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Bendamustine Plus Bortezomib Plus Dexamethasone in Relapsed or Refractory Multiple Myeloma (BBD)

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
bendamustine plus bortezomib plus dexamethasone
Sponsored by
Austrian Forum Against Cancer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring multiple myeloma, bendamustine, bortezomib, dexamethasone

Eligibility Criteria

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

Inclusion Criteria:

  • Age min. 18 years at the time of signing the informed consent form
  • Life expectancy of at least 3 months
  • Able to adhere to the study visit schedule and other protocol requirements
  • Measurable disease, defined as any quantifiable monoclonal protein value, defined by at least one of the following three measurements: Serum M-protein ≥ 10g/l; Urine light-chain (M-protein) of ≥ 200 mg/24 hours; Serum FLC assay: involved FLC level ≥10 mg/dl provided sFLC ratio is abnormal
  • Relapsed or refractory MM in stage II or III after autologous SCT or conventional chemotherapy (histologically or cytologically proven/ Salmon and Durie criteria) in need of therapy
  • All previous cancer therapy, including cytostatic therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study, except corticosteroid therapy (dosage 40 to max. 160mg). Localised radiation therapy is allowed, but the increased risk of leukocytopenia, erythrocytopenia and thrombocytopenia based on the combination of a polychemotherapy and radiation therapy has to be considered and a close monitoring of the patients has to be assured.
  • ECOG performance status of 0-2 at study entry
  • Laboratory test results within these ranges:

    • Absolute neutrophil count min. 1.5 x 109/L
    • Platelet count min. 75 x 109/L
    • Total bilirubin max. 1.5 mg/dL
    • AST (SGOT) and ALT (SGPT) max. 2 x ULN or max. 5 x ULN if hepatic lesions are present.
  • Disease free of prior malignancies for min. 5 years with exception of curatively treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast
  • Fertile patients must use effective contraception during and for 6 months after study treatment

No study treatment or any other procedure within the framework of the trial (except for screening) will be performed in any patient prior to receipt of written informed consent.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
  • Pregnant or breast feeding females
  • Any condition, including 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.
  • Peripheral neuropathy or neuropathic pain of grade 2 or greater intensity, as defined by NCI CTCAE, version 3.0.
  • Use of any other experimental drug or therapy within 28 days of pre-study visit.
  • Known hypersensitivity to the study drugs
  • Any prior use of bortezomib or bendamustine in the last six months
  • Concurrent use of other anti-cancer agents or treatments other than those stated in this treatment plan
  • Known positive for HIV or infectious hepatitis, type A, B or C
  • Active, uncontrolled infections
  • Acute diffuse infiltrative pulmonary disease and pericardial disease.

Sites / Locations

  • Medical University Hospital Graz
  • Hospital Elisabethinen Linz
  • LKH Salzburg, 3rd Med. Dept.
  • Med. University Vienna, Clinic for Internal Medicine 1 (Hematology and Hemostaseology)
  • Hanusch Hospital Vienna
  • Wilhelminenspital Vienna
  • Clinic Wels-Grieskirchen, 4th Internal Dept.
  • Faculty Hospital Brno

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

single arm bendamustine bortezomib dexamethasone

Arm Description

single arm combination regimen: bendamustine - bortezomib- dexamethasone

Outcomes

Primary Outcome Measures

efficacy
evaluation of the overall response rate (sCR + CR + VGPR + PR + MR)

Secondary Outcome Measures

efficacy and safety
assessment of progression-free survival, overall survival, time to maximum response and toxicity

Full Information

First Posted
July 22, 2010
Last Updated
November 21, 2013
Sponsor
Austrian Forum Against Cancer
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1. Study Identification

Unique Protocol Identification Number
NCT01168804
Brief Title
Bendamustine Plus Bortezomib Plus Dexamethasone in Relapsed or Refractory Multiple Myeloma
Acronym
BBD
Official Title
Bendamustine Plus Bortezomib Plus Dexamethasone in the Treatment of Stage II/III Relapsed or Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2013
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
May 2013 (Actual)
Study Completion Date
May 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Austrian Forum Against Cancer

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate efficacy and safety of the combination regimen of bortezomib-bendamustine-dexamethasone in patients with relapsed or refractory multiple myeloma
Detailed Description
After relapse after or early progression on first-line treatment the prognosis of multiple myeloma patients is unfavourable, with no remaining chance for cure. Therefore the search for new treatment regimens, including drugs with novel, and different, mechanisms of action is mandatory. Both bendamustine and bortezomib are not yet established parts of standard first-line regimens, but showed to have high activity both in chemo-naïve and pre-treated patients. The novel mechanism of action of the proteasome inhibitor and the non-cross resistance of bendamustine to other alkylating agents established in the first-line treatment of multiple myeloma seem to recommend a combination of the two drugs for salvage therapy. The promising response data in a series of relapsing MM patients treated with bendamustine, bortezomib and prednisone support this assumption, as well as the feasibility and tolerability of the combination. In summary, there is some evidence for a favourable risk/benefit ratio for the combination of bendamustine, bortezomib and a glucocorticoid drug, warranting the exploration in a larger, prospectively designed multicenter phase II study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
multiple myeloma, bendamustine, bortezomib, dexamethasone

