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Study of Lenalidomide and Low-Dose Dexamethasone in Chinese Subjects With Relapsed/Refractory Multiple Myeloma

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Lenalidomide
Dexamethasone
Sponsored by
Celgene
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Efficacy/Safety, Lenalidomide and Low-Dose Dexamethasone, Chinese Subjects, Relapsed/Refractory Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  1. Understand and voluntarily sign informed consent form
  2. Age ≥ 18 years at the time of signing consent
  3. Prior or current diagnosis of Durie-Salmon Stage II or III multiple myeloma AND have disease progression after at least 2 cycles of systemic anti-myeloma treatment or have relapsed with progressive disease after treatment.
  4. Measurable levels of myeloma paraprotein in serum (≥ 0.5 g/dL [5 g/L] or urine (≥ 0.2 g excreted in a 24-hour collection sample).
  5. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
  6. Able to adhere to the study visit schedule and other protocol requirements.
  7. Must agree to comply to Lenalidomide Pregnancy Prevention Risk Management Plan requirements.

Exclusion Criteria

  1. Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
  2. Subjects with non-secretory multiple myeloma by Serum Protein Electrophoresis (SPEP) and Urine Protein Electrophoresis (UPEP) assessment.
  3. Pregnant or lactating females
  4. Any of the following laboratory abnormalities:

    • Absolute neutrophil count of < 1000 cells/mm3 (1.0 X 109/L)
    • Platelet count < 50,000/mm3 (50 X 109/L) in subjects in whom < 50% of the bone marrow nucleated cells were plasma cells
    • Renal failure requiring dialysis or peritoneal dialysis
    • Serum glutamic oxaloacetic transaminase, (SGOT)/ Aspartate-Aminotransferase (AST) > 3.0 x upper limit of normal (ULN)
    • Serum total bilirubin > 2.0 mg/dL (34μmol/L)
  5. Any condition, including the presence of laboratory abnormalities, which placed subject at unacceptable risk if participating in the study or which would confound the ability to interpret study data.
  6. Significant active cardiac disease within the previous 6 months.
  7. Prior history of malignancies, other than multiple myeloma, unless the subject has been free of disease for ≥ 3 years. Exceptions include the following:

    • Basal cell carcinoma of the skin
    • Carcinoma in situ of the cervix
    • Carcinoma in situ of the breast
    • Squamous cell carcinoma of the skin
  8. Incidental histologic finding of prostate cancer (Tumor, Node, and Metastasis [TNM] stage of T1a or T1b)
  9. Known hypersensitivity to thalidomide or dexamethasone
  10. Prior history of uncontrollable side effects to dexamethasone therapy
  11. Peripheral neuropathy ≥ grade 2
  12. Prior use of lenalidomide
  13. Use of any standard/experimental anti-myeloma drug therapy within 28 days of the start of study drug or use of any experimental non-drug therapy (e.g. donor leukocyte/mononuclear cell infusion) within 56 days of the start of study drug)
  14. Unable or unwilling to undergo antithrombotic therapy
  15. History of deep vein thrombosis (DVT) or pulmonary emboli (PE) within the past 12 months
  16. Known HIV positivity
  17. Active infectious hepatitis A, B, or C or chronic carriers of hepatitis B with hepatitis B surface antigen (HBsAG) positive or if the hepatitis B viral deoxyribonucleic acid (HBV DNA) level is detectable by polymerase chain reaction (PCR).

Sites / Locations

  • 307 Hospital of Chinese PLA
  • Peking University Third Hospital
  • Peking Union Medical College Hospital
  • Chinese PLA General Hospital
  • Xiangya Hospital of Central- South University
  • Guangdong General Hospital
  • Nanfang Hospital of Southern Medical University
  • The First Hospital Affiliated of College Medicine, Zhejiang University
  • The First Hospital Affiliated of College Medicine, Zhejiang University
  • Shanghai Changzheng Hospital
  • Shanghai 6th People's Hospital
  • Changhai Hospital
  • The First Affiliated Hospital of Soochow University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lenalidomide and dexamethasone

Arm Description

Cycle 1: 25 mg oral lenalidomide once daily on Days 1-21 every 28 Days and 40 mg oral dexamethasone on Days 8, 15, and 22. Cycle 2 and beyond: 25 oral lenalidomide once daily on Days 1-21 every 28 days and 40 mg oral dexamethasone once daily on Days 1, 8, 15, and 22.

