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Ixazomib, Lenalidomide, Dexamethasone Induction and Extended Consolidation Plus Lenalidomide Maintenance in Multiple Myeloma (IFM2014-03)

Primary Purpose

Multiple Myeloma

Status
Terminated
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Ixazomib
Lenalidomide
Dexamethasone
Sponsored by
University Hospital, Toulouse
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Multiple myeloma based on the new IMWG Diagnostic Criteria for plasma cells disorders
  • Symptomatic myeloma with CRAB criteria
  • Measurable disease requiring systemic therapy defined by serum M-component ≥ 5g/l or urine M-component ≥ 200 mg/24h or serum FLC ≥ 100 mg/l.
  • Subjects must not have been treated previously with any systemic therapy for multiple myeloma.
  • Eligibility for high dose therapy.
  • Life expectancy ≥ 3 months
  • ECOG performance status 0, 1 or 2
  • Patients must meet the following clinical laboratory criteria:

    • Adequate hepatic function,
    • Absolute neutrophil count (ANC) ≥ 1.0 × 109/L within 14 days prior to enrollment.
    • Hemoglobin ≥ 8 g/dL (80 g/L) within 14 days prior to enrollment
    • Platelet count ≥ 75 × 109/L eRenal eGFR ≥ 50 mL/minute within 7 days

Exclusion Criteria:

  • Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening
  • Evidence of mucosal or internal bleeding and/or platelet refractory.
  • Prior myeloma systemic therapy
  • Major surgery within 14 days before first dose of study drug.
  • Radiotherapy within 14 days before first dose of study drug.
  • Corticosteroids if exceed the equivalent of 160 mg of dexamethasone within 14 days before first dose of study drug
  • Central nervous system involvement
  • Growth factors within 7 days of screening
  • Transfusion within 7 days of screening
  • Uncontrolled hypertension or uncontrolled diabetes within 14 days prior to first dose of study drug
  • Infection .
  • Evidence of current uncontrolled cardiovascular conditions,
  • Systemic treatment, within 14 days before first dose of study drug, with strong inhibitors of CYP1A2 , strong inhibitors of CYP3A or use of Ginkgo biloba or St. John's wort.
  • Ongoing or active systemic infection, known human immunodeficiency virus (HIV) positive, known active hepatitis B virus hepatitis, or known active hepatitis C virus hepatitis and history of hepatitis B or C virus hepatitis.

    15. Co-morbid systemic illnesses or other severe concurrent disease that, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens.

  • Psychiatric illness/social situation that would limit compliance with study requirements.
  • Known allergy to any of the study medications,
  • Contraindication to any of the required concomitant drugs
  • Diagnosed or treated for another malignancy within 5 years before study enrollment or previously diagnosed with another malignancy and have any evidence of residual disease.
  • Patient has significant neuropathy

Sites / Locations

  • University Hosptial Toulouse

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Study treatment

Arm Description

Ixazomib, Lenalidomide, Dexamethasone Induction and extended Consolidation followed by Lenalidomide Maintenance

Outcomes

Primary Outcome Measures

rate of stringent complete response
after consolidation and before maintenance therapy

Secondary Outcome Measures

Adverse events
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
response rates
response rates according to the IMWG criteria after induction, high dose Melphalan, early consolidation, late consolidation and maintenance therapy
Progression free survival
overall survival
Percentage of patients for whom more than 5X106 CD34 cells will be collected.
At stem cell harvest
Correlation between presence of deletion 17p and response rate
biological prognostic factors assessed at D1 influencing outcome and response rates assessed at 60th month
Correlation between presence of translocation4-14 and response rate
biological prognostic factors assessed at D1 influencing outcome and response rates assessed at 60th month

