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Doxorubicin Hydrochloride Liposome, Melphalan, and Bortezomib in Treating Patients With Relapsed or Refractory Stage I, Stage II, or Stage III Multiple Myeloma

Primary Purpose

Multiple Myeloma and Plasma Cell Neoplasm

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bortezomib
melphalan
pegylated liposomal doxorubicin hydrochloride
Sponsored by
Herbert Irving Comprehensive Cancer Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Diagnosis of multiple myeloma Stage I, II, or III disease according to Durie-Salmon staging criteria Progressive disease, defined as one of the following: For secretory disease: A 25% increase in serum M-protein or Bence Jones protein (an absolute increase of 0.5 g/dL serum M-protein or ≥ 200 mg/24 hours of urine light chain excretion) For nonsecretory disease: Bone marrow biopsy with > 25% increase in plasma cells or an absolute increase of ≥ 10% over prior known level Development of new or worsening existing lytic bone lesions or soft tissue plasmacytomas Hypercalcemia (i.e., calcium > 11.5 mg/dL) Relapsed after complete response Must have received ≥ 2 of the following therapeutic regimens for multiple myeloma: Nonmyeloablative transplantation No significant graft-versus-host disease At least 30 days since prior immunosuppressive therapy (concurrent prednisone allowed provided dose is ≤ 10 mg daily) Mobilization with chemotherapy followed by either single or tandem autologous stem cell transplantation (considered 1 prior regimen) Mobilization with chemotherapy followed by autologous and subsequent nonmyeloablative allogeneic stem cell transplantation (considered 1 prior regimen) Any combination of drugs given concurrently (considered 1 prior regimen) PATIENT CHARACTERISTICS: ECOG performance status 0-2 Life expectancy ≥ 3 months Absolute neutrophil count > 1,000/mm^3 (no colony-stimulating factors) Platelet count > 50,000/mm^3 (no transfusion support) Bilirubin ≤ 2.0 mg/dL AST ≤ 4 times upper limit of normal Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 4 weeks after completion of study treatment No history of allergic reaction to compounds containing boron or mannitol No active uncontrolled viral (including HIV), bacterial, or fungal infection No motor or sensory neuropathy ≥ grade 2 No myocardial infarction within the past 6 months No New York Heart Association class III or IV heart failure No uncontrolled angina No severe uncontrolled arrhythmia No acute ischemia by EKG LVEF ≥ 35% by MUGA (MUGA required in patients whose lifetime cumulative doxorubicin hydrochloride dose > 400 mg/m^2) PRIOR CONCURRENT THERAPY: See Disease Characteristics No grade III or IV toxicity due to previous antineoplastic therapy (except alopecia) At least 3 weeks since prior chemotherapy No prior doxorubicin HCl liposome, melphalan, and bortezomib as combination therapy (single or two-drug combinations of these are allowed) No concurrent corticosteroids (≤ 10 mg prednisone/day or equivalent allowed) No other concurrent chemotherapy No concurrent thalidomide No other concurrent investigational therapy No other concurrent antineoplastic treatment for multiple myeloma, including clarithromycin No concurrent radiation therapy No concurrent nonsteroidal anti-inflammatory agents

Sites / Locations

  • UCSF Helen Diller Family Comprehensive Cancer CenterRecruiting
  • Herbert Irving Comprehensive Cancer Center at Columbia University Medical CenterRecruiting

Outcomes

Primary Outcome Measures

Proportion of patients experiencing treatment-related ≥ grade 3 hematologic or nonhematologic toxicity or treatment-related death (phase I)

Secondary Outcome Measures

Time to response (phase II)
Progression-free survival (phase II)
Overall survival (phase II)
Toxicities by NCI criteria (phase II)