Outcomes

Primary Outcome Measures

Overall Response Rate
Complete Response (CR) or partial Response (PR) using the European Group for Blood and Marrow Transplantation (EBMT) (Bladé) criteria.

Secondary Outcome Measures

Adverse Events
Number of participants with Adverse Events
Progression Free Survival (PFS)
Number of participants who survive without progressing by the EBMT (Bladé) criteria
Overall Survival
Number of participants alive
Response duration
Length of time participants respond
Maximum observed concentration in plasma
Pharmacokinetics - Cmax
Area under the plasma concentration-time curve
Pharmacokinetics - AUC
Time to maximum concentration
PK- Tmax
Terminal half-life
Pharmacokinetics - T1/2
Apparent total body clearance
Pharmacokinetics - CL/F
Apparent volume of distribution
Pharmacokinetics - Vz/F

Full Information

First Posted
May 4, 2012
Last Updated
September 18, 2017
Sponsor
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT01593410
Brief Title
Study of Lenalidomide and Low-Dose Dexamethasone in Chinese Subjects With Relapsed/Refractory Multiple Myeloma
Official Title
A Multi-center, Open-Label Phase II Study to Determine the Efficacy and Safety of Lenalidomide Plus Low-Dose Dexamethasone in Chinese Subjects With Relapsed/Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
August 1, 2010 (Actual)
Primary Completion Date
January 3, 2013 (Actual)
Study Completion Date
January 3, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Celgene