Full Information

First Posted
July 17, 2015
Last Updated
November 9, 2020
Sponsor
University Hospital, Toulouse
Collaborators
Takeda, Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT02897830
Brief Title
Ixazomib, Lenalidomide, Dexamethasone Induction and Extended Consolidation Plus Lenalidomide Maintenance in Multiple Myeloma
Acronym
IFM2014-03
Official Title
Evaluation of Ixazomib, Lenalidomide, Dexamethasone Induction and Extended Consolidation Followed by Lenalidomide Maintenance in Newly Diagnosed Multiple Myeloma Patients ≤65 Years Eligible for High Dose Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Terminated
Why Stopped
negatives results
Study Start Date
August 5, 2016 (Actual)
Primary Completion Date
November 2018 (Actual)
Study Completion Date
August 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Toulouse
Collaborators
Takeda, Celgene

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Open-label study to evaluate the safety and efficacy of Ixazomib in combination with Lenalidomide and Dexamethasone in patients with newly diagnosed multiple myeloma (MM). The patient population will consist of adult men and women up to 65 years, who have a confirmed diagnosis of MM who meet eligibility criteria.
Detailed Description
Patients will receive induction therapy, comprising three cycles with Ixazomib, plus Lenalidomide and Dexamethasone. Peripheral Blood Stem Cells (PBSC) will be mobilized within 2 weeks (+/- 1 week) after the last dose of Lenalidomide, with Cyclophosphamide plus G-CSF or Granulocyte-CSF(Colony Stimulating Factor). Intensification: High Dose Melphalan (HDM) will be performed within 3 weeks +/- 1 week following stem cell harvest. After Peripheral Blood Stem Cell Transplantation, patient will enter in the consolidation phase: Early consolidation (consolidation part 1) will start 2 months after transplantation and will comprise 2 cycles of MLN - Rd (MLN R identical to induction therapy but low dose of Dexamethasone). Late consolidation (consolidation part 2) will consist in 6 additional cycles of Ixazomib plus Lenalidomide. No Dexamethasone. Maintenance therapy will start within 28 days after the last dose of Lenalidomide in last cycle of Late Consolidation for thirteen 28-day cycles (approximately 12 months duration) Patients will be seen at regular treatment cycle intervals while they are participating in the study. Response will be assessed according to the International Myeloma Working Group (IMWG) criteria until disease progression. All patients will be followed for survival after progression.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
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
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Study treatment
Arm Type
Experimental
Arm Description
Ixazomib, Lenalidomide, Dexamethasone Induction and extended Consolidation followed by Lenalidomide Maintenance
Intervention Type
Drug
Intervention Name(s)
Ixazomib
Other Intervention Name(s)
MLN 9708
Intervention Description
induction therapy: comprising three 28-day cycles with Ixazomib (4 mg) on Days 1, 8 and 15 plus Lenalidomide (25 mg) on Days 1 through 21 and Dexamethasone (40 mg) on Days 1, 8, 15 and 22. Early consolidation : (consolidation part 1) will start 2 months (-/+ 14 days) after transplantation and will comprise 2 cycles of MLN - Rd (MLN R identical to induction therapy but low dose of Dexamethasone 20mg/d once a week). Late consolidation (consolidation part 2) will consist in 6 additional 28-day cycles of Ixazomib (4 mg on Days 1, 8 and 15) plus Lenalidomide (25 mg on Days 1 through 21).
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Other Intervention Name(s)
Revlimid
Intervention Description
induction therapy: comprising three 28-day cycles with Ixazomib (4 mg) on Days 1, 8 and 15 plus Lenalidomide (25 mg) on Days 1 through 21 and Dexamethasone (40 mg) on Days 1, 8, 15 and 22. Early consolidation : (consolidation part 1) will start 2 months (-/+ 14 days) after transplantation and will comprise 2 cycles of MLN - Rd (MLN R identical to induction therapy but low dose of Dexamethasone 20mg/d once a week). Late consolidation (consolidation part 2) will consist in 6 additional 28-day cycles of Ixazomib (4 mg on Days 1, 8 and 15) plus Lenalidomide (25 mg on Days 1 through 21). Maintenance therapy will start within 28 days after the last dose of Lenalidomide in last cycle of Late Consolidation: Lenalidomide 10 mg/d taken on Days 1 through 21 for thirteen 28-day cycles
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
