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Combination of Lenalidomide and Dexamethasone in Treatment of Multiple Myeloma (DSM XIII)

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Lenalidomide, Dexamethasone
Lenalidomide, Dexamethasone, PBSCT
Sponsored by
Gesellschaft fur Medizinische Innovation - Hamatologie und Onkologie mbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma

Eligibility Criteria

60 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

1. Understand and voluntarily sign an informed consent form. 2. Age 60-75 years at the time of signing the informed consent form. 3. Able to adhere to the study visit schedule and other protocol requirements. 4. Symptomatic MM requiring therapy. 5. Measurable monoclonal protein in serum and/or urine 6. Monoclonal plasma cells in the bone marrow >/= 10% and/or biopsy-proven plasmacytoma 7. Myeloma-related organ dysfunction, at least one of [C] Calcium elevation in the serum (> 11.5 mg/dL or > 2.65 mmol/l) [R] Renal insufficiency (creatinine > 173 μmol/l or > 2 mg/dL) [A] Anemia (Hb < 10 g/dL or 2 g/dL < normal) [B] Bone lesions or general osteoporosis 8. ECOG PS of </= 2 ... 9. Laboratory test results within these ranges within 1 week prior to randomization:

  • ANC >/= 1.0 x 109/L.
  • Platelet count >/= 75 x 109/L or in case of bone marrow infiltration with myeloma cells >/= 30 x 109/L.
  • Total bilirubin </= 2 mg/dL.
  • AST (SGOT) and ALT (SGPT) </= 3 x ULN. 8. Female subjects of childbearing potential must: o Understand the study drug is expected to have a teratogenic risk

    o Agree to use, ..., effective contraception without interruption,...

    o Understand that even if she has amenorrhea, she must follow all the advice on effective contraception.

    o She understands the potential consequences of pregnancy and the need to rapidly consult if there is a risk of pregnancy

    o Agree to have a medically supervised pregnancy test ...

  • Male subjects must

    o Agree to use condoms throughout study drug therapy, during any dose interruption and for one week after cessation of study drug therapy ...

    • Agree not to donate semen during study drug therapy and for one week after end of study drug therapy.
  • All subjects must

    • Agree to abstain from donating blood while taking study drug therapy and for one week following discontinuation of study drug therapy.
    • Agree not to share study drug with another person and to return all unused study drug to the investigator.

      9. Disease free of prior malignancies for >/= 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.

      10. Able to receive antithrombotic prophylaxis (...). 11. Life-expectancy > 3 months.

Exclusion Criteria:

  1. Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the ICF.
  2. Pregnant or lactating females
  3. Any condition, incl. the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  4. Patient currently is enrolled in another clinical research study or has been enrolled ...within 4 weeks before randomization and/or is receiving an investigational agent for any reason ...
  5. Known hypersensitivity to thalidomide, dexamethasone, or melphalan.
  6. The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
  7. Any prior use of lenalidomide.
  8. Concurrent use of other anti-cancer agents or treatments.
  9. Known positive for HIV or active infectious hepatitis, type A, B or C or treponema pallidum
  10. Prior treatment with dexamethasone discontinued because of ≥ grade 3 dexamethasone-related toxicity.
  11. Any prior chemotherapy with the exception of a short course of dexamethasone more than 4 weeks before randomization.
  12. Immunotherapy or antibody therapy within 8 weeks before randomization.
  13. Major surgery within 4 weeks before randomization.
  14. Renal failure requiring dialysis.
  15. Myocardial infarction within 6 months before randomization, NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities.
  16. Severe pulmonary disease (diffusion capacity < 60% of normal).
  17. Treatment for cancer other than MM within 5 years before randomization, with the exception of basal cell carcinoma or cervical cancer in situ.
  18. Cardiac amyloidosis.
  19. Poorly controlled hypertension, diabetes mellitus, or other serious medical or psychiatric illness that could potentially interfere with the completion of treatment according to the protocol.
  20. Any systemic infection requiring treatment.
  21. Unability or unwillingness of the patient to receive antithrombotic prophylaxis.

