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Viral Immunotherapy in Relapsed/Refractory Multiple Myeloma (MUKeleven)

Primary Purpose

Multiple Myeloma

Status
Unknown status
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Lenalidomide or Pomalidomide
REOLYSIN
Sponsored by
University of Leeds
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosed with symptomatic multiple myeloma (according to IMWG 2014 criteria)
  • Evaluable disease by modified IMWG criteria (i.e. by abnormal serum M protein, urinary M protein or serum free light chain assays)
  • Currently receiving either lenalidomide or pomalidomide therapy, alone or in combination with other myeloma therapy, with evidence of serological or clinical disease progression as defined by IMWG criteria (2011)
  • Life expectancy of ≥ 3 months
  • ECOG performance status of ≤2
  • Required laboratory values within 14 days prior to dose allocation:
  • Absolute neutrophil count ≥ 1.0 x10^9 /L. (growth factor support is not permitted)
  • Platelet count ≥ 70 x 10^9/L. (platelet support is not permitted; platelets < 70 but ≥ 25 acceptable if bone marrow is > 50% infiltrated by MM)
  • Haemoglobin ≥ 8 g/dL. Blood support is permitted
  • Serum bilirubin ≤ 2 x upper limit of normal (ULN)
  • ALT or AST ≤ 2.5 x ULN
  • Serum creatinine ≤ 2 x ULN
  • Corrected calcium ≤ 2.8 mmol/l
  • Negative HIV and viral (B and C) hepatitis test result within 14 days prior to dose allocation
  • Able to give informed consent and willing to follow trial protocol
  • Aged 18 years or over
  • All participants must agree to follow the Celgene Pregnancy Prevention Programme (PPP) and participate in the counselling associated with this:
  • Females of childbearing potential (FCBP) must agree to utilise two reliable forms of contraception simultaneously or practice complete abstinence for at least for 28 days prior to starting trial treatment, during the trial and for at least 28 days after trial treatment discontinuation, and even in case of dose interruption, and must agree to Celgene PPP pregnancy testing during this timeframe
  • Females must agree to abstain from breastfeeding during trial participation and 28 days after trial drug discontinuation
  • Males must agree to use a latex condom during any sexual contact with FCBP (or must practice complete abstinence) during the trial, including during dose interruptions and for 28 days following discontinuation from this trial even if he has undergone a successful vasectomy
  • Males must also agree to refrain from donating semen or sperm while on pomalidomide including during any dose interruptions and for 28 days after discontinuation from this trial
  • All participants must agree to refrain from donating blood while on trial drug including during dose interruptions and for 28 days after discontinuation from this trial

Exclusion Criteria:

  • Non-secretory multiple myeloma
  • Pregnant (positive pregnancy test) in line with the Celgene Pregnancy Prevention Programme or breast feeding
  • Previous anti-tumour therapies including experimental agents, other than lenalidomide or pomalidomide, within 28 days of the start of protocol treatment. Steroid therapy is permitted, but must be stopped 48 hours prior to cycle 1 day 1
  • Concurrent or previous malignancies (<12 months post end of treatment) at other sites, with the exception of appropriately treated localised epithelial skin or cervical cancer, or incidental histologic findings of prostate cancer (TNM stage T1a or 1b). Participants with histories (≥12 months) of other tumours, in remission and not currently on therapy, may be entered
  • System corticosteroid therapy for comorbidities (i.e. medical conditions other than multiple myeloma) that cannot be stopped for the duration of the trial. Topical corticosteroid therapy is not an exclusion criterion.
  • Any history of known hypersensitivity to any of the trial medications or excipients
  • Active symptomatic fungal, bacterial, and/or viral infection
  • Poorly controlled or serious medical or psychiatric illness that, in the Investigator's opinion, is likely to interfere with participation and/or compliance in this clinical trial
  • Patients with significant cardiovascular disease (e.g. history of congestive heart failure requiring therapy (≥ NYHA Class III), presence of severe valvular heart disease, presence of an atrial or ventricular arrhythmia requiring treatment, uncontrolled hypertension, or history of QTc abnormalities)
  • Radiotherapy or major surgery within 4 weeks prior to registration
  • Greater than or equal to grade 2 neuropathy, with or without pain

Sites / Locations

  • St James's University Hospital
  • Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lenalidomide or pomalidomide, plus REOLYSIN

Arm Description

Lenalidomide capsules, oral, maximum 10mg daily on days 1-21 of 28-day cycles. OR Pomalidomide capsules, oral, maximum 1mg daily on days 1-21 of 28-day cycles. Plus (all patients): REOLYSIN® , intravenous infusion, maximum 3x10^10 TCID50 on days 1, 8, 15 and 22 of 28-day cycles.

