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Bortezomib in Treating Patients With Multiple Myeloma Who Have Undergone an Autologous Peripheral Blood Stem Cell Transplant

Primary Purpose

Multiple Myeloma and Plasma Cell Neoplasm

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bortezomib
Sponsored by
Barbara Ann Karmanos Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma and Plasma Cell Neoplasm focused on measuring stage I multiple myeloma, stage II multiple myeloma, stage III multiple myeloma, refractory multiple myeloma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Diagnosis of multiple myeloma Must have completed high-dose melphalan and autologous peripheral blood stem cell transplantation Transplant must have been completed 30-120 days ago Must not be receiving maintenance therapy Patients must have received 200 mg/m² of melphalan intravenously as a conditioning regimen (no dose reduction allowed) No evidence of amyloidosis No available donor PATIENT CHARACTERISTICS: ECOG performance status (PS) 0-2 or Karnofsky PS 60-100% Absolute neutrophil count > 1,500/mm^3 Platelet count > 75,000/mm^3 Bilirubin ≤ 1.5 times upper limit of normal Transaminase ≤ 3 times upper limit of normal Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Must have a negative HIV test No baseline neurological disease > grade I No cranial nerve palsy No demonstrated resistance to bortezomib No history of allergic reactions attributed to bortezomib, boron, or mannitol No cardiac arrhythmia No unstable angina pectoris No symptomatic congestive heart failure No ongoing or active infection No other uncontrolled illness No psychiatric illness or social situations that would limit compliance with study requirements PRIOR CONCURRENT THERAPY: See Disease Characteristics No other concurrent anticancer therapies or agents No other concurrent investigational agents Not receiving maintenance therapy after prior stem cell transplantation on another clinical trial

Sites / Locations

  • Barbara Ann Karmanos Cancer Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bortezomib

Arm Description

Bortezomib is administered as a 5 second IV bolus on days 1, 4, 8,11 or 1,8 and 15 of a 21-35 days cycle (Depending on the Dosing schedule). The dosage will be calculated based on actual weight of the patient unless the actual weight is greater than 40% above the ideal body weight. In this instance the dosage will be based on the adjusted ideal body weight. The Adjusted IBW (kg) = IBW + 0.25 x (actual body weight - IBW). The dosage will be adjusted based on the safety and toxicity profile, until a MTD is determined.

Outcomes

Primary Outcome Measures

Maximum tolerated dose
Safety and tolerability

Secondary Outcome Measures

Overall response rate by Southwest Oncology Group (SWOG) criteria
Complete response rate by SWOG criteria
Response duration by SWOG criteria

