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Efficacy and Safety of Pomalidomide and Dexamethasone in RRMM Patients With Renal Insufficiency

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Pomalidomide and 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 Multiple Myeloma, Relapsed Multiple Myeloma, Refactory Multiple Myeloma, Renal Insufficiency, Pomalidomide, Dexamethasone

Eligibility Criteria

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

Inclusion Criteria:

- Subjects must satisfy the following criteria to be enrolled in the study.

1. Subjects must have documented diagnosis of multiple myeloma and have measurable disease (serum M-protein ≥ 0.5 g/dL or urine M-protein ≥ 200 mg/24 hours).

5. Subjects must have had at least 1 prior antimyeloma regimen including lenalidomide and documented progression as per the International Myeloma Working Group uniform response criteria (Durie, 2006) during or after the last antimyeloma regimen. Induction therapy followed by Autologous Stem Cell Transplant and consolidation/ maintenance will be considered as one regimen.

6. Subjects must have an impaired renal function with an estimated Glomerular Filtrate Rate of < 45 mL/min/1.73 m2 according to the modification of diet in renal disease equation.

  1. Impaired renal function must be due to multiple myeloma which needs to be confirmed by kidney biopsy.
  2. Subjects may have acute myeloma related renal failure or chronic myeloma related renal failure; they may also have been treated with dialysis before, including dialysis with high cut off membranes.

Exclusion Criteria:

The presence of any of the following will exclude a subject from enrollment

  1. Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
  2. Any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study.
  3. Renal insufficiency due to other reasons than multiple myeloma or due to hypocalcaemia only.
  4. Prior history of malignancies, other than MM, unless the subject has been free of the disease for ≥ 5 years; exceptions include the following:

    1. Basal or squamous cell carcinoma of the skin
    2. Carcinoma in situ of the cervix or breast
    3. Incidental histological finding of prostate cancer (Tumour lymphNode Metastasis stage of T1a or T1b)

6. Previous therapy with pomalidomide. 7. Hypersensitivity to thalidomide, lenalidomide, or dexamethasone (this includes ≥ Grade 3 rash during prior thalidomide or lenalidomide therapy).

10. Subjects who are planning for or who are eligible for stem cell transplant.

Sites / Locations

  • Krankenhaus der Elisabethinen Linz, I Interne Abteilung
  • Medizinische Universitat Wien
  • Wilhelminenspital der Stadt Wien
  • Hopital Dypuytren-CHU de Limoges
  • Hopital Saint Louis
  • CHU de Poitiers
  • Medizinische Klinik und Poliklinik V Hamatologie, Onkologie und Rheumatologie
  • University Hospital Tubingen
  • Alexandra Hospital, University of Athens
  • Azienda Ospedaliero Universitaria Ospedali
  • S.C. Oncologia Medica
  • Ospedale Maggiore Policlinico Mangiagalli Regina Elena
  • Arcispedale Santa Maria Nuova
  • VU University Medical Center VU Medisch Centrum
  • Daniel den Hoed Kliniek Medical Oncology, Erasmus MC
  • Hospital de La Princesa
  • CEIC Hospital Universitario de Salamanca
  • Hospital Universitario Doctor Peset
  • Queen Elizabeth Hospital UHB NHS Foundation Trust
  • Ninewells Hospital and Medical School
  • Oxford Radcliffe Hospital ICRF Medical Oncology Unit
  • St Thomas' HospitalGuy's Hospital Dept. of Haematology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pomalidomide and low dose Dexamethasone

Arm Description

Pomalidomide 4mg, and low dose Dexamethasone, starting at 40mgs(≤ 75 years old) or 20 mg/day (> 75 years old)

Outcomes

Primary Outcome Measures

Evaluate efficacy of the combination of pomalidomide and low-dose dexamethasone in subjects with RRMM and impaired renal function
Overall response rate determined by Myeloma responses determined by modified IMWG criteria

Secondary Outcome Measures

Assessment of renal response according to the criteria defined by Dimopoulos and Ludwig (Dimopoulos, 2009; Dimopoulos, 2010 b,c; Ludwig, 2010).
Assessment of renal response according to the criteria defined by Ludwig and Dimopoulos
Time to Myeloma response
Evaluated according to the CTCAE grading
Time to renal response
Evaluated according to the CTCAE grading
Duration of response
Evaluated according to the CTCAE grading
Progression-free survival
Evaluated according to the CTCAE grading
Time to progression
Evaluated according to the CTCAE grading
Overall Survival
Evaluated according to the CTCAE grading
Adverse events (AEs) assessment (type, frequency, seriousness, severity, relationship to pomalidomide and/or dexamethasone and outcomes) including second primary malignancy (SPM).
Pharmacokinetics (PK) of pomalidomide in subjects with RRMM and impaired renal function (moderate to severe renal impairment).

