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Bevacizumab in Treating Patients With Relapsed or Refractory Multiple Myeloma

Primary Purpose

Multiple Myeloma and Plasma Cell Neoplasm

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
bevacizumab
gene expression analysis
protein expression analysis
laboratory biomarker analysis
Sponsored by
Mayo Clinic
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 relapsed or refractory multiple myeloma
  • Measurable or evaluable disease as defined by ≥ 1 of the following:

    • Serum monoclonal protein ≥ 1.0 g by protein electrophoresis
    • Monoclonal protein ≥ 200 mg by 24-hour urine electrophoresis
    • Serum immunoglobulin free light chain ≥ 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
    • Monoclonal bone marrow plasmacytosis ≥ 30% (evaluable disease)
  • No concurrent amyloidosis

PATIENT CHARACTERISTICS:

  • ECOG performance status (PS) 0 or 1

    • ECOG PS 2 based on immobility from myeloma bone disease alone allowed at the discretion of treating physician
  • Creatinine ≤ 2.0 mg/dL
  • ANC ≥ 1,000/mm³
  • Platelet count ≥ 75,000/mm³
  • Hemoglobin ≥ 8.0 g/dL
  • Proteinuria ≤ 1 g/dL by 24-hour urine collection (excluding monoclonal protein)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 4 weeks after completion of study treatment
  • No bleeding diathesis
  • No hypertension (defined as BP > 150/100 mm Hg)
  • No active bleeding, healing or nonhealing wound, ulcer, or bone fracture (excluding fractures secondary to myeloma)
  • No active ulcerative disease including, but not limited to, any of the following:

    • Peptic ulcer disease
    • Ulcerative esophagitis
    • Ulcerative colitis
    • Crohn's disease
  • LVEF ≥ 50% by 2-dimensional ECHO or MUGA scan
  • No NYHA class III or IV heart disease
  • No other active malignancy except for nonmelanoma skin cancer or in situ cervical or breast cancer
  • No active infection
  • No other comorbidity that would interfere with study compliance
  • No transient ischemic attack, cerebrovascular accident, or myocardial infarction within the past year
  • No abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within the past 6 months
  • No significant traumatic injury within the past 28 days

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No more than 2 prior antimyeloma treatment courses, except for bisphosphonates
  • No standard or experimental drug therapy, other than ongoing bisphosphonate treatment and/or epoetin alfa, within the past 28 days
  • No experimental non-drug therapy within the past 28 days
  • Palliative radiation therapy within the past 28 days allowed provided ≤ 3 sites of bone disease was irradiated
  • No prior bevacizumab or other experimental antiangiogenic agents other than thalidomide or lenalidomide
  • No minor surgical procedures, fine-needle aspiration, or core biopsies within the past 7 days
  • No major surgical procedure or open biopsy within the past 28 days
  • No concurrent corticosteroids

    • Chronic steroids ≤ 20 mg/day (prednisone equivalent) for disorders other than myeloma (i.e., adrenal insufficiency, rheumatoid arthritis) allowed
  • No other concurrent investigational therapy
  • No other concurrent systemic antineoplastic therapy including, but not limited to, the following:

    • Cytotoxic chemotherapy
    • Immunotherapy
    • Hormonal therapy
    • Monoclonal antibody therapy
  • Concurrent bisphosphonates allowed

Sites / Locations

  • Mayo Clinic

Outcomes

Primary Outcome Measures

Confirmed hematologic response
Progression-free survival at 1 year

Secondary Outcome Measures

Toxicity as measured by NCI CTCAE v3.0
Time to progression
Duration of response
Survival

