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A Open-label Study of Ultra-High Dose Dexamethasone for Relapsed Multiple Myeloma (UltraDex)

Primary Purpose

Multiple Myeloma

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Dexamethasone
Sponsored by
Boston Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Relapsed Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  1. Relapsed multiple myeloma (MM) with measurable disease parameters according to the International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma
  2. Relapsed is defined as the development of disease progression following the achievement of stable disease (SD), partial response (PR), very good partial response (VGPR), complete response (CR) or stringent complete response (sCR) to the most recent anti-myeloma regimen
  3. Received ≥ 2 prior regimen for MM
  4. The patient or the patient's legal representative is able to understand the risks of the study and provide signed informed consent and authorization to use protected health information (in accordance with national and local privacy regulations)
  5. ≥18 years of age
  6. Karnofsky Performance Status score of ≥70
  7. Able to adhere to the study visit schedule and other protocol requirements in the Investigator's opinion
  8. Adequate hepatic function, as evidenced by serum bilirubin values <6.0 mg/dL and serum alanine transaminase (ALT) and/or aspartate transaminase (AST) values <3 × the upper limit of normal (ULN) of the local laboratory reference range. (Patients with isolated elevations in alkaline phosphatase [ALP] <5 × ULN in the presence of bony disease are not excluded from participating in the study)
  9. If a female participant is of childbearing potential, she must have a negative pregnancy test (urine or serum) at baseline (Cycle 1, Day 0). (A female participant is considered to be NOT of childbearing potential if she has undergone bilateral oophorectomy or if she has been menopausal without a menstrual period for 12 consecutive months)

Exclusion Criteria:

  1. Received any of the following therapies: Radiotherapy within 2 weeks of Cycle 1 Day 1; Systemic therapy within 3 weeks of Cycle 1 Day 1
  2. Prior peripheral autologous stem cell transplant within 12 weeks of Cycle 1 Day 1
  3. Prior allogeneic stem cell transplant
  4. Active systemic infection requiring treatment
  5. Active malignancy (the following are allowable: patients with basal cell carcinoma of the skin; superficial carcinoma of the bladder; carcinoma of the prostate with a current prostate-specific antigen <0.1 ng/mL; or cervical intraepithelial neoplasia).
  6. Known or suspected human immunodeficiency virus (HIV) positive or hepatitis B surface antigen-positive status or is known or suspected to have an active hepatitis C infection
  7. If female, patient is lactating
  8. History of significant cardiovascular, neurological, endocrine, gastrointestinal, respiratory, or inflammatory illness that could preclude study participation, pose an undue medical hazard, or interfere with the interpretation of the study results, including, but not limited to, patients with:

    1. Congestive heart failure (New York Heart Association [NYHA] Class 3 or 4
    2. Unstable angina
    3. Cardiac arrhythmia
    4. Recent (within the preceding 6 months) myocardial infarction or stroke
    5. Hypertension requiring >3 medications for adequate control
    6. Chronic obstructive pulmonary disease
  9. History of uncontrolled diabetes mellitus (Type I or II) (Hemoglobin A1C>8.5)
  10. Any other medical, psychiatric, or social condition that would preclude participation in the study, pose an undue medical hazard, interfere with the conduct of the study, or interfere with interpretation of the study results
  11. History of adverse reaction to dexamethasone or other corticosteroids.
  12. History of allergic reaction attributable to any of the required prophylactic medications (proton pump inhibitor (PPI), fluconazole, trimethoprim-sulfamethoxazole) or reasonable alternative medications
  13. Inability to monitor glucose at home with glucometer if glucose is found to be abnormal at any study center visit
  14. Known or suspected AL Amyloidosis
  15. Currently receiving an investigational agent for any reason

Sites / Locations

  • Boston Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ultra-high dose dexamethasone

Arm Description

Ultra-high dose dexamethasone administered intravenously and orally

Outcomes

Primary Outcome Measures

Determine antitumor activity of ultrahigh dose dexamethasone (UHDD) as monotherapy in relapsed multiple myeloma.

Secondary Outcome Measures

Characterize the safety and tolerability by assessing the number of related adverse events of UHDD as monotherapy in patients with relapsed multiple myeloma.
Determine the progression free survival amongst responders.
Determine the subset of patients in whom UHDD can be used as monotherapy for treatment of relapsed multiple myeloma

