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Ferric Carboxymaltose for Treatment of Anaemia of Cancer in Subjects With Multiple Myeloma Receiving Chemotherapy (AOC-MM)

Primary Purpose

Iron-Deficiency Anemia

Status
Terminated
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Ferric carboxymaltose
Sponsored by
Vifor Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Iron-Deficiency Anemia focused on measuring Anemia, Lymphoproliferative Disorders, Chemotherapy, ferric carboxymaltose, iron

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects (male or female) aged ≥18, suffering from a newly diagnosed or progressed/relapsed MM and scheduled to receive anti-myeloma treatment. Progression is defined according to "Uniform Response Criteria for Multiple Myeloma"
  • Subjects with progressed/relapsed MM should have had stable disease (during the last 6 months since prior treatment).
  • Life expectancy at least 6 months.
  • 8.5 g/dL ≤Hb ≤11 g/dL at time of randomisation.
  • Iron-restricted erythropoiesis as defined:

    • Stainable iron in bone marrow (BM) combined with transferrin saturation (TSAT) ≤20%, or
    • where the evaluation of stainable iron in BM is not possible or available:
  • ferritin >30 ng/mL (women) or >40 ng/mL (men), and
  • TSAT ≤20%
  • Females of child-bearing potential must have a negative urine pregnancy test at screening.
  • Before any study-specific procedure, the appropriate written informed consent must be obtained.

Exclusion Criteria:

  • Any anaemia treatment within 4 weeks prior to randomisation (including red blood cell transfusions, treatment with ESA or any oral/parenteral iron preparations).
  • Anthracycline containing chemotherapy regimens.
  • Subjects weighing <35 kg.
  • Folate deficiency (serum-folate <4.5 nmol/L) and/or Vitamin B12 deficiency (serum-cobalamin <145 pmol/L).
  • Ongoing haemolysis defined as serum-haptoglobin <0.2 g/L.
  • Known chronic renal failure, glomerular filtration rate <30 mL/min/m2.
  • Recent (within last 4 weeks) significant bleeding/surgery, defined as drop in Hb of ≥2 g/dL.
  • Clinically relevant active inflammatory disease other than MM (according to the judgement of the Investigator).
  • Clinically relevant ongoing infectious disease including known human immunodeficiency virus.
  • Serum ferritin >600 ng/mL.
  • Ongoing significant neurological or psychiatric disorders including psychotic disorders or dementia.
  • Significant cardiovascular disease prior to study inclusion including myocardial infarction within 12 months prior to study inclusion, congestive heart failure New York Heart Association Grade III or IV, or poorly controlled hypertension according to the judgment of the Investigator.
  • Elevation of liver enzymes (aspartate aminotransferase, alanine aminotransferase) over 3 times above the normal range or known acute hepatic disorder.
  • Subject currently is enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(ies), or subject is receiving other investigational agent(s).
  • Subject of child-bearing potential is evidently pregnant (e.g., positive human chorionic gonadotropin test) or is breast feeding.
  • Subject is not using adequate contraceptive precautions. Adequate contraceptive precautions are defined as those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intra-uterine devices, sexual abstinence or vasectomised partner. Non-childbearing potential includes being surgically sterilised at least 6 months prior to the study or post-menopausal, defined as amenorrhea for at least 12 months.
  • Subject has known sensitivity to any of the products to be administered during dosing.
  • Subject will not be available for follow-up assessment.
  • Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures.

Sites / Locations

  • Hopital Sud
  • Theagenion Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

No Intervention

Arm Label

Ferric carboxymaltose

Local standard of care.

Arm Description

Subjects will receive a total dose of 1,000 mg iron as FCM on the day of the next scheduled chemotherapy cycle after randomisation or continuous chemotherapy. In subjects with weight ≤66 kg, the first dose iron will be 500 mg; the second dose (500 mg) will be administered on the visit 3 (week 2).

Subjects will be treated according to the local institutional practice.