Full Information

First Posted
June 4, 2007
Last Updated
May 10, 2011
Sponsor
Mayo Clinic
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00482495
Brief Title
Bevacizumab in Treating Patients With Relapsed or Refractory Multiple Myeloma
Official Title
A Phase II Trial of Bevacizumab in Patients With Relapsed or Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2011
Overall Recruitment Status
Completed
Study Start Date
April 2006 (undefined)
Primary Completion Date
December 2006 (Actual)
Study Completion Date
November 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Mayo Clinic
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies, such as bevacizumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Bevacizumab may also stop the growth of multiple myeloma by blocking blood flow to the cancer. PURPOSE: This phase II trial is studying how well bevacizumab works in treating patients with relapsed or refractory multiple myeloma.
Detailed Description
OBJECTIVES: Primary Determine the hematologic response rate in patients with relapsed or refractory multiple myeloma treated with bevacizumab. Determine the proportion of patients who are progression free and have not failed treatment after 1 year. Secondary Determine the toxicity of this drug in these patient. Determine the time to disease progression in patients receiving this drug. Determine the overall survival and survival at 1 year in patients receiving this drug. OUTLINE: This is an open-label study. Patients receive bevacizumab IV on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity. Blood samples are obtained for correlative studies at baseline, after course 2, and at 12 weeks. Samples are analyzed for interleukin-6, Flt-1, and VEGF levels. After completion of study therapy, patients are followed every 3-6 months for up to 3 years.

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 2
Masking
None (Open Label)
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
bevacizumab
Intervention Type
Genetic
Intervention Name(s)
gene expression analysis
Intervention Type
Genetic
Intervention Name(s)
protein expression analysis
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Primary Outcome Measure Information:
Title
Confirmed hematologic response
Title
Progression-free survival at 1 year
Secondary Outcome Measure Information:
Title
Toxicity as measured by NCI CTCAE v3.0
Title
Time to progression
Title
Duration of response
Title
Survival

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of relapsed or refractory multiple myeloma Measurable or evaluable disease as defined by ≥ 1 of the following: Serum monoclonal protein ≥ 1.0 g by protein electrophoresis Monoclonal protein ≥ 200 mg by 24-hour urine electrophoresis Serum immunoglobulin free light chain ≥ 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio Monoclonal bone marrow plasmacytosis ≥ 30% (evaluable disease) No concurrent amyloidosis PATIENT CHARACTERISTICS: ECOG performance status (PS) 0 or 1 ECOG PS 2 based on immobility from myeloma bone disease alone allowed at the discretion of treating physician Creatinine ≤ 2.0 mg/dL ANC ≥ 1,000/mm³ Platelet count ≥ 75,000/mm³ Hemoglobin ≥ 8.0 g/dL Proteinuria ≤ 1 g/dL by 24-hour urine collection (excluding monoclonal protein) Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 4 weeks after completion of study treatment No bleeding diathesis No hypertension (defined as BP > 150/100 mm Hg) No active bleeding, healing or nonhealing wound, ulcer, or bone fracture (excluding fractures secondary to myeloma) No active ulcerative disease including, but not limited to, any of the following: Peptic ulcer disease Ulcerative esophagitis Ulcerative colitis Crohn's disease LVEF ≥ 50% by 2-dimensional ECHO or MUGA scan No NYHA class III or IV heart disease No other active malignancy except for nonmelanoma skin cancer or in situ cervical or breast cancer No active infection No other comorbidity that would interfere with study compliance No transient ischemic attack, cerebrovascular accident, or myocardial infarction within the past year No abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within the past 6 months No significant traumatic injury within the past 28 days PRIOR CONCURRENT THERAPY: See Disease Characteristics No more than 2 prior antimyeloma treatment courses, except for bisphosphonates No standard or experimental drug therapy, other than ongoing bisphosphonate treatment and/or epoetin alfa, within the past 28 days No experimental non-drug therapy within the past 28 days Palliative radiation therapy within the past 28 days allowed provided ≤ 3 sites of bone disease was irradiated No prior bevacizumab or other experimental antiangiogenic agents other than thalidomide or lenalidomide No minor surgical procedures, fine-needle aspiration, or core biopsies within the past 7 days No major surgical procedure or open biopsy within the past 28 days No concurrent corticosteroids Chronic steroids ≤ 20 mg/day (prednisone equivalent) for disorders other than myeloma (i.e., adrenal insufficiency, rheumatoid arthritis) allowed No other concurrent investigational therapy No other concurrent systemic antineoplastic therapy including, but not limited to, the following: Cytotoxic chemotherapy Immunotherapy Hormonal therapy Monoclonal antibody therapy Concurrent bisphosphonates allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Suzanne Hayman, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Study Chair
Facility Information:
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55940
Country
United States

12. IPD Sharing Statement

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Bevacizumab in Treating Patients With Relapsed or Refractory Multiple Myeloma

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