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Lenalidomide & Adriamycin & Dexamethasone (RAD) in Newly Diagnosed, Multiple Myeloma Patients (RAD)

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 2
Locations
Greece
Study Type
Interventional
Intervention
Lenalidomide
Adriamycin
Dexamethasone
Sponsored by
Meletios A. Dimopoulos
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects able to read and understand the Informed Consent Form (ICF).
  2. Subjects willing to participate in the study and comply with its procedures.
  3. Subjects who have signed the ICF
  4. Newly diagnosed patients with symptomatic MM according to the criteria of IMWG
  5. Subjects eligible for autologous stem cell transplantation
  6. Age 18-70 years, of either sex
  7. karnofsky ≥ 60
  8. Platelets ≥ 100x109/L
  9. Neutrophils ≥ 1.5x109/L
  10. Alanine transaminase (ALT) & Aspartate transaminase (AST) ≤ 3-fold of upper normal limit
  11. Bilirubin ≤ 2-fold of upper normal limit
  12. Creatinine clearance ≥60 ml/min
  13. Expected survival ≥ 6 months as per PI's clinical judgment
  14. Subjects able to tolerate aspirin, low molecular weight heparin or coumarinic agents as prophylactic anticoagulation
  15. Female subject of childbearing potential must have 2 negative serum pregnancy tests (hCG) at Screening (once within 10-14 days and once 24 h before the study drug administration) and if sexually active must be using two medically acceptable, highly effective, adequate forms of birth control (ie, failure rate <1% per year when used consistently and correctly) prior to Screening and and for time period at least 28 days before the study drug administration and agree to continue using it while being in the study (Screening and Treatment Periods including dose interruptions). A female subject should continue using a highly effective method of birth control for 30 days following the end of treatment.
  16. A male subject must agree to use an adequate form of contraception for the duration of the study, while taking the study drug, during dose interruptions at for at least 28 days after the last dose of study drug even if he has had a successful vasectomy and agree to have sexual relations only with women who use a highly effective birth control method.
  17. Subjects must be free of any clinically significant disease (other than MM) that would interfere with study evaluations

Exclusion Criteria:

  1. Pregnancy, breastfeeding οr intention of pregnancy during the trial
  2. Suspected or known hypersensitivity to any of the study drugs
  3. Ongoing severe infection requiring intravenous antibiotic treatment
  4. Prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer, or other cancer from which the subject has been disease-free for at least 5 years. Concurrent prostate cancer for which the patient is receiving therapy will not be considered an exclusion if the Prostatic specific antigen (PSA) has been stable for 3 years
  5. Solitary bone or solitary extramedullary plasmacytoma as the only evidence of plasma cell dyscrasia
  6. Myocardial infraction within 6 months before enrollment, New York Heart Association (NYHA) Class II or greater heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmia, clinically significant pericardial disease, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities
  7. Uncontrolled medical problems such as diabetes, coronary artery disease, hypertension, unstable angina, arrhythmia, pulmonary, hepatic and renal diseases unless renal insufficiency is considered to be secondary to MM
  8. Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the ICF
  9. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she will participate in the study or confounds the ability to interpret data from the study
  10. Subjects with any clinical condition that would affect study's outcome
  11. Participation in another interventional clinical trial in the 4 weeks preceding enrollment or planning to participate in another interventional clinical trial during the planned period of this study, except of the clinical trials that implicate drugs of supportive treatment

Sites / Locations

  • General Hospital of Athens "G. Gennimatas"
  • General Hospital of Athens "Alexandra"
  • University General Hospital of Patras
  • Theageneio Anticancer Hospital of Thessaloniki

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lenalidomide, adriamycin & dexamethasone

Arm Description

Lenalidomide 25 mg administered orally for the first 21 days of each 28-day-cycle, plus Adriamycin i.v. on days 1,2,3 & 4 of every cycle, plus Dexamethasone 40 mg orally on days 1, 8, 15 & 22 of every cycle for 4 cycles

Outcomes

Primary Outcome Measures

Overall response rate
Assessment of the overall response rate of study population to RAD regimen (including stringent complete response, complete response, very good partial response, partial response and stable disease) according to the uniform criteria of IMWG (International Myeloma Working Group) regarding the response to multiple myeloma therapy

Secondary Outcome Measures

Progression-free survival (PFS)
Time to progression (TTP)
Time to Next Therapy (TtNT)
Number and severity of Adverse events as a measure of safety and toxicity profile
Adverse events will be assessed at each visit and graded according to the National Cancer Institute Common Toxicity Criteria (version 2.0)

Full Information

First Posted
June 5, 2015
Last Updated
October 14, 2016
Sponsor
Meletios A. Dimopoulos
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1. Study Identification