Outcomes

Primary Outcome Measures

Dose-limiting toxicities
Dose-limiting toxicities (DLTs), within the first cycle (until cycle 2, day 1), in order to establish the Maximum Tolerated Dose (MTD) of REOLYSIN® in combination with lenalidomide or pomalidomide, in two separate groups of participants.

Secondary Outcome Measures

Safety profile of REOLYSIN® and lenalidomide
Safety will be reported based on the occurrence of SAEs, SARs and SUSARs.
Safety profile of REOLYSIN® and pomalidomide
Safety will be reported based on the occurrence of SAEs, SARs and SUSARs.
Toxicity profile of REOLYSIN® and lenalidomide
Toxicity will be reported based on adverse events, as graded by CTCAE V4.0, and determined by routine clinical assessments at each centre.
Toxicity profile of REOLYSIN® and pomalidomide
Toxicity will be reported based on adverse events, as graded by CTCAE V4.0, and determined by routine clinical assessments at each centre.
Response rate (stable disease or better) after 6 cycles of therapy
Measured only in patients treated at the maximum tolerated dose
Maximum response within 6 cycles of therapy
Measured only in patients treated at the maximum tolerated dose
Maximum response overall
Measured only in patients treated at the maximum tolerated dose
Time to maximum response
Measured only in patients treated at the maximum tolerated dose
Progression-free survival
Measured only in patients treated at the maximum tolerated dose. Participants who have not progressed at the time of analysis will be censored at the last date they were known to be alive and progression free.
Overall survival
Measured only in patients treated at the maximum tolerated dose. Participants who have not died at the time of analysis will be censored at the last date they were known to be alive.

Full Information

First Posted
November 16, 2016
Last Updated
January 21, 2020
Sponsor
University of Leeds
Collaborators
Myeloma UK, Oncolytics Biotech, Celgene Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT03015922
Brief Title
Viral Immunotherapy in Relapsed/Refractory Multiple Myeloma
Acronym
MUKeleven
Official Title
VIRel: Viral Immunotherapy in Relapsed/Refractory Multiple Myeloma - A Phase I Study to Assess the Safety and Tolerability of REOLYSIN® (Pelareorep) in Combination With Lenalidomide or Pomalidomide
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 5, 2017 (Actual)
Primary Completion Date
September 1, 2021 (Anticipated)
Study Completion Date
October 1, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Leeds
Collaborators
Myeloma UK, Oncolytics Biotech, Celgene Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will recruit patients currently receiving either lenalidomide or pomalidomide whose disease is relapsing. This is a dose escalation study and the aim is to determine the maximum tolerated dose (MTD) of REOLYSIN® that can be given in combination with lenalidomide or pomalidomide. The study will also investigate the safety, side effects and effectiveness of this treatment combination. Pomalidomide and lenalidomide will be evaluated separately as two separate groups.