Full Information

First Posted
December 16, 2013
Last Updated
August 25, 2021
Sponsor
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT02045017
Brief Title
Efficacy and Safety of Pomalidomide and Dexamethasone in RRMM Patients With Renal Insufficiency
Official Title
A Phase 2 Multicenter, Open-label Study to Determine the Efficacy and Safety of Pomalidomide (CC-4047) in Combination With Low-Dose Dexamethasone in Subjects With Relapsed or Refractory Multiple Myeloma and Moderate or Severe Renal Impairment Including Subjects Undergoing Hemodialysis
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
February 28, 2014 (Actual)
Primary Completion Date
January 27, 2017 (Actual)
Study Completion Date
July 28, 2021 (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 primary purpose of the study is to determine the safety and efficacy and to generate PK and biomarker data for the combination of Pomalidomide and low-dose Dexamethasone in patients with relapsed or refractory multiple myeloma, with moderate or severe renal impairment.
Detailed Description
The study will consist of a Screening phase within 28 days prior to cycle 1 day 1. Subjects once enrolled will enter the Treatment phase, in which patients will be treated until progression, or study discontinuation due to other reasons. Subjects will enter the long term Follow-up phase of the study where data will be collected every 3 months for up to 5 years on Secondary primary malignancies, survival, subsequent anti myeloma treatments and date of progression. Subjects will be recruited into one of 3 cohorts depending on the severity of their renal impairment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Multiple Myeloma, Relapsed Multiple Myeloma, Refactory Multiple Myeloma, Renal Insufficiency, Pomalidomide, 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
81 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pomalidomide and low dose Dexamethasone
Arm Type
Experimental
Arm Description
Pomalidomide 4mg, and low dose Dexamethasone, starting at 40mgs(≤ 75 years old) or 20 mg/day (> 75 years old)
Intervention Type
Drug
Intervention Name(s)
Pomalidomide and Dexamethasone
Other Intervention Name(s)
Tablet
Primary Outcome Measure Information:
Title
Evaluate efficacy of the combination of pomalidomide and low-dose dexamethasone in subjects with RRMM and impaired renal function
Description
Overall response rate determined by Myeloma responses determined by modified IMWG criteria
Time Frame
Approximately 2 years
Secondary Outcome Measure Information:
Title
Assessment of renal response according to the criteria defined by Dimopoulos and Ludwig (Dimopoulos, 2009; Dimopoulos, 2010 b,c; Ludwig, 2010).
Description
Assessment of renal response according to the criteria defined by Ludwig and Dimopoulos
Time Frame
Approximately 2 years
Title
Time to Myeloma response
Description
Evaluated according to the CTCAE grading
Time Frame
Approximately 2 years
Title
Time to renal response
Description
Evaluated according to the CTCAE grading
Time Frame
Approximately 2 years
Title
Duration of response
Description
Evaluated according to the CTCAE grading
Time Frame
Approximately 2 years
Title
Progression-free survival
Description
Evaluated according to the CTCAE grading
Time Frame
Approximately 2 years
Title
Time to progression
Description
Evaluated according to the CTCAE grading
Time Frame
Approximately 2 years
Title
Overall Survival
Description
Evaluated according to the CTCAE grading
Time Frame
Approximately 2 years
Title
Adverse events (AEs) assessment (type, frequency, seriousness, severity, relationship to pomalidomide and/or dexamethasone and outcomes) including second primary malignancy (SPM).
Description
Pharmacokinetics (PK) of pomalidomide in subjects with RRMM and impaired renal function (moderate to severe renal impairment).
Time Frame
Approximately 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - Subjects must satisfy the following criteria to be enrolled in the study. 1. Subjects must have documented diagnosis of multiple myeloma and have measurable disease (serum M-protein ≥ 0.5 g/dL or urine M-protein ≥ 200 mg/24 hours). 5. Subjects must have had at least 1 prior antimyeloma regimen including lenalidomide and documented progression as per the International Myeloma Working Group uniform response criteria (Durie, 2006) during or after the last antimyeloma regimen. Induction therapy followed by Autologous Stem Cell Transplant and consolidation/ maintenance will be considered as one regimen. 