Outcomes

Primary Outcome Measures

Change in haemoglobin (Hb) from baseline to Weeks 4, 6 and 8
Mean change in Hb from baseline to Weeks 4, 6 and 8 (end of treatment) in the absence of any red cell transfusion or erythropoiesis stimulating agents (ESA) treatment.

Secondary Outcome Measures

Percentage of subjects with blood Hb response of at least 1 g/dL
Percentage of subjects with blood Hb response of at least 1 g/dL in the absence of any red cell transfusion or ESA treatment.
Percentage of subjects with a blood Hb correction to at least 12 g/dL
Percentage of subjects with a blood Hb correction to at least 12 g/dL in the absence of any red cell transfusion or ESA treatment
Time to Hb response defined as increase in Hb equal to or more than 1 g/dL
Median time to Hb response defined as increase in Hb equal to or more than 1 g/dL in the absence of any red cell transfusion or ESA treatment
Subjects receiving red blood cell transfusions or subjects treated with ESA
Proportion of subjects receiving red blood cell transfusions or subjects treated with ESA during the study period
Adverse events
Adverse events: type, nature, incidence and outcome
Transfusion/treatment with ESA
Time to transfusion/treatment with ESA
Change in serum ferritin from baseline to Weeks 2, 4, 6 and 8
Mean change in serum ferritin from baseline to Weeks 2, 4, 6 and 8
Change in transferrin saturation (TSAT) from baseline to Weeks 2, 4, 6 and 8
Mean change in TSAT from baseline to Weeks 2, 4, 6 and 8
Change in serum iron from baseline to Weeks 2, 4, 6 and 8
Mean change in serum iron from baseline to Weeks 2, 4, 6 and 8
Change in endogenous erythropoietin from baseline to Weeks 2, 4, 6 and 8
Mean change in endogenous erythropoietin from baseline to Weeks 2, 4, 6 and 8
Change in blood reticulocyte haemoglobin content/red blood cell size factor from baseline to Weeks 2, 4, 6 and 8
Mean change in blood reticulocyte haemoglobin content/red blood cell size factor from baseline to Weeks 2, 4, 6 and 8
Change in percentage of hypochromic red cells/percentage of low Hb density from baseline to Weeks 2, 4, 6 and 8
Mean change in percentage of hypochromic red cells/percentage of low Hb density from baseline to Weeks 2, 4, 6 and 8
Change in hepcidin from baseline to Weeks 2, 4, 6 and 8
Mean change in hepcidin from baseline to Weeks 2, 4, 6 and 8
Change in interleukin-6 from baseline to Weeks 2, 4, 6 and 8
Mean change in interleukin-6 from baseline to Weeks 2, 4, 6 and 8

Full Information

First Posted
March 29, 2010
Last Updated
May 3, 2022
Sponsor
Vifor Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT01100879
Brief Title
Ferric Carboxymaltose for Treatment of Anaemia of Cancer in Subjects With Multiple Myeloma Receiving Chemotherapy
Acronym
AOC-MM
Official Title
Randomised Controlled Open-label Study to Evaluate Efficacy & Safety of Intravenous Ferric Carboxymaltose Versus no Treatment in Anaemic Subjects With Multiple Myeloma & Iron Restricted Erythropoiesis Receiving Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
June 2011
Overall Recruitment Status
Terminated
Why Stopped
Lack of Recruitment
Study Start Date
March 2010 (undefined)
Primary Completion Date
July 2011 (Actual)
Study Completion Date
October 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vifor Pharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Multicentre, randomised, controlled, 2-arm open-label prospective pilot study to evaluate efficacy and safety of ferric carboxymaltose (FCM) in treatment of anaemia in subjects with multiple myeloma (MM) initiating chemotherapy. The subjects will be screened for eligibility within 4 weeks prior to inclusion and randomised to receive intravenous infusions of FCM or standard care (the subjects may be treated according to the local institutional practice if requiring symptomatic management of anaemia). Thereafter the visits are scheduled at Weeks 0, 2, 4, 6 and 8.
Detailed Description
Patients will be randomised into two groups. One will receive active FCM treatment and the other group will receive local standard of care. Active treatment group: Subjects will receive a total dose of 1,000 mg iron as FCM on the day of the first scheduled chemotherapy cycle or within 24 hours before or after receiving chemotherapy. In subjects of weight ≤66 kg, the first dose (500 mg) will be administered on the day of the first scheduled chemotherapy cycle and the second dose (500 mg) on the next study visit. Standard of care group: Subjects will be treated according to the local institutional practice if requiring management of symptomatic anaemia. Intravenous iron should only be used to treat absolute iron deficiency (as defined as ferritin less than the lower limit of normal based on the test reference ranges). Patients with absolute iron deficiency are not eligible for inclusion to the study. Rescue medication to manage anaemia is permitted in both arms at the discretion of the treating physician and/or per institutional practice.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Iron-Deficiency Anemia
Keywords
Anemia, Lymphoproliferative Disorders, Chemotherapy, ferric carboxymaltose, iron