induction therapy: comprising three 28-day cycles with Ixazomib (4 mg) on Days 1, 8 and 15 plus Lenalidomide (25 mg) on Days 1 through 21 and Dexamethasone (40 mg) on Days 1, 8, 15 and 22. Early consolidation : (consolidation part 1) will start 2 months (-/+ 14 days) after transplantation and will comprise 2 cycles of MLN - Rd (MLN R identical to induction therapy but low dose of Dexamethasone 20mg/d once a week).
Primary Outcome Measure Information:
Title
rate of stringent complete response
Description
after consolidation and before maintenance therapy
Time Frame
13 months
Secondary Outcome Measure Information:
Title
Adverse events
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
up 60 Months
Title
response rates
Description
response rates according to the IMWG criteria after induction, high dose Melphalan, early consolidation, late consolidation and maintenance therapy
Time Frame
3 months, 5 months, 7 months, 13 months, 25 months
Title
Progression free survival
Time Frame
60 months
Title
overall survival
Time Frame
60 months
Title
Percentage of patients for whom more than 5X106 CD34 cells will be collected.
Description
At stem cell harvest
Time Frame
3 months
Title
Correlation between presence of deletion 17p and response rate
Description
biological prognostic factors assessed at D1 influencing outcome and response rates assessed at 60th month
Time Frame
60 months
Title
Correlation between presence of translocation4-14 and response rate
Description
biological prognostic factors assessed at D1 influencing outcome and response rates assessed at 60th month
Time Frame
60 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Multiple myeloma based on the new IMWG Diagnostic Criteria for plasma cells disorders Symptomatic myeloma with CRAB criteria Measurable disease requiring systemic therapy defined by serum M-component ≥ 5g/l or urine M-component ≥ 200 mg/24h or serum FLC ≥ 100 mg/l. Subjects must not have been treated previously with any systemic therapy for multiple myeloma. Eligibility for high dose therapy. Life expectancy ≥ 3 months ECOG performance status 0, 1 or 2 Patients must meet the following clinical laboratory criteria: Adequate hepatic function, Absolute neutrophil count (ANC) ≥ 1.0 × 109/L within 14 days prior to enrollment. Hemoglobin ≥ 8 g/dL (80 g/L) within 14 days prior to enrollment Platelet count ≥ 75 × 109/L eRenal eGFR ≥ 50 mL/minute within 7 days Exclusion Criteria: Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening Evidence of mucosal or internal bleeding and/or platelet refractory. Prior myeloma systemic therapy Major surgery within 14 days before first dose of study drug. Radiotherapy within 14 days before first dose of study drug. Corticosteroids if exceed the equivalent of 160 mg of dexamethasone within 14 days before first dose of study drug Central nervous system involvement Growth factors within 7 days of screening Transfusion within 7 days of screening Uncontrolled hypertension or uncontrolled diabetes within 14 days prior to first dose of study drug Infection . Evidence of current uncontrolled cardiovascular conditions, Systemic treatment, within 14 days before first dose of study drug, with strong inhibitors of CYP1A2 , strong inhibitors of CYP3A or use of Ginkgo biloba or St. John's wort. Ongoing or active systemic infection, known human immunodeficiency virus (HIV) positive, known active hepatitis B virus hepatitis, or known active hepatitis C virus hepatitis and history of hepatitis B or C virus hepatitis. 15. Co-morbid systemic illnesses or other severe concurrent disease that, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens. Psychiatric illness/social situation that would limit compliance with study requirements. Known allergy to any of the study medications, Contraindication to any of the required concomitant drugs Diagnosed or treated for another malignancy within 5 years before study enrollment or previously diagnosed with another malignancy and have any evidence of residual disease. Patient has significant neuropathy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michel ATTAL, MD
Organizational Affiliation
CHU Toulouse
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Murielle ROUSSEL, MD
Organizational Affiliation
CHU Toulouse
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hosptial Toulouse
City
Toulouse
ZIP/Postal Code
31000
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Ixazomib, Lenalidomide, Dexamethasone Induction and Extended Consolidation Plus Lenalidomide Maintenance in Multiple Myeloma

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