search
Back to results

Bortezomib Based Consolidation in Multiple Myeloma Patients Completing Stem Cell Transplant

Primary Purpose

Stage I Multiple Myeloma, Stage II Multiple Myeloma, Stage III Multiple Myeloma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
bortezomib
cyclophosphamide
lenalidomide
laboratory biomarker analysis
dexamethasone
quality-of-life assessment
Sponsored by
Mayo Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stage I Multiple Myeloma focused on measuring Maintenance, Consolidation

Eligibility Criteria

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

Inclusion Criteria:

  • Creatinine =< 2 mg/dL
  • Absolute neutrophil count (ANC) >= 1000/mm^3
  • Platelet count >= 75000/mm^3
  • Hemoglobin >= 8.0 g/dL
  • Total bilirubin =< 1.5 x upper limit of normal (ULN)
  • Treated myeloma: Prior induction therapy (any) and followed by autologous stem cell transplantation
  • Measurable disease at initial diagnosis, pre-stem cell transplant (SCT) or post-SCT of multiple myeloma as defined by at least ONE of the following:

    • Serum monoclonal protein >= 0.5 g/dL
    • > 200 mg of monoclonal protein in the urine on 24 hour electrophoresis
    • Serum immunoglobulin free light chain >= 5 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
    • Monoclonal bone marrow plasmacytosis >= 30% (evaluable disease)
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2
  • < 120 days post SCT with no evidence of relapse or progression prior to registration
  • Provide voluntary informed written consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care
  • Negative serum pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
  • Willing to return to enrolling institution for follow-up during the active monitoring phase of the study
  • Ability to complete questionnaire(s) by themselves or with assistance
  • Female patients who:

    • Are postmenopausal for at least 1 year before the screening visit, OR
    • Are surgically sterile, OR
    • If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 30 days after the last dose of study treatment, OR agree to completely abstain from heterosexual intercourse
  • Male patients, even if surgically sterilized (ie, status postvasectomy), who:

    • Agree to practice effective barrier contraception during the entire study treatment period and through 30 days after the last dose of study treatment, OR
    • Agree to completely abstain from heterosexual intercourse

Exclusion Criteria:

  • Other active malignancy =< 3 years prior to registration; EXCEPTIONS: Non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: If there is a history of prior malignancy, they must not be receiving other specific treatment for their cancer
  • Other co-morbidity which would interfere with patient's ability to participate in trial, e.g. uncontrolled infection, uncompensated heart or lung disease
  • Other concurrent chemotherapy, radiotherapy, or any ancillary therapy considered investigational; NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment
  • Known to be human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus positive (HBV+)
  • Hypersensitivity to study drugs, boron or mannitol
  • Patient refractory to bortezomib (defined as patients who progressed while on bortezomib or within 60 days of receiving bortezomib)
  • Any serious medical or psychiatric condition that would prevent the subject from complying with the protocol treatment and procedures
  • Grade >= 2 peripheral neuropathy
  • Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities; prior to study entry, any electrocardiogram (ECG) abnormality at screening must be documented by the investigator as not medically relevant
  • Participation in clinical trials with other investigational agents not included in this trial, within 14 days of the start of this trial and throughout the duration of this trial
  • Radiation therapy within 3 weeks before randomization; enrollment of subjects who require concurrent radiotherapy (which must be localized in its field size) should be deferred until the radiotherapy is completed and 3 weeks have elapsed since the last date of therapy
  • Female patients who are lactating or pregnant

Sites / Locations

  • Mayo Clinic in Arizona
  • Johns Hopkins University
  • Washington University School of Medicine
  • Baylor Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Arm A (bortezomib)

Arm B (bortezomib, cyclophosphamide, dexamethasone)

Arm C (bortezomib, lenalidomide)

Arm Description

Patients receive bortezomib SC on days 1 and 15 of courses 1-12 and day 1 of courses 13-24.

Patients receive bortezomib SC as in Arm A, cyclophosphamide PO on days 1 and 15 of courses 1-12 and day 1 of courses 13-24, and dexamethasone PO on days 1 and 15 of courses 1-12 and day 1 of courses 13-24.

Patients receive bortezomib SC as in Arm A and lenalidomide PO QD on days 1-28.