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the efficacy of lenalidomide plus low-dose dexamethasone in Chinese subjects with relapsed or refractory multiple myeloma. Even though the efficacy and safety of lenalidomide has already been well-demonstrated in other populations including Asians, this study will assess the efficacy and safety as well as pharmacokinetics of lenalidomide in Chinese subjects. In addition, this study will generate clinically meaningful information in guiding the therapeutic use of lenalidomide for Chinese subjects.
Detailed Description
This is a Phase II, multicenter, single arm, open-label trial which will enroll Chinese subjects in China with relapsed/refractory multiple myeloma that will assess the efficacy and safety of lenalidomide plus low-dose dexamethasone regimen (Rd) given until progressive disease (PD) or discontinuation of lenalidomide for any reason. There are two cohorts in this protocol, Pharmacokinetic Assessment Treatment Cohort and Treatment Cohort without Pharmacokinetic (PK) Assessment. The first 10 subjects who are ≤ 75 years old and have a baseline Creatinine Clearance ≥ 60 mL/min will participate in pharmacokinetic assessment during the first 8 days of Cycle 1. During this cohort, all subjects will receive 25mg oral lenalidomide once daily on days 1 -21 of each 28-day cycle. During the first cycle of this cohort, subjects will also receive 40mg oral dexamethasone daily on Days 8, 15, and 22 (and no dexamethasone on day 1). Beginning with Cycle 2, subjects will receive 25mg oral lenalidomide once daily on days 1 -21 of each 28-day cycle and 40mg oral dexamethasone daily on Days 1, 8, 15 and 22 of each 28-day cycle. Once 10 subjects have been enrolled in the PK Assessment Treatment Cohort, the Treatment Cohort without PK Assessment will begin. During this cohort, subjects will receive lenalidomide 25 mg p.o. once daily on Days 1-21 and dexamethasone 40 mg p.o. once daily on Days 1, 8, 15, and 22 of each 28-day cycle. In both cohorts, subjects will continue Rd therapy until the documentation of PD or discontinuation of study therapy due to any reason including intolerable toxicity. For the primary analysis, response will be assessed according to the European Group for Blood and Marrow Transplantation EBMT (Bladé) criteria by an Independent Response Adjudication Committee (IRAC). Response will also be assessed according to the International Myeloma Working Group (IMWG) criteria and used as an exploratory analysis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Efficacy/Safety, Lenalidomide and Low-Dose Dexamethasone, Chinese Subjects, Relapsed/Refractory Multiple Myeloma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Lenalidomide and dexamethasone
Arm Type
Experimental
Arm Description
Cycle 1: 25 mg oral lenalidomide once daily on Days 1-21 every 28 Days and 40 mg oral dexamethasone on Days 8, 15, and 22. Cycle 2 and beyond: 25 oral lenalidomide once daily on Days 1-21 every 28 days and 40 mg oral dexamethasone once daily on Days 1, 8, 15, and 22.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Other Intervention Name(s)
Revlimid
Intervention Description
25 mg oral lenalidomide once daily on Days 1-21 every 28 days
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
Cycle 1: 40 mg oral dexamethasone once daily on Days 8, 15, and 22. Cycle 2 and beyond: 40 mg oral dexamethasone once daily on Days 1, 8, 15, and 22
Primary Outcome Measure Information:
Title
Overall Response Rate
Description
Complete Response (CR) or partial Response (PR) using the European Group for Blood and Marrow Transplantation (EBMT) (Bladé) criteria.
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Adverse Events
Description
Number of participants with Adverse Events
Time Frame
Up to 24 months
Title
Progression Free Survival (PFS)
Description
Number of participants who survive without progressing by the EBMT (Bladé) criteria
Time Frame
Up to 24 months
Title
Overall Survival
Description
Number of participants alive
Time Frame
Up to 24 months
Title
Response duration
Description
Length of time participants respond
Time Frame
Up to 24 months
Title
Maximum observed concentration in plasma
Description
Pharmacokinetics - Cmax
Time Frame
Days 1, 2, 7, 8, and 9 of Cycle 1
Title
Area under the plasma concentration-time curve
Description
Pharmacokinetics - AUC
Time Frame
Days 1, 2, 7, 8, and 9 of Cycle 1
Title
Time to maximum concentration
Description
PK- Tmax
Time Frame
Days 1, 2, 7, 8, and 9 of Cycle 1
Title
Terminal half-life
Description
Pharmacokinetics - T1/2
Time Frame
Days 1, 2, 7, 8, and 9 of Cycle 1
Title
Apparent total body clearance
Description
Pharmacokinetics - CL/F
Time Frame
Days 1, 2, 7, 8, and 9 of Cycle 1
Title
Apparent volume of distribution
Description
Pharmacokinetics - Vz/F
Time Frame
