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A Safety Study of Carfilzomib, Cyclophosphamide & Dexamethasone Prior to ASCT in Patients With Newly Diagnosed Myeloma (11-MM-01)

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Carfilzomib
Cyclophosphamide
Dexamethasone
Sponsored by
Criterium, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring newly diagnosed multiple myeloma, transplant eligible multiple myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Cytopathologically or histologically confirmed diagnosis of MM
  • Measurable disease, as indicated by one or more of the following:
  • Serum M-protein ≥ 1.0 g/dL
  • Urine Bence Jones protein ≥ 200 mg/24 hr
  • Elevated Free Light Chain as per the International Myeloma Working Group (IMWG) criteria
  • Males and females ≥ 18 years of age
  • Life expectancy of more than 5 months
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
  • Adequate hepatic function, with bilirubin < 2 times the upper limit of normal (ULN), and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3.5 times ULN
  • Serum Creatinine Clearance(CrCl) ≥ 30 mL/min, either measured or calculated using a standard formula (e.g. Cockcroft and Gault)
  • Additional Laboratory Requirements
  • Absolute neutrophil count (ANC) ≥1.0 x 109/L
  • Hemoglobin ≥8 g/dL [transfusion permitted]
  • Platelet count ≥50.0 x 109/L
  • Screening ANC should be independent of granulocyte-and granulocyte/macrophage colony stimulating factor (G-CSF and GM-CSF) support for at least 1 week and of pegylated G-CSF for at least 2 weeks
  • Patients may receive RBC or platelet transfusions, if clinically indicated, in accordance with institutional guidelines
  • Written informed consent in accordance with federal, local, and institutional guidelines
  • Patients must agree to practice contraception
  • Male patients must agree not to donate semen or sperm.

Exclusion Criteria:

  • Patients with non-secretory or hyposecretory MM
  • Prior treatment for MM (prior radiation therapy or dexamethasone up to 160 mg for spinal cord compression is allowed. Other limited field radiation involving ≤ 1/3 of the pelvic area is also allowed)
  • Plasma cell leukemia
  • Pregnant or lactating females
  • Major surgery within 21 days prior to first dose
  • Congestive heart failure (CHF) (New York Heart Association class III to IV), symptomatic ischemia, conduction abnormalities uncontrolled by conventional intervention or myocardial infarction in the previous six months
  • Acute active infection requiring systemic antibiotics, antivirals, or antifungals within 14 days prior to first dose
  • Patients receiving active treatment or intervention for any other malignancy or patients who, at the Investigator's discretion, may require active treatment or intervention for any other malignancy within 8 months of starting study treatment.
  • Serious psychiatric or medical conditions that could interfere with treatment
  • Significant neuropathy (Grade 3, Grade 4, or Grade 2 with pain) at the time of the first dose and/or within 14 days before study treatment
  • Contraindication to any of the required concomitant drugs, including antiviral (e.g. Valacyclovir) and proton-pump inhibitor (e.g. lansoprazole). Corticosteroid therapy in a dose equivalent to dexamethasone ≥ 1.5 mg/day or prednisone ≥ 10 mg/day. (Steroid use is allowed if necessary to treat spinal cord compression and/or hypocalcaemia.)
  • Patients in whom the required program of oral and IV fluid hydration is contraindicated, e.g. due to pre-existing pulmonary, cardiac, or renal impairment
  • Patients with primary systemic amyloidosis.

Sites / Locations

  • Samuel Oschin Comprehensive Cancer Center at Cedars-Sinai Medical Center
  • Comprehensive Cancer Center at Desert Regional Medical Center
  • University of Massachusettes Memorial
  • Duke University Medical Center
  • Fred Hutchinson Cancer Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Carfilzomib, Cyclophosphamide, Dexamethasone

Arm Description

All eligible subjects will receive Carfilzomib, Cyclophosphamide, and Dexamethasone.

Outcomes

Primary Outcome Measures

Adverse Events as a measure of safety and tolerability
Review of adverse events for safety and to determine the maximum tolerated dose of the combination treatment.

Secondary Outcome Measures

Overall Response after induction therapy
Overall response (PR, VGPR, CR, sCR)
Overall Response post ASCT
Overall Response (PR, VGPR, CR, sCR) at 3 and 6 months post ASCT.
Time to Progression
Time to progression will be noted if it occurs within 6 months post ASCT.
Progression Free Survival
Time to Next Therapy
Time to Next Therapy if occurs within 6 months post ASCT