Outcomes

Primary Outcome Measures

Proportion of Patients Experiencing a Stringent Complete Response (sCR) After 12 Cycles, 24 Months
Estimated by the number of sCRs divided by the total number of evaluable patients in each arm. Exact binomial confidence intervals for the true sCR rate will be calculated by arm. Stringent complete response (sCR) is defined as a complete response plus normal serum free light chain ratio and the absence of clonal cells in bone marrow by flow cytometry.

Secondary Outcome Measures

Survival Time
The distribution of survival time will be estimated by arm using the method of Kaplan-Meier.
Progression-free Survival
The distribution of progression-free survival will be estimated by arm using the method of Kaplan-Meier.

Full Information

First Posted
October 11, 2012
Last Updated
August 13, 2018
Sponsor
Mayo Clinic
search

1. Study Identification

Unique Protocol Identification Number
NCT01706666
Brief Title
Bortezomib Based Consolidation in Multiple Myeloma Patients Completing Stem Cell Transplant
Official Title
A Phase II Randomized Study of Three Subcutaneous Bortezomib-based Consolidation Treatments for Patients Completing Induction Therapy and Stem Cell Transplantation for Newly Diagnosed Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
December 7, 2012 (Actual)
Primary Completion Date
July 10, 2014 (Actual)
Study Completion Date
May 17, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mayo Clinic