Full Information

First Posted
June 7, 2006
Last Updated
January 9, 2014
Sponsor
Herbert Irving Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00334932
Brief Title
Doxorubicin Hydrochloride Liposome, Melphalan, and Bortezomib in Treating Patients With Relapsed or Refractory Stage I, Stage II, or Stage III Multiple Myeloma
Official Title
Phase I/II Study of Liposomal Doxorubicin (Doxil®)/ Melphalan/Bortezomib (Velcade®) in Relapsed/Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2008
Overall Recruitment Status
Unknown status
Study Start Date
February 2006 (undefined)
Primary Completion Date
January 2010 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Herbert Irving Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride liposome and melphalan, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving doxorubicin hydrochloride liposome and melphalan together with bortezomib may kill more cancer cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of doxorubicin hydrochloride liposome , melphalan, and bortezomib and to see how well they work in treating patients with relapsed or refractory stage I, stage II, or stage III multiple myeloma.
Detailed Description
OBJECTIVES: Primary Determine the safety and tolerability of doxorubicin HCl liposome, melphalan, and bortezomib in patients with relapsed or refractory stage I-III multiple myeloma. Determine the maximum tolerated dose (MTD) of this regimen in these patients. Secondary Determine the overall response rate, including complete, near-complete, partial, and minimal response rate, in patients treated with this regimen. Determine the time to response, progression-free survival, and overall survival of patients treated with this regimen. Determine the toxic effects of this regimen at the MTD in these patients. OUTLINE: This is a multicenter, phase I, dose-escalation study followed by a phase II study. Phase I: Patients receive doxorubicin HCl liposome IV over 30-60 minutes and melphalan IV over 30 minutes on day 1 and bortezomib IV on days 1, 4, 8, and 11. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of doxorubicin HCl liposome, melphalan, and bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 4 of 6 patients experience dose-limiting toxicity after 2 courses of therapy. Phase II: Patients receive doxorubicin HCl liposome, melphalan, and bortezomib at the MTD as in phase I. After completion of study treatment, patients are followed every 3 months. PROJECTED ACCRUAL: Approximately 32 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
refractory multiple myeloma, stage I multiple myeloma, stage II multiple myeloma, stage III multiple myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Enrollment
32 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
bortezomib
Intervention Type
Drug
Intervention Name(s)
melphalan
Intervention Type
Drug
Intervention Name(s)
pegylated liposomal doxorubicin hydrochloride
Primary Outcome Measure Information:
Title
Proportion of patients experiencing treatment-related ≥ grade 3 hematologic or nonhematologic toxicity or treatment-related death (phase I)
Secondary Outcome Measure Information:
Title
Time to response (phase II)
Title
Progression-free survival (phase II)
Title
Overall survival (phase II)
Title
Toxicities by NCI criteria (phase II)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of multiple myeloma Stage I, II, or III disease according to Durie-Salmon staging criteria Progressive disease, defined as one of the following: For secretory disease: A 25% increase in serum M-protein or Bence Jones protein (an absolute increase of 0.5 g/dL serum M-protein or ≥ 200 mg/24 hours of urine light chain excretion) For nonsecretory disease: Bone marrow biopsy with > 25% increase in plasma cells or an absolute increase of ≥ 10% over prior known level Development of new or worsening existing lytic bone lesions or soft tissue plasmacytomas Hypercalcemia (i.e., calcium > 11.5 mg/dL) Relapsed after complete response Must have received ≥ 2 of the following therapeutic regimens for multiple myeloma: Nonmyeloablative transplantation No significant graft-versus-host disease At least 30 days since prior immunosuppressive therapy (concurrent prednisone allowed provided dose is ≤ 10 mg daily) Mobilization with chemotherapy followed by either single or tandem autologous stem cell transplantation (considered 1 prior regimen) Mobilization with chemotherapy followed by autologous and subsequent nonmyeloablative allogeneic stem cell transplantation (considered 1 prior regimen) Any combination of drugs given concurrently (considered 1 prior regimen) PATIENT CHARACTERISTICS: ECOG performance status 0-2 Life expectancy ≥ 3 months Absolute neutrophil count > 1,000/mm^3 (no colony-stimulating factors) Platelet count > 50,000/mm^3 (no transfusion support) Bilirubin ≤ 2.0 mg/dL AST ≤ 4 times upper limit of normal Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 4 weeks after completion of study treatment No history of allergic reaction to compounds containing boron or mannitol No active uncontrolled viral (including HIV), bacterial, or fungal infection No motor or sensory neuropathy ≥ grade 2 No myocardial infarction within the past 6 months No New York Heart Association class III or IV heart failure No uncontrolled angina No severe uncontrolled arrhythmia No acute ischemia by EKG LVEF ≥ 35% by MUGA (MUGA required in patients whose lifetime cumulative doxorubicin hydrochloride dose > 400 mg/m^2) PRIOR CONCURRENT THERAPY: See Disease Characteristics No grade III or IV toxicity due to previous antineoplastic therapy (except alopecia) At least 3 weeks since prior chemotherapy No prior doxorubicin HCl liposome, melphalan, and bortezomib as combination therapy (single or two-drug combinations of these are allowed) No concurrent corticosteroids (≤ 10 mg prednisone/day or equivalent allowed) No other concurrent chemotherapy No concurrent thalidomide No other concurrent investigational therapy No other concurrent antineoplastic treatment for multiple myeloma, including clarithromycin No concurrent radiation therapy No concurrent nonsteroidal anti-inflammatory agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ajai Chari, MD
Organizational Affiliation
Herbert Irving Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCSF Helen Diller Family Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clinical Trials Office - UCSF Helen Diller Family Comprehensi
Phone
877-827-3222
Facility Name
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clinical Trials Office - Herbert Irving Comprehensive Cancer C
Phone
212-305-8615

12. IPD Sharing Statement

Citations:
Citation
Chari A, Kaplan L, Linker C, et al.: Phase I/II study of bortezomib in combination with liposomal doxorubicin and melphalan in relapsed or refractory multiple myeloma. [Abstract] Blood 106 (11): A-5182, 2005 .
Results Reference
result

Learn more about this trial

Doxorubicin Hydrochloride Liposome, Melphalan, and Bortezomib in Treating Patients With Relapsed or Refractory Stage I, Stage II, or Stage III Multiple Myeloma

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