000 cells/mm3; Hypocellular bone marrow; Marked reduction in bone marrow precursors of one or more cell lines (granulocytic, megakaryocytic, erythroid); History of failed stem cell collection; Myelodysplastic syndrome (MDS) or evidence of other than myeloma clonogenic abnormalities; Prior radioimmunotherapy; Prior anti-CD20 therapy; Other than myeloma malignancy, except B-cell non-Hodgkin's lymphoma, basal and squamous cell carcinoma of the skin, and cervical and breast cancer in situ, unless patient is cancer free for > 3 years; Central nervous system (CNS) involvement; Patients with known HIV infection; Patients with pleural effusion; Patients with abnormal liver function: total bilirubin > 2.0 mg/dL; Patients with abnormal renal function: serum creatinine > 2.0 mg/dL; Patients who have received prior external beam radiation therapy to > 25% of active bone marrow (involved field or regional); Patients who have received G-CSF or GM-CSF therapy within two weeks prior to treatment; Serious nonmalignant disease or infection which, in the opinion of the investigator and/or the sponsor, would compromise other protocol objectives; Major surgery, other than diagnostic surgery, within four weeks; Presence of anti-murine antibody (HAMA) reactivity. This result must be available prior to receiving treatment for those patients with prior exposure to murine antibodies or proteins.
Sites / Locations
- University of Michigan
Arms of the Study
Arm 1
Experimental
Bexxar therapeutic
The Bexxar therapeutic regimen is delivered in two sets of intravenous infusions given 7-14 days apart. Nonradioactive Tositumomab is given before both the "dosimetric" infusion and the "therapeutic" infusion to improve distribution of these doses throughout the body. A trace amount of radioactive Iodine 131 Tositumomab is initially given to enable physicians to evaluate the clearance of radiation from the subject's body with gamma camera scans. Calculations made on the basis of these individualized radiation clearance rates allow the therapeutic dose (given 7-14 days after the dosimetric infusion) to be tailored for each patient. The therapeutic dose contains Tositumomab labeled with the amount of Iodine 131 tositumomab specifically calculated based on the scans performed following the dosimetric dose.