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ferric carboxymaltose
Arm Type
Active Comparator
Arm Description
Subjects will receive a total dose of 1,000 mg iron as FCM on the day of the next scheduled chemotherapy cycle after randomisation or continuous chemotherapy. In subjects with weight ≤66 kg, the first dose iron will be 500 mg; the second dose (500 mg) will be administered on the visit 3 (week 2).
Arm Title
Local standard of care.
Arm Type
No Intervention
Arm Description
Subjects will be treated according to the local institutional practice.
Intervention Type
Drug
Intervention Name(s)
Ferric carboxymaltose
Other Intervention Name(s)
Ferinject
Intervention Description
Subjects will receive a single dose of 1,000 mg iron as FCM infusion at baseline. Subjects of bw ≤66 kg will receive a single dose of 500 mg iron as FCM infusion at baseline (Week 0) and at Visit 3 (Week 2). Ferric carboxymaltose will be administered on the same day with chemotherapy treatment or within 24 hours before or after the chemotherapy. For subjects with bw ≤66 kg, if no chemotherapy planned for the visit 4 (Week 2), the second FCM dose should be infused independent of chemotherapy.
Primary Outcome Measure Information:
Title
Change in haemoglobin (Hb) from baseline to Weeks 4, 6 and 8
Description
Mean change in Hb from baseline to Weeks 4, 6 and 8 (end of treatment) in the absence of any red cell transfusion or erythropoiesis stimulating agents (ESA) treatment.
Time Frame
week 4, 6 and 8 post baseline
Secondary Outcome Measure Information:
Title
Percentage of subjects with blood Hb response of at least 1 g/dL
Description
Percentage of subjects with blood Hb response of at least 1 g/dL in the absence of any red cell transfusion or ESA treatment.
Time Frame
12 weeks post baseline
Title
Percentage of subjects with a blood Hb correction to at least 12 g/dL
Description
Percentage of subjects with a blood Hb correction to at least 12 g/dL in the absence of any red cell transfusion or ESA treatment
Time Frame
12 weeks post baseline
Title
Time to Hb response defined as increase in Hb equal to or more than 1 g/dL
Description
Median time to Hb response defined as increase in Hb equal to or more than 1 g/dL in the absence of any red cell transfusion or ESA treatment
Time Frame
Baseline until end of study (week 8)
Title
Subjects receiving red blood cell transfusions or subjects treated with ESA
Description
Proportion of subjects receiving red blood cell transfusions or subjects treated with ESA during the study period
Time Frame
Baseline until end of study (week 8)
Title
Adverse events
Description
Adverse events: type, nature, incidence and outcome
Time Frame
Baseline until end of study (week 8)
Title
Transfusion/treatment with ESA
Description
Time to transfusion/treatment with ESA
Time Frame
Baseline until end of study (week 8)
Title
Change in serum ferritin from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in serum ferritin from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in transferrin saturation (TSAT) from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in TSAT from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in serum iron from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in serum iron from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in endogenous erythropoietin from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in endogenous erythropoietin from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in blood reticulocyte haemoglobin content/red blood cell size factor from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in blood reticulocyte haemoglobin content/red blood cell size factor from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in percentage of hypochromic red cells/percentage of low Hb density from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in percentage of hypochromic red cells/percentage of low Hb density from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in hepcidin from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in hepcidin from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline
