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Early Response-adapted Intensification of Induction Chemotherapy in Patients With Newly Diagnosed Multiple Myeloma (MM) (KMM-97)

Primary Purpose

Multiple Myeloma

Status
Unknown status
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Thalidomide, cyclophosphamide, dexamethasone, bortezomib
Sponsored by
Chonnam National University Hospital
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring age under 65, Previous untreated

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Newly diagnosed MM
  2. Aged between 18 and 65 years old
  3. With following measurable lesions (serum M-protein ≥ 1 g/dL or urine M-protein ≥ 400 mg/day, or free light chain ≥ 100 mg/L)

Exclusion Criteria:

  1. Smoldering or indolent myeloma
  2. ECOG performance status > 3 point
  3. Known hypersensitivity to cyclophosphamide, thalidomide or dexamethasone
  4. Peripheral neuropathy or neuropathic pain Grade 2 or higher as defined by NCI CTCAE version 3
  5. Uncontrolled or severe cardiovascular disease, including MI within 6 months of enrolment, NYHA Class III or IV heart failure, uncontrolled angina, clinically significant pericardial disease, or cardiac amyloidosis, cardiac ejection fraction <0.5 : Severe conduction disorder : Hypotension (sitting systolic BP ≤ 100 mmHg and/or sitting diastolic BP ≤ 60 mmHg
  6. Impaired hepatic function (AST or ALT ≥ x 3 upper normal, T-bilirubin ≥ x 2 upper normal)
  7. Creatinine clearance < 20 ml/min
  8. Corrected serum calcium ≥ 14 mg/dL
  9. Sepsis or current active infection
  10. Pregnancy or breast feeding
  11. Uncontrolled Diabetes Mellitus
  12. Previous history of Recurrent DVT or pulmonary embolism
  13. Active ulcers detected by gastroscopy
  14. Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
  15. Receipt of extensive radiation therapy within 4 weeks

Sites / Locations

  • Chonnam National University Hwasun HospitalRecruiting

Outcomes

Primary Outcome Measures

response rate for induction chemotherapy

Secondary Outcome Measures

Full Information

First Posted
April 28, 2010
Last Updated
September 21, 2011
Sponsor
Chonnam National University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT01114048
Brief Title
Early Response-adapted Intensification of Induction Chemotherapy in Patients With Newly Diagnosed Multiple Myeloma (MM)
Acronym
KMM-97
Official Title
Early Response-adapted Intensification of Induction Chemotherapy in Patients With Newly Diagnosed Multiple Myeloma (MM) Who Are Eligible for Autologous Stem Cell Transplantation: Multicenter Phase 2 Study
Study Type
Interventional

2. Study Status

Record Verification Date
September 2011
Overall Recruitment Status
Unknown status
Study Start Date
March 2010 (undefined)
Primary Completion Date
March 2012 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Chonnam National University Hospital

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In this study, the investigators will analyze the long-term outcomes of remission and survival, and identify those with primary resistant disease as more likely to benefit from CTD (thalidomide, cyclophosphamide, dexamethasone) and early intensification of Vel-CD (bortezomib and CD) as induction chemotherapy followed by autologous stem cell transplantation for the patients with newly diagnosed multiple myeloma.
Detailed Description
This study aims to assess the efficacy and toxicities of CTD and Vel-CD induction followed by high-dose therapy with autologous stem cell transplantation as a first line treatment for the patients with multiple myeloma.The investigators already investigated the thalidomide-based chemotherapy in patients with newly diagnosed MM. The combined regimen consisted of cyclophosphamide, thalidomide and dexamethasone (CTD) for induction treatment. CTD chemotherapy resulted in a favorable response with 79.4% overall response rate including 42.6% complete response (CR) or very good partial complete response (VGPR), and tolerable toxicity in MM patients. Moreover, CTD chemotherapy did not affect the yield of the stem cell collection.The investigators also published that the clinical efficacy and safety of a four-drug combination of bortezomib, cyclophosphamide, thalidomide, and dexamethasone was assessed for patients with relapsed or refractory multiple myeloma Vel-CTD chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
age under 65, Previous untreated

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
78 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Thalidomide, cyclophosphamide, dexamethasone, bortezomib
Intervention Description
Induction therapy with CTD regimen for 4 cycles Thalidomide 50-100 mg P.O. HS D 1~28 Cyclophosphamide 150 mg/m² P.O. D 1~4 Dexamethasone 20 mg/ m² IV or P.O. D 1~4, 15-18 Repeated every 28 days Intensification with Vel-CD regimen for 4 cycles (patients who fail to achieve more than PR after 2 cycles of CTD) Velcade 1.3 mg/m2 IV D1, 4, 8, 11 Cyclophosphamide 150 mg/m² P.O. D 1~4 Dexamethasone 20 mg/ m² IV or P.O. D1, 4, 8, 11 Repeated every 21 days Bactrim prophylaxis during dexamethasone administration Acyclovir prophylaxis during velcade administration Aspirin medication during thalidomide administration
Primary Outcome Measure Information:
Title
response rate for induction chemotherapy
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Newly diagnosed MM Aged between 18 and 65 years old With following measurable lesions (serum M-protein ≥ 1 g/dL or urine M-protein ≥ 400 mg/day, or free light chain ≥ 100 mg/L) Exclusion Criteria: Smoldering or indolent myeloma ECOG performance status > 3 point Known hypersensitivity to cyclophosphamide, thalidomide or dexamethasone Peripheral neuropathy or neuropathic pain Grade 2 or higher as defined by NCI CTCAE version 3 Uncontrolled or severe cardiovascular disease, including MI within 6 months of enrolment, NYHA Class III or IV heart failure, uncontrolled angina, clinically significant pericardial disease, or cardiac amyloidosis, cardiac ejection fraction <0.5 : Severe conduction disorder : Hypotension (sitting systolic BP ≤ 100 mmHg and/or sitting diastolic BP ≤ 60 mmHg Impaired hepatic function (AST or ALT ≥ x 3 upper normal, T-bilirubin ≥ x 2 upper normal) Creatinine clearance < 20 ml/min Corrected serum calcium ≥ 14 mg/dL Sepsis or current active infection Pregnancy or breast feeding Uncontrolled Diabetes Mellitus Previous history of Recurrent DVT or pulmonary embolism Active ulcers detected by gastroscopy Serious medical or psychiatric illness likely to interfere with participation in this clinical study. Receipt of extensive radiation therapy within 4 weeks
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Je-Jung Lee, M.D. and Ph.D.
Phone
82-61-3797638
Email
drjejung@chonnam.ac.kr
First Name & Middle Initial & Last Name or Official Title & Degree
Deok-Hwan Yang, M.D. and Ph.D.
Phone
82-61-3797636
Email
drydh1685@gmail.com
Facility Information:
Facility Name
Chonnam National University Hwasun Hospital
City
Hwasun-gun
State/Province
Jeollanam-do
ZIP/Postal Code
519-809
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Je-Jung Lee, M.D. and Ph.D.

12. IPD Sharing Statement

Learn more about this trial

Early Response-adapted Intensification of Induction Chemotherapy in Patients With Newly Diagnosed Multiple Myeloma (MM)

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