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized phase II trial studies how well giving bortezomib with or without combination chemotherapy works as consolidation therapy in patients with newly diagnosed multiple myeloma who have completed stem cell transplant. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cyclophosphamide, dexamethasone, and lenalidomide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It is not yet known whether giving bortezomib is more effective with or without combination chemotherapy in the post transplant setting.
Detailed Description
PRIMARY OBJECTIVES: I. To compare the stringent complete response (sCR) rate after 12 cycles among arms. SECONDARY OBJECTIVES: I. To compare progression-free and overall survival among arms. II. To describe the adverse event profile of each arm. TERTIARY OBJECTIVES: I. To compare sCR after 6 cycles and 24 cycles and quality of life among arms. OUTLINE: Patients are randomized to 1 of 3 treatment arms. ARM A: Patients receive bortezomib subcutaneously (SC) on days 1 and 15 of courses 1-12 and day 1 of courses 13-24. ARM B: Patients receive bortezomib SC as in Arm A, cyclophosphamide orally (PO) on days 1 and 15 of courses 1-12 and day 1 of courses 13-24, and dexamethasone PO on days 1 and 15 of courses 1-12 and day 1 of courses 13-24. ARM C: Patients receive bortezomib SC as in Arm A and lenalidomide PO once daily (QD) on days 1-28. In all arms, treatment continues every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6 months for 3 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage I Multiple Myeloma, Stage II Multiple Myeloma, Stage III Multiple Myeloma
Keywords
Maintenance, Consolidation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A (bortezomib)
Arm Type
Experimental
Arm Description
Patients receive bortezomib SC on days 1 and 15 of courses 1-12 and day 1 of courses 13-24.
Arm Title
Arm B (bortezomib, cyclophosphamide, dexamethasone)
Arm Type
Experimental
Arm Description
Patients receive bortezomib SC as in Arm A, cyclophosphamide PO on days 1 and 15 of courses 1-12 and day 1 of courses 13-24, and dexamethasone PO on days 1 and 15 of courses 1-12 and day 1 of courses 13-24.
Arm Title
Arm C (bortezomib, lenalidomide)
Arm Type
Experimental
Arm Description
Patients receive bortezomib SC as in Arm A and lenalidomide PO QD on days 1-28.
Intervention Type
Drug
Intervention Name(s)
bortezomib
Other Intervention Name(s)
LDP 341, MLN341, VELCADE
Intervention Description
Given SC
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Other Intervention Name(s)
CPM, CTX, Cytoxan, Endoxan, Endoxana
Intervention Description
Given PO
Intervention Type
Drug
Intervention Name(s)
lenalidomide
Other Intervention Name(s)
CC-5013, IMiD-1, Revlimid
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Intervention Type
Drug
Intervention Name(s)
dexamethasone
Other Intervention Name(s)
Aeroseb-Dex, Decaderm, Decadron, DM, DXM
Intervention Description
Given PO
Intervention Type
Procedure
Intervention Name(s)
quality-of-life assessment
Other Intervention Name(s)
quality of life assessment
Intervention Description
Ancillary studies
Primary Outcome Measure Information:
Title
Proportion of Patients Experiencing a Stringent Complete Response (sCR) After 12 Cycles, 24 Months
Description
Estimated by the number of sCRs divided by the total number of evaluable patients in each arm. Exact binomial confidence intervals for the true sCR rate will be calculated by arm. Stringent complete response (sCR) is defined as a complete response plus normal serum free light chain ratio and the absence of clonal cells in bone marrow by flow cytometry.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Survival Time
Description
The distribution of survival time will be estimated by arm using the method of Kaplan-Meier.
Time Frame
From registration to death due to any cause, assessed up to 3 years
Title
Progression-free Survival
Description
The distribution of progression-free survival will be estimated by arm using the method of Kaplan-Meier.
Time Frame
From registration to the earliest date of documentation of disease progression or death due to any cause, assessed up to 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Creatinine =< 2 mg/dL Absolute neutrophil count (ANC) >= 1000/mm^3 Platelet count >= 75000/mm^3 Hemoglobin >= 8.0 g/dL Total bilirubin =< 1.5 x upper limit of normal (ULN) Treated myeloma: Prior induction therapy (any) and followed by autologous stem cell transplantation Measurable disease at initial diagnosis, pre-stem cell transplant (SCT) or post-SCT of multiple myeloma as defined by at least ONE of the following: Serum monoclonal protein >= 0.5 g/dL > 200 mg of monoclonal protein in the urine on 24 hour electrophoresis Serum immunoglobulin free light chain >= 5 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio Monoclonal bone marrow plasmacytosis >= 30% (evaluable disease) Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2 < 120 days post SCT with no evidence of relapse or progression prior to registration Provide voluntary informed written consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care Negative serum pregnancy test done =< 7 days prior to registration, for women of childbearing potential only Willing to return to enrolling institution for follow-up during the active monitoring phase of the study Ability to complete questionnaire(s) by themselves or with assistance Female patients who: Are postmenopausal for at least 1 year before the screening visit, OR Are surgically sterile, OR If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 30 days after the last dose of study treatment, OR agree to completely abstain from heterosexual intercourse Male patients, even if surgically sterilized (ie, status postvasectomy), who: Agree to practice effective barrier contraception during the entire study treatment period and through 30 days after the last dose of study treatment, OR Agree to completely abstain from heterosexual intercourse Exclusion Criteria: Other active malignancy =< 3 years prior to registration; EXCEPTIONS: Non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: If there is a history of prior malignancy, they must not be receiving other specific treatment for their cancer Other co-morbidity which would interfere with patient's ability to participate in trial, e.g. uncontrolled infection, uncompensated heart or lung disease Other concurrent chemotherapy, radiotherapy, or any ancillary therapy considered investigational; NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment Known to be human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus positive (HBV+) Hypersensitivity to study drugs, boron or mannitol Patient refractory to bortezomib (defined as patients who progressed while on bortezomib or within 60 days of receiving bortezomib) Any serious medical or psychiatric condition that would prevent the subject from complying with the protocol treatment and procedures Grade >= 2 peripheral neuropathy Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities; prior to study entry, any electrocardiogram (ECG) abnormality at screening must be documented by the investigator as not medically relevant Participation in clinical trials with other investigational agents not included in this trial, within 14 days of the start of this trial and throughout the duration of this trial Radiation therapy within 3 weeks before randomization; enrollment of subjects who require concurrent radiotherapy (which must be localized in its field size) should be deferred until the radiotherapy is completed and 3 weeks have elapsed since the last date of therapy Female patients who are lactating or pregnant
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Craig B. Reeder, M.D.
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Arizona
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85259
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287-8936
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Baylor Medical Center
City
Garland
State/Province
Texas
ZIP/Postal Code
75042
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Bortezomib Based Consolidation in Multiple Myeloma Patients Completing Stem Cell Transplant

We'll reach out to this number within 24 hrs