Full Information

First Posted
March 9, 2015
Last Updated
February 14, 2017
Sponsor
Boston Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT02402725
Brief Title
A Open-label Study of Ultra-High Dose Dexamethasone for Relapsed Multiple Myeloma
Acronym
UltraDex
Official Title
A Phase II, Open-label, Single Center Study of Ultra-High Dose Dexamethasone (UHDD) Administered Intravenously and Orally as Monotherapy for the Treatment of Relapsed Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Withdrawn
Why Stopped
poor accrual
Study Start Date
May 2015 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Boston Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase II, open label, single-center study of ultra-high dose dexamethasone administered intravenously and orally as monotherapy for the treatment of relapsed multiple myeloma. Dexamethasone has known anti-myeloma activity, and has been studied extensively both alone, and in combination with other agents, in the treatment of multiple myeloma. This study implements an optimal 2-stage design. In Stage 1, 10 patients will be enrolled. Each patient will receive 100mg of intravenous dexamethasone once on Day 1, immediately followed by 24mg of oral (PO) dexamethasone every 6 hours for 3 days (Days 1-3) in a 28-day cycle. After 4 cycles, the patients will be evaluated for efficacy and safety. If 2 or more of the original 10 patients experience a CR, very good partial response (VGPR), or PR, an additional 20 patients will be enrolled in Stage 2. The enrollment for Stage 2 will occur after the completion of 4 cycles of ultra-high dose dexamethasone. If <2 patients experience a CR, VGPR, or PR, the study will be discontinued. Patients will be treated until progression, intolerable side effects, or death. The purpose of the proposed phase II study is to determine the overall response rate, progression free survival, and tolerability of "ultra-high" dose dexamethasone.
Detailed Description
STUDY OBJECTIVES Primary objective: • Determine antitumor activity of ultrahigh dose dexamethasone (UHDD) as monotherapy in relapsed multiple myeloma. Secondary objectives: Characterize the safety and tolerability of UHDD as monotherapy in patients with relapsed multiple myeloma. Determine the progression free survival amongst responders. Determine the subset of patients in whom UHDD can be used as monotherapy for treatment of relapsed multiple myeloma STUDY ENDPOINTS Primary endpoint: To determine the anti-tumor activity of UHDD as monotherapy in patients with relapsed multiple myeloma as measured by the International Myeloma Working Group (IMWG) response criteria: Change from baseline in M protein component. Objective response rate (complete response [CR] + partial response [PR]) assessed according to IMWG response criteria. Disease control rate (CR+PR+stable disease [SD]). Secondary endpoints: Safety and tolerability of UHDD Progression free survival. Characteristics of patients responding to UHDD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Relapsed 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
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ultra-high dose dexamethasone
Arm Type
Experimental
Arm Description
Ultra-high dose dexamethasone administered intravenously and orally
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Other Intervention Name(s)
Dexamethasone Acetate
Intervention Description
(1 cycle = 28 days) D1: Dexamethasone 100mg IV; Dex 24mg PO every 6 hrs (begin immediately after IV dex) D2: Dex 24mg PO every 6 hrs D3: Dex 24mg PO every 6 hrs
Primary Outcome Measure Information:
Title
Determine antitumor activity of ultrahigh dose dexamethasone (UHDD) as monotherapy in relapsed multiple myeloma.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Characterize the safety and tolerability by assessing the number of related adverse events of UHDD as monotherapy in patients with relapsed multiple myeloma.
Time Frame
3 months
Title
Determine the progression free survival amongst responders.
Time Frame
5 years
Title
Determine the subset of patients in whom UHDD can be used as monotherapy for treatment of relapsed multiple myeloma
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Relapsed multiple myeloma (MM) with measurable disease parameters according to the International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma Relapsed is defined as the development of disease progression following the achievement of stable disease (SD), partial response (PR), very good partial response (VGPR), complete response (CR) or stringent complete response (sCR) to the most recent anti-myeloma regimen Received ≥ 2 prior regimen for MM The patient or the patient's legal representative is able to understand the risks of the study and provide signed informed consent and authorization to use protected health information (in accordance with national and local privacy regulations) ≥18 years of age Karnofsky Performance Status score of ≥70 Able to adhere to the study visit schedule and other protocol requirements in the Investigator's opinion Adequate hepatic function, as evidenced by serum bilirubin values <6.0 mg/dL and serum alanine transaminase (ALT) and/or aspartate transaminase (AST) values <3 × the upper limit of normal (ULN) of the local laboratory reference range. (Patients with isolated elevations in alkaline phosphatase [ALP] <5 × ULN in the presence of bony disease are not excluded from participating in the study) If a female participant is of childbearing potential, she must have a negative pregnancy test (urine or serum) at baseline (Cycle 1, Day 0). (A female participant is considered to be NOT of childbearing potential if she has undergone bilateral oophorectomy or if she has been menopausal without a menstrual period for 12 consecutive months) Exclusion Criteria: Received any of the following therapies: Radiotherapy within 2 weeks of Cycle 1 Day 1; Systemic therapy within 3 weeks of Cycle 1 Day 1 Prior peripheral autologous stem cell transplant within 12 weeks of Cycle 1 Day 1 Prior allogeneic stem cell transplant Active systemic infection requiring treatment Active malignancy (the following are allowable: patients with basal cell carcinoma of the skin; superficial carcinoma of the bladder; carcinoma of the prostate with a current prostate-specific antigen <0.1 ng/mL; or cervical intraepithelial neoplasia). Known or suspected human immunodeficiency virus (HIV) positive or hepatitis B surface antigen-positive status or is known or suspected to have an active hepatitis C infection If female, patient is lactating History of significant cardiovascular, neurological, endocrine, gastrointestinal, respiratory, or inflammatory illness that could preclude study participation, pose an undue medical hazard, or interfere with the interpretation of the study results, including, but not limited to, patients with: Congestive heart failure (New York Heart Association [NYHA] Class 3 or 4 Unstable angina Cardiac arrhythmia Recent (within the preceding 6 months) myocardial infarction or stroke Hypertension requiring >3 medications for adequate control Chronic obstructive pulmonary disease History of uncontrolled diabetes mellitus (Type I or II) (Hemoglobin A1C>8.5) Any other medical, psychiatric, or social condition that would preclude participation in the study, pose an undue medical hazard, interfere with the conduct of the study, or interfere with interpretation of the study results History of adverse reaction to dexamethasone or other corticosteroids. History of allergic reaction attributable to any of the required prophylactic medications (proton pump inhibitor (PPI), fluconazole, trimethoprim-sulfamethoxazole) or reasonable alternative medications Inability to monitor glucose at home with glucometer if glucose is found to be abnormal at any study center visit Known or suspected AL Amyloidosis Currently receiving an investigational agent for any reason
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John M Sloan, MD
Organizational Affiliation
Boston Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Boston Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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A Open-label Study of Ultra-High Dose Dexamethasone for Relapsed Multiple Myeloma

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