Unique Protocol Identification Number
NCT02471820
Brief Title
Lenalidomide & Adriamycin & Dexamethasone (RAD) in Newly Diagnosed, Multiple Myeloma Patients
Acronym
RAD
Official Title
Phase II Open Label Study for the Assessment of the Efficacy and Safety of Lenalidomide & Adriamycin & Low Dose Dexamethasone (RAD) in Newly Diagnosed, Symptomatic Multiple Myeloma Patients
Study Type
Interventional

2. Study Status

Record Verification Date
October 2016
Overall Recruitment Status
Completed
Study Start Date
November 2014 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Meletios A. Dimopoulos

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is to assess the efficacy and safety of lenalidomide in combination with adriamycin and low dose dexamethasone in newly diagnosed patients with symptomatic multiple myeloma as well as to collect information regarding the effect of this regimen on angiogenesis and bone remodeling of the study population.
Detailed Description
This is a Phase II, non randomized, non- comparative, open label trial which assess the efficacy and safety of lenalidomide, adriamycin and low dose dexamethasone combination (RAD) in 45 newly diagnosed patients with symptomatic multiple myeloma as well as to collect information regarding the effect of this regimen on angiogenesis and bone remodeling of the study population. The recruitment period is estimated for 5 months while the treatment period and the follow up period 4 months and 1 month respectively. During the treatment initiation visit the response to the combination RAD according the International Myeloma Working Group (IMWG) criteria will be evaluated, biochemical markers of bone metabolism and angiogenic cytokines will be measured as well. IMWG Response evaluation will be repeated the day 1 of each treatment cycle as well as at the response evaluation visit. Finally biochemical markers of bone metabolism and angiogenic cytokines will be measured once more at the end of treatment visit.