    -

Sites / Locations

  • Universitätsklinikum Münster
  • Universitätsklinikum Aachen
  • Agirov Klinik
  • HELIOS Klinikum Berlin-Buch
  • Evangelisches Krankenhaus Bielefeld
  • Klinikum Bremen-Mitte
  • Universitätsklinik Erlangen
  • Universitätsklinikum Freiburg
  • Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald -Anstalt öffentlichen Rechts-
  • Universitätsklinikum Göttingen
  • Universitätsklinikum Hamburg-Eppendorf
  • Asklepios Klinik Altona
  • Universitätsklinikum Schleswig-Holstein
  • Stiftungsklinikum Mittelrhein gGmbH
  • Klinikum Landshut gemeinnützige GmbH
  • Stauferklinikum Schwäbisch Gmünd
  • Hämato-Onkologische Schwerpunktpraxis
  • Onkologische Praxis Elisenhof
  • Klinikum München Harlaching
  • Klinikum rechts der Isar
  • Klinikum Nord
  • Klinikum Oldenburg
  • Klinikum Ernst von Bergmann gGmbH
  • Gemeinschaftspraxis für Innere Medizin, Hämatologie und Onkologie
  • Klinikum der Universität Regensburg
  • Diakonie-Klinikum Stuttgart-Diakonissenkrankenhaus und Paulinenhilfe gGmbH
  • Robert-Bosch-Krankenhaus
  • Klinikum Traunstein
  • Universitätsklinikum Ulm
  • HSK Dr. Horst-Schmidt-Kliniken gmbh
  • Universitätsklinikum Würzburg

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Lenalidomid, PBSCT

Lenalidomid

Arm Description

A1 Rd until progression or max. 5 years (Rd = lenalidomide 25 mg d1-21/28d + dexamethasone 40 mg po d1, d8, d15, d22/28d)

A2 Induction with 3 cycles Rd, tandem high dose melphalan (140 mg/m²) with autologous peripheral blood stem cell transplantation (PBSCT) followed by lenalidomide maintenance (10 mg/day) until progression or max. 5 years

Outcomes

Primary Outcome Measures

Progression-free survival (PFS)
To compare the efficacy of both treatment regimens with regard to progression-free survival.

Secondary Outcome Measures

Overall survival (OS)
To assess the safety and overall survival of both treatment regimens.
• Response (complete response [CR], stringent complete response [sCR], very good partial response [VGPR], partial response [PR] and overall response [CR (incl. sCR)+ VGPR + PR]) according to IMWG criteria
To investigate other efficacy parameters of both treatment regimens

Full Information

First Posted
March 18, 2010
Last Updated
February 22, 2023
Sponsor
Gesellschaft fur Medizinische Innovation - Hamatologie und Onkologie mbH
Collaborators
ClinAssess GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT01090089
Brief Title
Combination of Lenalidomide and Dexamethasone in Treatment of Multiple Myeloma
Acronym
DSM XIII
Official Title
The Combination of Lenalidomide and Dexamethasone With or Without Intensification by High-dose Melphalan in the Treatment of Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
March 1, 2010 (Actual)
Primary Completion Date
January 31, 2020 (Actual)
Study Completion Date
January 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gesellschaft fur Medizinische Innovation - Hamatologie und Onkologie mbH
Collaborators
ClinAssess GmbH