6. Subjects must have an impaired renal function with an estimated Glomerular Filtrate Rate of < 45 mL/min/1.73 m2 according to the modification of diet in renal disease equation. Impaired renal function must be due to multiple myeloma which needs to be confirmed by kidney biopsy. Subjects may have acute myeloma related renal failure or chronic myeloma related renal failure; they may also have been treated with dialysis before, including dialysis with high cut off membranes. Exclusion Criteria: The presence of any of the following will exclude a subject from enrollment Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study. Any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study. Renal insufficiency due to other reasons than multiple myeloma or due to hypocalcaemia only. Prior history of malignancies, other than MM, unless the subject has been free of the disease for ≥ 5 years; exceptions include the following: Basal or squamous cell carcinoma of the skin Carcinoma in situ of the cervix or breast Incidental histological finding of prostate cancer (Tumour lymphNode Metastasis stage of T1a or T1b) 6. Previous therapy with pomalidomide. 7. Hypersensitivity to thalidomide, lenalidomide, or dexamethasone (this includes ≥ Grade 3 rash during prior thalidomide or lenalidomide therapy). 10. Subjects who are planning for or who are eligible for stem cell transplant.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elisabeth Kueenburg, MD
Organizational Affiliation
Celgene
Official's Role
Study Director
Facility Information:
Facility Name
Krankenhaus der Elisabethinen Linz, I Interne Abteilung
City
Linz
ZIP/Postal Code
4020
Country
Austria
Facility Name
Medizinische Universitat Wien
City
Wien
ZIP/Postal Code
1090
Country
Austria
Facility Name
Wilhelminenspital der Stadt Wien
City
Wien
ZIP/Postal Code
1160
Country
Austria
Facility Name
Hopital Dypuytren-CHU de Limoges
City
Limoges cedex
ZIP/Postal Code
87042
Country
France
Facility Name
Hopital Saint Louis
City
Paris
ZIP/Postal Code
75475
Country
France
Facility Name
CHU de Poitiers
City
Poitiers
ZIP/Postal Code
86021
Country
France
Facility Name
Medizinische Klinik und Poliklinik V Hamatologie, Onkologie und Rheumatologie
City
Neuenheimer Feld 410
ZIP/Postal Code
69120
Country
Germany
Facility Name
University Hospital Tubingen
City
Tubingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Alexandra Hospital, University of Athens
City
Athens
ZIP/Postal Code
11528
Country
Greece
Facility Name
Azienda Ospedaliero Universitaria Ospedali
City
Ancona
ZIP/Postal Code
60126
Country
Italy
Facility Name
S.C. Oncologia Medica
City
Lecco
ZIP/Postal Code
23900
Country
Italy
Facility Name
Ospedale Maggiore Policlinico Mangiagalli Regina Elena
City
Milano
ZIP/Postal Code
20122
Country
Italy
Facility Name
Arcispedale Santa Maria Nuova
City
Reggio Emilia
ZIP/Postal Code
42100
Country
Italy
Facility Name
VU University Medical Center VU Medisch Centrum
City
Amsterdam
ZIP/Postal Code
1081 HV
Country
Netherlands
Facility Name
Daniel den Hoed Kliniek Medical Oncology, Erasmus MC
City
Rotterdam
ZIP/Postal Code
3075 EA
Country
Netherlands
Facility Name
Hospital de La Princesa
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Facility Name
CEIC Hospital Universitario de Salamanca
City
Salamanca
ZIP/Postal Code
37007
Country
Spain
Facility Name
Hospital Universitario Doctor Peset
City
Valencia
ZIP/Postal Code
46017
Country
Spain
Facility Name
Queen Elizabeth Hospital UHB NHS Foundation Trust
City
Birmingham
ZIP/Postal Code
B15 2TH
Country
United Kingdom
Facility Name
Ninewells Hospital and Medical School
City
Dundee
ZIP/Postal Code
DD1 9SY
Country
United Kingdom
Facility Name
Oxford Radcliffe Hospital ICRF Medical Oncology Unit
City
Headington
ZIP/Postal Code
OX37LJ
Country
United Kingdom
Facility Name
St Thomas' HospitalGuy's Hospital Dept. of Haematology
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
29184451
Citation
Li Y, Wang X, O'Mara E, Dimopoulos MA, Sonneveld P, Weisel KC, Matous J, Siegel DS, Shah JJ, Kueenburg E, Sternas L, Cavanaugh C, Zaki M, Palmisano M, Zhou S. Population pharmacokinetics of pomalidomide in patients with relapsed or refractory multiple myeloma with various degrees of impaired renal function. Clin Pharmacol. 2017 Nov 8;9:133-145. doi: 10.2147/CPAA.S144606. eCollection 2017.
Results Reference
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PubMed Identifier
29394124
Citation
Dimopoulos M, Weisel K, van de Donk NWCJ, Ramasamy K, Gamberi B, Streetly M, Offidani M, Bridoux F, de la Rubia J, Mateos MV, Ardizzoia A, Kueenburg E, Collins S, Di Micco A, Rosettani B, Li Y, Bacon P, Sonneveld P. Pomalidomide Plus Low-Dose Dexamethasone in Patients With Relapsed/Refractory Multiple Myeloma and Renal Impairment: Results From a Phase II Trial. J Clin Oncol. 2018 Jul 10;36(20):2035-2043. doi: 10.1200/JCO.2017.76.1742. Epub 2018 Feb 2.
Results Reference
background

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Efficacy and Safety of Pomalidomide and Dexamethasone in RRMM Patients With Renal Insufficiency

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