6. Conditions and Keywords

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

8. Arms, Groups, and Interventions

Arm Title
Lenalidomide, adriamycin & dexamethasone
Arm Type
Experimental
Arm Description
Lenalidomide 25 mg administered orally for the first 21 days of each 28-day-cycle, plus Adriamycin i.v. on days 1,2,3 & 4 of every cycle, plus Dexamethasone 40 mg orally on days 1, 8, 15 & 22 of every cycle for 4 cycles
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Other Intervention Name(s)
Combination of Lenalidomide, adriamycin & dexamethasone
Intervention Description
Lenalidomide 25 mg by mouth for the first 21 days of a 28-day-cycle for 4 cycles
Intervention Type
Drug
Intervention Name(s)
Adriamycin
Other Intervention Name(s)
Combination of Lenalidomide, adriamycin & dexamethasone
Intervention Description
Adriamycin as intravenous bolus infusion at a dose of 9 mg/m2, on days 1-4 of a 28-day cycle for 4 cycles
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Other Intervention Name(s)
Combination of Lenalidomide, adriamycin & dexamethasone
Intervention Description
Dexamethasone by mouth at a dose of 40 mg, on days 1, 8, 15, and 22 of a 28-day cycle for 4 cycles
Primary Outcome Measure Information:
Title
Overall response rate
Description
Assessment of the overall response rate of study population to RAD regimen (including stringent complete response, complete response, very good partial response, partial response and stable disease) according to the uniform criteria of IMWG (International Myeloma Working Group) regarding the response to multiple myeloma therapy
Time Frame
142 days
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Time Frame
142 days
Title
Time to progression (TTP)
Time Frame
142 days
Title
Time to Next Therapy (TtNT)
Time Frame
142 days
Title
Number and severity of Adverse events as a measure of safety and toxicity profile
Description
Adverse events will be assessed at each visit and graded according to the National Cancer Institute Common Toxicity Criteria (version 2.0)
Time Frame
142 days
Other Pre-specified Outcome Measures:
Title
Number of stem cell collected before Autologous Stem Cell Transplantation (ASCT)
Time Frame
142 days
Title
Dickkopf-1 (DKK-1)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Dickkopf-1 (DKK-1)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
C-telopeptide of type-I collagen (CTX)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
C-telopeptide of type-I collagen (CTX)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Tartrate-resistant acid phosphatase isoform-5b (TRACP-5b)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 days
Title
Tartrate-resistant acid phosphatase isoform-5b (TRACP-5b)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Bone-alkaline phosphatase (bALP)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Bone-alkaline phosphatase (bALP)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Osteocalcin (OC)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Osteocalcin (OC)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
C-terminal propeptide of procollagen type-I (CICP)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
C-terminal propeptide of procollagen type-I (CICP)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Soluble and total RANKL (sRANKL, tRANKL)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Soluble and total RANKL (sRANKL, tRANKL)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Osteoprotegerin (OPG)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Osteoprotegerin (OPG)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Osteopontin (OPN)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Osteopontin (OPN)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Macrophage inflammatory protein 1-alpha (MIP-1α)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Macrophage inflammatory protein 1-alpha (MIP-1α)
Description
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Angiopoietin-1 & -2
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Angiopoietin-1 & -2
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
Angiogenin
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Angiogenin
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
VEGF
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
Vascular endothelial growth factor (VEGF)
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
VEGF-A
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
VEGF-A
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days
Title
basic fibroblast growth factor (bFGF)
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
1 day
Title
basic fibroblast growth factor (bFGF)
Description
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
Time Frame
112 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects able to read and understand the Informed Consent Form (ICF). Subjects willing to participate in the study and comply with its procedures. Subjects who have signed the ICF Newly diagnosed patients with symptomatic MM according to the criteria of IMWG Subjects eligible for autologous stem cell transplantation Age 18-70 years, of either sex karnofsky ≥ 60 Platelets ≥ 100x109/L Neutrophils ≥ 1.5x109/L Alanine transaminase (ALT) & Aspartate transaminase (AST) ≤ 3-fold of upper normal limit Bilirubin ≤ 2-fold of upper normal limit Creatinine clearance ≥60 ml/min Expected survival ≥ 6 months as per PI's clinical judgment Subjects able to tolerate aspirin, low molecular weight heparin or coumarinic agents as prophylactic anticoagulation Female subject of childbearing potential must have 2 negative serum pregnancy tests (hCG) at Screening (once within 10-14 days and once 24 h before the study drug administration) and if sexually active must be using two medically acceptable, highly effective, adequate forms of birth control (ie, failure rate <1% per year when used consistently and correctly) prior to Screening and and for time period at least 28 days before the study drug administration and agree to continue using it while being in the study (Screening and Treatment Periods including dose interruptions). A female subject should continue using a highly effective method of birth control for 30 days following the end of treatment. A male subject must agree to use an adequate form of contraception for the duration of the study, while taking the study drug, during dose interruptions at for at least 28 days after the last dose of study drug even if he has had a successful vasectomy and agree to have sexual relations only with women who use a highly effective birth control method. Subjects must be free of any clinically significant disease (other than MM) that would interfere with study evaluations Exclusion Criteria: Pregnancy, breastfeeding οr intention of pregnancy during the trial Suspected or known hypersensitivity to any of the study drugs Ongoing severe infection requiring intravenous antibiotic treatment Prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer, or other cancer from which the subject has been disease-free for at least 5 years. Concurrent prostate cancer for which the patient is receiving therapy will not be considered an exclusion if the Prostatic specific antigen (PSA) has been stable for 3 years Solitary bone or solitary extramedullary plasmacytoma as the only evidence of plasma cell dyscrasia Myocardial infraction within 6 months before enrollment, New York Heart Association (NYHA) Class II or greater heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmia, clinically significant pericardial disease, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities Uncontrolled medical problems such as diabetes, coronary artery disease, hypertension, unstable angina, arrhythmia, pulmonary, hepatic and renal diseases unless renal insufficiency is considered to be secondary to MM Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the ICF Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she will participate in the study or confounds the ability to interpret data from the study Subjects with any clinical condition that would affect study's outcome Participation in another interventional clinical trial in the 4 weeks preceding enrollment or planning to participate in another interventional clinical trial during the planned period of this study, except of the clinical trials that implicate drugs of supportive treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Meletios Dimopoulos, Doctor
Organizational Affiliation
General Hospital of Athens "Alexandra"
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Eirini Katodritou, Doctor
Organizational Affiliation
Theageneio Anticancer Hospital of Thessaloniki
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nikolaos Anagnostopoulos, Doctor
Organizational Affiliation
General Hospital of Athens "G. Gennimatas''
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Argirios Symeonidis, Doctor
Organizational Affiliation
University General Hospital of Patras
Official's Role
Principal Investigator
Facility Information:
Facility Name
General Hospital of Athens "G. Gennimatas"
City
Athens
State/Province
Attica
ZIP/Postal Code
11527
Country
Greece
Facility Name
General Hospital of Athens "Alexandra"
City
Athens
State/Province
Attica
ZIP/Postal Code
11528
Country
Greece
Facility Name
University General Hospital of Patras
City
Patra
ZIP/Postal Code
26504
Country
Greece
Facility Name
Theageneio Anticancer Hospital of Thessaloniki
City
Thessaloniki
ZIP/Postal Code
54007
Country
Greece

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Lenalidomide & Adriamycin & Dexamethasone (RAD) in Newly Diagnosed, Multiple Myeloma Patients

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