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
single arm bendamustine bortezomib dexamethasone
Arm Type
Experimental
Arm Description
single arm combination regimen: bendamustine - bortezomib- dexamethasone
Intervention Type
Drug
Intervention Name(s)
bendamustine plus bortezomib plus dexamethasone
Intervention Description
Bendamustine 70 mg/m2 on days 1+4 Velcade 1.3 mg/m2 on days 1,4,8,11 Dexamethasone 20 mg on days 1,4,8 and 11 Repeated every 4 weeks
Primary Outcome Measure Information:
Title
efficacy
Description
evaluation of the overall response rate (sCR + CR + VGPR + PR + MR)
Time Frame
8 cycles à 28 days plus follow-up phase
Secondary Outcome Measure Information:
Title
efficacy and safety
Description
assessment of progression-free survival, overall survival, time to maximum response and toxicity
Time Frame
8 cycles à 28 days plus follow-up phase

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age min. 18 years at the time of signing the informed consent form Life expectancy of at least 3 months Able to adhere to the study visit schedule and other protocol requirements Measurable disease, defined as any quantifiable monoclonal protein value, defined by at least one of the following three measurements: Serum M-protein ≥ 10g/l; Urine light-chain (M-protein) of ≥ 200 mg/24 hours; Serum FLC assay: involved FLC level ≥10 mg/dl provided sFLC ratio is abnormal Relapsed or refractory MM in stage II or III after autologous SCT or conventional chemotherapy (histologically or cytologically proven/ Salmon and Durie criteria) in need of therapy All previous cancer therapy, including cytostatic therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study, except corticosteroid therapy (dosage 40 to max. 160mg). Localised radiation therapy is allowed, but the increased risk of leukocytopenia, erythrocytopenia and thrombocytopenia based on the combination of a polychemotherapy and radiation therapy has to be considered and a close monitoring of the patients has to be assured. ECOG performance status of 0-2 at study entry Laboratory test results within these ranges: Absolute neutrophil count min. 1.5 x 109/L Platelet count min. 75 x 109/L Total bilirubin max. 1.5 mg/dL AST (SGOT) and ALT (SGPT) max. 2 x ULN or max. 5 x ULN if hepatic lesions are present. Disease free of prior malignancies for min. 5 years with exception of curatively treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast Fertile patients must use effective contraception during and for 6 months after study treatment No study treatment or any other procedure within the framework of the trial (except for screening) will be performed in any patient prior to receipt of written informed consent. Exclusion Criteria: Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form Pregnant or breast feeding females Any condition, including 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. Peripheral neuropathy or neuropathic pain of grade 2 or greater intensity, as defined by NCI CTCAE, version 3.0. Use of any other experimental drug or therapy within 28 days of pre-study visit. Known hypersensitivity to the study drugs Any prior use of bortezomib or bendamustine in the last six months Concurrent use of other anti-cancer agents or treatments other than those stated in this treatment plan Known positive for HIV or infectious hepatitis, type A, B or C Active, uncontrolled infections Acute diffuse infiltrative pulmonary disease and pericardial disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heinz P. Ludwig, Univ. Prof.
Organizational Affiliation
Wilhelminenspital Vienna
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University Hospital Graz
City
Graz
ZIP/Postal Code
8036
Country
Austria
Facility Name
Hospital Elisabethinen Linz
City
Linz
ZIP/Postal Code
4010
Country
Austria
Facility Name
LKH Salzburg, 3rd Med. Dept.
City
Salzburg
ZIP/Postal Code
5020
Country
Austria
Facility Name
Med. University Vienna, Clinic for Internal Medicine 1 (Hematology and Hemostaseology)
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Facility Name
Hanusch Hospital Vienna
City
Vienna
ZIP/Postal Code
1140
Country
Austria
Facility Name
Wilhelminenspital Vienna
City
Vienna
ZIP/Postal Code
1160
Country
Austria
Facility Name
Clinic Wels-Grieskirchen, 4th Internal Dept.
City
Wels
ZIP/Postal Code
4600
Country
Austria
Facility Name
Faculty Hospital Brno
City
Brno
ZIP/Postal Code
63900
Country
Czech Republic

12. IPD Sharing Statement

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Bendamustine Plus Bortezomib Plus Dexamethasone in Relapsed or Refractory Multiple Myeloma

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