Title
Change in interleukin-6 from baseline to Weeks 2, 4, 6 and 8
Description
Mean change in interleukin-6 from baseline to Weeks 2, 4, 6 and 8
Time Frame
week 2, 4, 6, and 8 post baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects (male or female) aged ≥18, suffering from a newly diagnosed or progressed/relapsed MM and scheduled to receive anti-myeloma treatment. Progression is defined according to "Uniform Response Criteria for Multiple Myeloma" Subjects with progressed/relapsed MM should have had stable disease (during the last 6 months since prior treatment). Life expectancy at least 6 months. 8.5 g/dL ≤Hb ≤11 g/dL at time of randomisation. Iron-restricted erythropoiesis as defined: Stainable iron in bone marrow (BM) combined with transferrin saturation (TSAT) ≤20%, or where the evaluation of stainable iron in BM is not possible or available: ferritin >30 ng/mL (women) or >40 ng/mL (men), and TSAT ≤20% Females of child-bearing potential must have a negative urine pregnancy test at screening. Before any study-specific procedure, the appropriate written informed consent must be obtained. Exclusion Criteria: Any anaemia treatment within 4 weeks prior to randomisation (including red blood cell transfusions, treatment with ESA or any oral/parenteral iron preparations). Anthracycline containing chemotherapy regimens. Subjects weighing <35 kg. Folate deficiency (serum-folate <4.5 nmol/L) and/or Vitamin B12 deficiency (serum-cobalamin <145 pmol/L). Ongoing haemolysis defined as serum-haptoglobin <0.2 g/L. Known chronic renal failure, glomerular filtration rate <30 mL/min/m2. Recent (within last 4 weeks) significant bleeding/surgery, defined as drop in Hb of ≥2 g/dL. Clinically relevant active inflammatory disease other than MM (according to the judgement of the Investigator). Clinically relevant ongoing infectious disease including known human immunodeficiency virus. Serum ferritin >600 ng/mL. Ongoing significant neurological or psychiatric disorders including psychotic disorders or dementia. Significant cardiovascular disease prior to study inclusion including myocardial infarction within 12 months prior to study inclusion, congestive heart failure New York Heart Association Grade III or IV, or poorly controlled hypertension according to the judgment of the Investigator. Elevation of liver enzymes (aspartate aminotransferase, alanine aminotransferase) over 3 times above the normal range or known acute hepatic disorder. Subject currently is enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(ies), or subject is receiving other investigational agent(s). Subject of child-bearing potential is evidently pregnant (e.g., positive human chorionic gonadotropin test) or is breast feeding. Subject is not using adequate contraceptive precautions. Adequate contraceptive precautions are defined as those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intra-uterine devices, sexual abstinence or vasectomised partner. Non-childbearing potential includes being surgically sterilised at least 6 months prior to the study or post-menopausal, defined as amenorrhea for at least 12 months. Subject has known sensitivity to any of the products to be administered during dosing. Subject will not be available for follow-up assessment. Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Katodritou Eirini, MD
Organizational Affiliation
Theagenion Hospital, Thessaloniki, Greece
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Timothy R Cushway
Organizational Affiliation
Vifor Pharma, CH-8152 Glattbrugg, Switzerland
Official's Role
Study Director
Facility Information:
Facility Name
Hopital Sud
City
Rennes
ZIP/Postal Code
35203
Country
France
Facility Name
Theagenion Cancer Center
City
Thessaloniki
ZIP/Postal Code
54007
Country
Greece

12. IPD Sharing Statement

Learn more about this trial

Ferric Carboxymaltose for Treatment of Anaemia of Cancer in Subjects With Multiple Myeloma Receiving Chemotherapy

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