Full Information

First Posted
February 6, 2006
Last Updated
November 18, 2013
Sponsor
Barbara Ann Karmanos Cancer Institute
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00288028
Brief Title
Bortezomib in Treating Patients With Multiple Myeloma Who Have Undergone an Autologous Peripheral Blood Stem Cell Transplant
Official Title
A Phase I Study of Bortezomib During Maintenance Phase After High Dose Melphalan and Autologous Stem Cell Transplantation in Patients With Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2013
Overall Recruitment Status
Completed
Study Start Date
July 2005 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Barbara Ann Karmanos Cancer Institute
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving bortezomib after an autologous peripheral blood stem cell transplant may stop the growth of any cancer cells that remain after transplant. PURPOSE: This phase I trial is studying the side effects and best dose of bortezomib in treating patients with multiple myeloma who have undergone an autologous peripheral blood stem cell transplant.
Detailed Description
OBJECTIVES: Primary Determine the maximum tolerated dose (MTD) of bortezomib during maintenance phase after high-dose melphalan and autologous peripheral blood stem cell transplantation in patients with multiple myeloma. Determine the safety and tolerability of bortezomib in these patients. Secondary Determine the overall response rate, complete response rate, and response duration in patients treated with bortezomib at the MTD. OUTLINE: This is an open-label, dose-finding study. Patients receive bortezomib IV on days 1, 4, 8, and 11. Treatment repeats every 21 or 28 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive de-escalating doses of bortezomib (at varying dosing schedules) until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. At least 6 patients are treated at the MTD. After completion of study treatment, patients are followed at 1 year. PROJECTED ACCRUAL: A total of 24 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma and Plasma Cell Neoplasm
Keywords
stage I multiple myeloma, stage II multiple myeloma, stage III multiple myeloma, refractory multiple myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bortezomib
Arm Type
Experimental
Arm Description
Bortezomib is administered as a 5 second IV bolus on days 1, 4, 8,11 or 1,8 and 15 of a 21-35 days cycle (Depending on the Dosing schedule). The dosage will be calculated based on actual weight of the patient unless the actual weight is greater than 40% above the ideal body weight. In this instance the dosage will be based on the adjusted ideal body weight. The Adjusted IBW (kg) = IBW + 0.25 x (actual body weight - IBW). The dosage will be adjusted based on the safety and toxicity profile, until a MTD is determined.
Intervention Type
Drug
Intervention Name(s)
bortezomib
Other Intervention Name(s)
Velcade®
Intervention Description
Dose of Bortezomib* Level 1: 1.3 mg/m2 on Day 1, 4, 8, 11 - Every 21 days; Level 2: 1.3 mg/m2 on Day 1, 4, 8, 11 - Every 28 days; Level 3: 1.0 mg/m2 on Day 1, 8, 15 - Every 28 days; Level 4: 1.0 mg/m2 on Day 1, 8, 15 - Every 35 days
Primary Outcome Measure Information:
Title
Maximum tolerated dose
Time Frame
At course 8
Title
Safety and tolerability
Time Frame
At course 8
Secondary Outcome Measure Information:
Title
Overall response rate by Southwest Oncology Group (SWOG) criteria
Time Frame
At day 30 following stem cell transplant and following course 4, course 8, and 1 year of study treatment
Title
Complete response rate by SWOG criteria
Time Frame
At day 30 following stem cell transplant and following course 4, course 8, and 1 year of study treatment
Title
Response duration by SWOG criteria
Time Frame
At day 30 following stem cell transplant and following course 4, course 8, and 1 year of study treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of multiple myeloma Must have completed high-dose melphalan and autologous peripheral blood stem cell transplantation Transplant must have been completed 30-120 days ago Must not be receiving maintenance therapy Patients must have received 200 mg/m² of melphalan intravenously as a conditioning regimen (no dose reduction allowed) No evidence of amyloidosis No available donor PATIENT CHARACTERISTICS: ECOG performance status (PS) 0-2 or Karnofsky PS 60-100% Absolute neutrophil count > 1,500/mm^3 Platelet count > 75,000/mm^3 Bilirubin ≤ 1.5 times upper limit of normal Transaminase ≤ 3 times upper limit of normal Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Must have a negative HIV test No baseline neurological disease > grade I No cranial nerve palsy No demonstrated resistance to bortezomib No history of allergic reactions attributed to bortezomib, boron, or mannitol No cardiac arrhythmia No unstable angina pectoris No symptomatic congestive heart failure No ongoing or active infection No other uncontrolled illness No psychiatric illness or social situations that would limit compliance with study requirements PRIOR CONCURRENT THERAPY: See Disease Characteristics No other concurrent anticancer therapies or agents No other concurrent investigational agents Not receiving maintenance therapy after prior stem cell transplantation on another clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Muneer H. Abidi, MD
Organizational Affiliation
Barbara Ann Karmanos Cancer Institute
Official's Role
Study Chair
Facility Information:
Facility Name
Barbara Ann Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201-1379
Country
United States

12. IPD Sharing Statement

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Bortezomib in Treating Patients With Multiple Myeloma Who Have Undergone an Autologous Peripheral Blood Stem Cell Transplant

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