Full Information

First Posted
August 7, 2012
Last Updated
October 16, 2017
Sponsor
Criterium, Inc.
Collaborators
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT01660750
Brief Title
A Safety Study of Carfilzomib, Cyclophosphamide & Dexamethasone Prior to ASCT in Patients With Newly Diagnosed Myeloma
Acronym
11-MM-01
Official Title
A Multi-Center Phase Ib, Open-Label, Dose-Finding Pilot Study to Evaluate the Combination of Carfilzomib and Cyclophosphamide With Dexamethasone Prior to ASCT in Patients With Transplant Eligible Newly Diagnosed Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
January 2013 (undefined)
Primary Completion Date
August 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Criterium, Inc.
Collaborators
Amgen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a dose finding pilot study to evaluate the safety and determine the maximum tolerated dose of the combination of carfilzomib and cyclophosphamide with dexamethasone (Car-Cy-Dex) prior to autologous stem cell transplant (ASCT) in patients with newly diagnosed transplant eligible multiple myeloma.
Detailed Description
This is a dose finding pilot study to evaluate the safety and determine the maximum tolerated dose of the combination of carfilzomib and cyclophosphamide with dexamethasone (Car-Cy-Dex) prior to autologous stem cell transplant (ASCT) in patients with newly diagnosed transplant eligible multiple myeloma. The study will also explore the efficacy of Car-Cy-Dex including overall response after induction therapy, overall response at 3 and 6 months post ASCT, and time to progression, progression free survival, and time to next therapy if it occurs within 6 months post ASCT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
newly diagnosed multiple myeloma, transplant eligible multiple myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
29 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Carfilzomib, Cyclophosphamide, Dexamethasone
Arm Type
Experimental
Arm Description
All eligible subjects will receive Carfilzomib, Cyclophosphamide, and Dexamethasone.
Intervention Type
Drug
Intervention Name(s)
Carfilzomib
Other Intervention Name(s)
PR-171, Kyprolis
Intervention Description
IV over 30 minutes on Days 1,2,8,9,15, and 16 every 28 days
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
Cytoxan
Intervention Description
PO on days 1, 8, and 15 every 28 days
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Other Intervention Name(s)
Decadron
Intervention Description
40 mg weekly PO or IV on Days 1, 8, 15, and 22, every 28 days.
Primary Outcome Measure Information:
Title
Adverse Events as a measure of safety and tolerability
Description
Review of adverse events for safety and to determine the maximum tolerated dose of the combination treatment.
Time Frame
Throughout treatment, estimated to be 4-6 months per patients
Secondary Outcome Measure Information:
Title
Overall Response after induction therapy
Description
Overall response (PR, VGPR, CR, sCR)
Time Frame
Every 28 days during induction therapy, estimated to be 4-6 months
Title
Overall Response post ASCT
Description
Overall Response (PR, VGPR, CR, sCR) at 3 and 6 months post ASCT.
Time Frame
3 and 6 months post ASCT
Title
Time to Progression
Description
Time to progression will be noted if it occurs within 6 months post ASCT.
Time Frame
Througout treatment and 3 and 6 months post ASCT
Title
Progression Free Survival
Time Frame
up to 6 months post ASCT
Title
Time to Next Therapy
Description
Time to Next Therapy if occurs within 6 months post ASCT
Time Frame
up to 6 months post ASCT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Cytopathologically or histologically confirmed diagnosis of MM Measurable disease, as indicated by one or more of the following: Serum M-protein ≥ 1.0 g/dL Urine Bence Jones protein ≥ 200 mg/24 hr Elevated Free Light Chain as per the International Myeloma Working Group (IMWG) criteria Males and females ≥ 18 years of age Life expectancy of more than 5 months Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 Adequate hepatic function, with bilirubin < 2 times the upper limit of normal (ULN), and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3.5 times ULN Serum Creatinine Clearance(CrCl) ≥ 30 mL/min, either measured or calculated using a standard formula (e.g. Cockcroft and Gault) Additional Laboratory Requirements Absolute neutrophil count (ANC) ≥1.0 x 109/L Hemoglobin ≥8 g/dL [transfusion permitted] Platelet count ≥50.0 x 109/L Screening ANC should be independent of granulocyte-and granulocyte/macrophage colony stimulating factor (G-CSF and GM-CSF) support for at least 1 week and of pegylated G-CSF for at least 2 weeks Patients may receive RBC or platelet transfusions, if clinically indicated, in accordance with institutional guidelines Written informed consent in accordance with federal, local, and institutional guidelines Patients must agree to practice contraception Male patients must agree not to donate semen or sperm. Exclusion Criteria: Patients with non-secretory or hyposecretory MM Prior treatment for MM (prior radiation therapy or dexamethasone up to 160 mg for spinal cord compression is allowed. Other limited field radiation involving ≤ 1/3 of the pelvic area is also allowed) Plasma cell leukemia Pregnant or lactating females Major surgery within 21 days prior to first dose Congestive heart failure (CHF) (New York Heart Association class III to IV), symptomatic ischemia, conduction abnormalities uncontrolled by conventional intervention or myocardial infarction in the previous six months Acute active infection requiring systemic antibiotics, antivirals, or antifungals within 14 days prior to first dose Patients receiving active treatment or intervention for any other malignancy or patients who, at the Investigator's discretion, may require active treatment or intervention for any other malignancy within 8 months of starting study treatment. Serious psychiatric or medical conditions that could interfere with treatment Significant neuropathy (Grade 3, Grade 4, or Grade 2 with pain) at the time of the first dose and/or within 14 days before study treatment Contraindication to any of the required concomitant drugs, including antiviral (e.g. Valacyclovir) and proton-pump inhibitor (e.g. lansoprazole). Corticosteroid therapy in a dose equivalent to dexamethasone ≥ 1.5 mg/day or prednisone ≥ 10 mg/day. (Steroid use is allowed if necessary to treat spinal cord compression and/or hypocalcaemia.) Patients in whom the required program of oral and IV fluid hydration is contraindicated, e.g. due to pre-existing pulmonary, cardiac, or renal impairment Patients with primary systemic amyloidosis.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jatin Shah, MD
Organizational Affiliation
AMyC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Brian GM Durie, MD
Organizational Affiliation
AMyC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Samuel Oschin Comprehensive Cancer Center at Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Comprehensive Cancer Center at Desert Regional Medical Center
City
Palm Springs
State/Province
California
ZIP/Postal Code
92262
Country
United States
Facility Name
University of Massachusettes Memorial
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Fred Hutchinson Cancer Research Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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A Safety Study of Carfilzomib, Cyclophosphamide & Dexamethasone Prior to ASCT in Patients With Newly Diagnosed Myeloma

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