Days 1, 2, 7, 8, and 9 of Cycle 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Understand and voluntarily sign informed consent form Age ≥ 18 years at the time of signing consent Prior or current diagnosis of Durie-Salmon Stage II or III multiple myeloma AND have disease progression after at least 2 cycles of systemic anti-myeloma treatment or have relapsed with progressive disease after treatment. Measurable levels of myeloma paraprotein in serum (≥ 0.5 g/dL [5 g/L] or urine (≥ 0.2 g excreted in a 24-hour collection sample). Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. Able to adhere to the study visit schedule and other protocol requirements. Must agree to comply to Lenalidomide Pregnancy Prevention Risk Management Plan requirements. Exclusion Criteria Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study. Subjects with non-secretory multiple myeloma by Serum Protein Electrophoresis (SPEP) and Urine Protein Electrophoresis (UPEP) assessment. Pregnant or lactating females Any of the following laboratory abnormalities: Absolute neutrophil count of < 1000 cells/mm3 (1.0 X 109/L) Platelet count < 50,000/mm3 (50 X 109/L) in subjects in whom < 50% of the bone marrow nucleated cells were plasma cells Renal failure requiring dialysis or peritoneal dialysis Serum glutamic oxaloacetic transaminase, (SGOT)/ Aspartate-Aminotransferase (AST) > 3.0 x upper limit of normal (ULN) Serum total bilirubin > 2.0 mg/dL (34μmol/L) Any condition, including the presence of laboratory abnormalities, which placed subject at unacceptable risk if participating in the study or which would confound the ability to interpret study data. Significant active cardiac disease within the previous 6 months. Prior history of malignancies, other than multiple myeloma, unless the subject has been free of disease for ≥ 3 years. Exceptions include the following: Basal cell carcinoma of the skin Carcinoma in situ of the cervix Carcinoma in situ of the breast Squamous cell carcinoma of the skin Incidental histologic finding of prostate cancer (Tumor, Node, and Metastasis [TNM] stage of T1a or T1b) Known hypersensitivity to thalidomide or dexamethasone Prior history of uncontrollable side effects to dexamethasone therapy Peripheral neuropathy ≥ grade 2 Prior use of lenalidomide Use of any standard/experimental anti-myeloma drug therapy within 28 days of the start of study drug or use of any experimental non-drug therapy (e.g. donor leukocyte/mononuclear cell infusion) within 56 days of the start of study drug) Unable or unwilling to undergo antithrombotic therapy History of deep vein thrombosis (DVT) or pulmonary emboli (PE) within the past 12 months Known HIV positivity Active infectious hepatitis A, B, or C or chronic carriers of hepatitis B with hepatitis B surface antigen (HBsAG) positive or if the hepatitis B viral deoxyribonucleic acid (HBV DNA) level is detectable by polymerase chain reaction (PCR).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jay Mei, M.D.
Organizational Affiliation
Celgene
Official's Role
Study Director
Facility Information:
Facility Name
307 Hospital of Chinese PLA
City
Beijing
ZIP/Postal Code
100071
Country
China
Facility Name
Peking University Third Hospital
City
Beijing
ZIP/Postal Code
100081
Country
China
Facility Name
Peking Union Medical College Hospital
City
Beijing
ZIP/Postal Code
100730
Country
China
Facility Name
Chinese PLA General Hospital
City
Beijing
ZIP/Postal Code
300200
Country
China
Facility Name
Xiangya Hospital of Central- South University
City
Changsha
ZIP/Postal Code
410008
Country
China
Facility Name
Guangdong General Hospital
City
Guangzhou
ZIP/Postal Code
510080
Country
China
Facility Name
Nanfang Hospital of Southern Medical University
City
Guangzhou
ZIP/Postal Code
510515
Country
China
Facility Name
The First Hospital Affiliated of College Medicine, Zhejiang University
City
Hangzhou
ZIP/Postal Code
310003
Country
China
Facility Name
The First Hospital Affiliated of College Medicine, Zhejiang University
City
Hangzhou
ZIP/Postal Code
310009
Country
China
Facility Name
Shanghai Changzheng Hospital
City
Shanghai
ZIP/Postal Code
200003
Country
China
Facility Name
Shanghai 6th People's Hospital
City
Shanghai
ZIP/Postal Code
200233
Country
China
Facility Name
Changhai Hospital
City
Shanghai
ZIP/Postal Code
200433
Country
China
Facility Name
The First Affiliated Hospital of Soochow University
City
Suzhou
ZIP/Postal Code
215006
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
23782711
Citation
Hou J, Du X, Jin J, Cai Z, Chen F, Zhou DB, Yu L, Ke X, Li X, Wu D, Meng F, Ai H, Zhang J, Wortman-Vayn H, Chen N, Mei J, Wang J. A multicenter, open-label, phase 2 study of lenalidomide plus low-dose dexamethasone in Chinese patients with relapsed/refractory multiple myeloma: the MM-021 trial. J Hematol Oncol. 2013 Jun 19;6:41. doi: 10.1186/1756-8722-6-41.
Results Reference
background
Links:
URL
http://www.celgene.com/research-development/clinical-trials/clinical-trials-data-sharing/clinical-study-report-csr-synopses/purposes-of-posting-clinical-study-report-csr-synopses
Description
Link to CSR synopsis

Learn more about this trial

Study of Lenalidomide and Low-Dose Dexamethasone in Chinese Subjects With Relapsed/Refractory Multiple Myeloma

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