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In this study for elderly myeloma patients lenalidomide plus low-dose dexamethasone until progression is being compared with age-adjusted tandem high-dose melphalan 140 mg/m² augmented by induction with 3 cycles of lenalidomide plus low-dose dexamethasone before transplantation and lenalidomide maintenance after transplantation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
348 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lenalidomid, PBSCT
Arm Type
Experimental
Arm Description
A1 Rd until progression or max. 5 years (Rd = lenalidomide 25 mg d1-21/28d + dexamethasone 40 mg po d1, d8, d15, d22/28d)
Arm Title
Lenalidomid
Arm Type
Active Comparator
Arm Description
A2 Induction with 3 cycles Rd, tandem high dose melphalan (140 mg/m²) with autologous peripheral blood stem cell transplantation (PBSCT) followed by lenalidomide maintenance (10 mg/day) until progression or max. 5 years
Intervention Type
Drug
Intervention Name(s)
Lenalidomide, Dexamethasone
Other Intervention Name(s)
Revlimid
Intervention Description
Rd until progression or max. 5 years (Rd = lenalidomide 25 mg d1-21/28d + dexamethasone 40 mg po d1, d8, d15, d22/28d)
Intervention Type
Drug
Intervention Name(s)
Lenalidomide, Dexamethasone, PBSCT
Other Intervention Name(s)
Revlimid
Intervention Description
Induction with 3 cycles Rd, tandem high dose melphalan (140 mg/m²) with autologous peripheral blood stem cell transplantation (PBSCT) followed by lenalidomide maintenance (10 mg/day) until progression or max. 5 years
Primary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
To compare the efficacy of both treatment regimens with regard to progression-free survival.
Time Frame
5 yrs
Secondary Outcome Measure Information:
Title
Overall survival (OS)
Description
To assess the safety and overall survival of both treatment regimens.
Time Frame
5 yrs
Title
• Response (complete response [CR], stringent complete response [sCR], very good partial response [VGPR], partial response [PR] and overall response [CR (incl. sCR)+ VGPR + PR]) according to IMWG criteria
Description
To investigate other efficacy parameters of both treatment regimens
Time Frame
5 yrs

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Understand and voluntarily sign an informed consent form. 2. Age 60-75 years at the time of signing the informed consent form. 3. Able to adhere to the study visit schedule and other protocol requirements. 4. Symptomatic MM requiring therapy. 5. Measurable monoclonal protein in serum and/or urine 6. Monoclonal plasma cells in the bone marrow >/= 10% and/or biopsy-proven plasmacytoma 7. Myeloma-related organ dysfunction, at least one of [C] Calcium elevation in the serum (> 11.5 mg/dL or > 2.65 mmol/l) [R] Renal insufficiency (creatinine > 173 μmol/l or > 2 mg/dL) [A] Anemia (Hb < 10 g/dL or 2 g/dL < normal) [B] Bone lesions or general osteoporosis 8. ECOG PS of </= 2 ... 9. Laboratory test results within these ranges within 1 week prior to randomization: ANC >/= 1.0 x 109/L. Platelet count >/= 75 x 109/L or in case of bone marrow infiltration with myeloma cells >/= 30 x 109/L. Total bilirubin </= 2 mg/dL. AST (SGOT) and ALT (SGPT) </= 3 x ULN. 8. Female subjects of childbearing potential must: o Understand the study drug is expected to have a teratogenic risk o Agree to use, ..., effective contraception without interruption,... o Understand that even if she has amenorrhea, she must follow all the advice on effective contraception. o She understands the potential consequences of pregnancy and the need to rapidly consult if there is a risk of pregnancy o Agree to have a medically supervised pregnancy test ... Male subjects must o Agree to use condoms throughout study drug therapy, during any dose interruption and for one week after cessation of study drug therapy ... Agree not to donate semen during study drug therapy and for one week after end of study drug therapy. All subjects must Agree to abstain from donating blood while taking study drug therapy and for one week following discontinuation of study drug therapy. Agree not to share study drug with another person and to return all unused study drug to the investigator. 9. Disease free of prior malignancies for >/= 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast. 10. Able to receive antithrombotic prophylaxis (...). 11. Life-expectancy > 3 months. Exclusion Criteria: Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the ICF. Pregnant or lactating females Any condition, incl. the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Patient currently is enrolled in another clinical research study or has been enrolled ...within 4 weeks before randomization and/or is receiving an investigational agent for any reason ... Known hypersensitivity to thalidomide, dexamethasone, or melphalan. The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs. Any prior use of lenalidomide. Concurrent use of other anti-cancer agents or treatments. Known positive for HIV or active infectious hepatitis, type A, B or C or treponema pallidum Prior treatment with dexamethasone discontinued because of ≥ grade 3 dexamethasone-related toxicity. Any prior chemotherapy with the exception of a short course of dexamethasone more than 4 weeks before randomization. Immunotherapy or antibody therapy within 8 weeks before randomization. Major surgery within 4 weeks before randomization. Renal failure requiring dialysis. Myocardial infarction within 6 months before randomization, NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Severe pulmonary disease (diffusion capacity < 60% of normal). Treatment for cancer other than MM within 5 years before randomization, with the exception of basal cell carcinoma or cervical cancer in situ. Cardiac amyloidosis. Poorly controlled hypertension, diabetes mellitus, or other serious medical or psychiatric illness that could potentially interfere with the completion of treatment according to the protocol. Any systemic infection requiring treatment. Unability or unwillingness of the patient to receive antithrombotic prophylaxis. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christian Straka
Organizational Affiliation
Agirov Klinik
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinikum Münster
City
Muenster
State/Province
North Rhein Westfallen
ZIP/Postal Code
48149
Country
Germany
Facility Name
Universitätsklinikum Aachen
City
Aachen
ZIP/Postal Code
52074
Country
Germany
Facility Name
Agirov Klinik
City
Berg
ZIP/Postal Code
82335
Country
Germany
Facility Name
HELIOS Klinikum Berlin-Buch
City
Berlin
ZIP/Postal Code
13125
Country
Germany
Facility Name
Evangelisches Krankenhaus Bielefeld
City
Bielefeld
ZIP/Postal Code
33611
Country
Germany
Facility Name
Klinikum Bremen-Mitte
City
Bremen
ZIP/Postal Code
28177
Country
Germany
Facility Name
Universitätsklinik Erlangen
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
Facility Name
Universitätsklinikum Freiburg
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald -Anstalt öffentlichen Rechts-
City
Greifswald
ZIP/Postal Code
17475
Country
Germany
Facility Name
Universitätsklinikum Göttingen
City
Göttingen
ZIP/Postal Code
37075
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Asklepios Klinik Altona
City
Hamburg
ZIP/Postal Code
22763
Country
Germany
Facility Name
Universitätsklinikum Schleswig-Holstein
City
Kiel
ZIP/Postal Code
24105
Country
Germany
Facility Name
Stiftungsklinikum Mittelrhein gGmbH
City
Koblenz
ZIP/Postal Code
56068
Country
Germany
Facility Name
Klinikum Landshut gemeinnützige GmbH
City
Landshut
ZIP/Postal Code
84034
Country
Germany
Facility Name
Stauferklinikum Schwäbisch Gmünd
City
Mutlangen
ZIP/Postal Code
73557
Country
Germany
Facility Name
Hämato-Onkologische Schwerpunktpraxis
City
München
ZIP/Postal Code
80331
Country
Germany
Facility Name
Onkologische Praxis Elisenhof
City
München
ZIP/Postal Code
80335
Country
Germany
Facility Name
Klinikum München Harlaching
City
München
ZIP/Postal Code
81545
Country
Germany
Facility Name
Klinikum rechts der Isar
City
München
ZIP/Postal Code
81675
Country
Germany
Facility Name
Klinikum Nord
City
Nürnberg
ZIP/Postal Code
90419
Country
Germany
Facility Name
Klinikum Oldenburg
City
Oldenburg
ZIP/Postal Code
26133
Country
Germany
Facility Name
Klinikum Ernst von Bergmann gGmbH
City
Potsdam
ZIP/Postal Code
14467
Country
Germany
Facility Name
Gemeinschaftspraxis für Innere Medizin, Hämatologie und Onkologie
City
Ravensburg
ZIP/Postal Code
88214
Country
Germany
Facility Name
Klinikum der Universität Regensburg
City
Regensburg
ZIP/Postal Code
93053
Country
Germany
Facility Name
Diakonie-Klinikum Stuttgart-Diakonissenkrankenhaus und Paulinenhilfe gGmbH
City
Stuttgart
ZIP/Postal Code
70176
Country
Germany
Facility Name
Robert-Bosch-Krankenhaus
City
Stuttgart
ZIP/Postal Code
70376
Country
Germany
Facility Name
Klinikum Traunstein
City
Traunstein
ZIP/Postal Code
83278
Country
Germany
Facility Name
Universitätsklinikum Ulm
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
HSK Dr. Horst-Schmidt-Kliniken gmbh
City
Wiesbaden
ZIP/Postal Code
65199
Country
Germany
Facility Name
Universitätsklinikum Würzburg
City
Würzburg
ZIP/Postal Code
97080
Country
Germany

12. IPD Sharing Statement

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Combination of Lenalidomide and Dexamethasone in Treatment of Multiple Myeloma

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