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 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lenalidomide or pomalidomide, plus REOLYSIN
Arm Type
Experimental
Arm Description
Lenalidomide capsules, oral, maximum 10mg daily on days 1-21 of 28-day cycles. OR Pomalidomide capsules, oral, maximum 1mg daily on days 1-21 of 28-day cycles. Plus (all patients): REOLYSIN® , intravenous infusion, maximum 3x10^10 TCID50 on days 1, 8, 15 and 22 of 28-day cycles.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide or Pomalidomide
Intervention Description
Patients will received either lenalidomide or pomalidomide, depending on which drug they were receiving prior to the trial (they will receive the same as before).
Intervention Type
Biological
Intervention Name(s)
REOLYSIN
Other Intervention Name(s)
Pelareorep, Reovirus
Intervention Description
Patients will receive Reolysin alongside either lenalidomide or pomalidomide
Primary Outcome Measure Information:
Title
Dose-limiting toxicities
Description
Dose-limiting toxicities (DLTs), within the first cycle (until cycle 2, day 1), in order to establish the Maximum Tolerated Dose (MTD) of REOLYSIN® in combination with lenalidomide or pomalidomide, in two separate groups of participants.
Time Frame
After cycle 1 (28 days) of treatment. Assessed in real-time for each patient to inform dose escalation decisions.
Secondary Outcome Measure Information:
Title
Safety profile of REOLYSIN® and lenalidomide
Description
Safety will be reported based on the occurrence of SAEs, SARs and SUSARs.
Time Frame
Until 28 days after the last dose of trial treatment for each patient. Assessed up to 27 months.
Title
Safety profile of REOLYSIN® and pomalidomide
Description
Safety will be reported based on the occurrence of SAEs, SARs and SUSARs.
Time Frame
Until 28 days after the last dose of trial treatment for each patient. Assessed up to 27 months.
Title
Toxicity profile of REOLYSIN® and lenalidomide
Description
Toxicity will be reported based on adverse events, as graded by CTCAE V4.0, and determined by routine clinical assessments at each centre.
Time Frame
Until 28 days after the last dose of trial treatment fior each patient. Assessed up to 27 months.
Title
Toxicity profile of REOLYSIN® and pomalidomide
Description
Toxicity will be reported based on adverse events, as graded by CTCAE V4.0, and determined by routine clinical assessments at each centre.
Time Frame
Until 28 days after the last dose of trial treatment fior each patient. Assessed up to 27 months.
Title
Response rate (stable disease or better) after 6 cycles of therapy
Description
Measured only in patients treated at the maximum tolerated dose
Time Frame
Data will be collected from each patient after they have received 6 cycles of therapy, if this stage is reached. 6 cycles are expected to take 24 weeks to complete.
Title
Maximum response within 6 cycles of therapy
Description
Measured only in patients treated at the maximum tolerated dose
Time Frame
Assessed for each patient after they have received 6 cycles of treatment. 6 cycles are expected to take 24 weeks to complete.
Title
Maximum response overall
Description
Measured only in patients treated at the maximum tolerated dose
Time Frame
Assessed for each patient after they have completed treatment on the trial. Assessed up to 27 months.
Title
Time to maximum response
Description
Measured only in patients treated at the maximum tolerated dose
Time Frame
Assessed for each patient after they have completed treatment on the trial. Assessed up to 27 months.
Title
Progression-free survival
Description
Measured only in patients treated at the maximum tolerated dose. Participants who have not progressed at the time of analysis will be censored at the last date they were known to be alive and progression free.
Time Frame
Calculated for each patient from the date of registration up to first documented evidence of disease progression or death. Assessed up to 27 months.
Title
Overall survival
Description
Measured only in patients treated at the maximum tolerated dose. Participants who have not died at the time of analysis will be censored at the last date they were known to be alive.
Time Frame
Calculated for each patient from the date of registration to death. Assessed up to 27 months.
Other Pre-specified Outcome Measures:
Title
Immune response biomarker profile of REOLYSIN and lenalidomide administered in combination
Description
Biomarker profiling of the combination treatment
Time Frame
This will be assessed based on samples taken throughout each patient's time on the trial. Assessed up to 27 months.
Title
Immune response biomarker profile of REOLYSIN® and pomalidomide administered in combination
Description
Biomarker profiling of the combination treatment
Time Frame
This will be assessed based on samples taken throughout each patient's time on the trial. Assessed up to 27 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosed with symptomatic multiple myeloma (according to IMWG 2014 criteria) Evaluable disease by modified IMWG criteria (i.e. by abnormal serum M protein, urinary M protein or serum free light chain assays) Currently receiving either lenalidomide or pomalidomide therapy, alone or in combination with other myeloma therapy, with evidence of serological or clinical disease progression as defined by IMWG criteria (2011) Life expectancy of ≥ 3 months ECOG performance status of ≤2 Required laboratory values within 14 days prior to dose allocation: Absolute neutrophil count ≥ 1.0 x10^9 /L. (growth factor support is not permitted) Platelet count ≥ 70 x 10^9/L. (platelet support is not permitted; platelets < 70 but ≥ 25 acceptable if bone marrow is > 50% infiltrated by MM) Haemoglobin ≥ 8 g/dL. Blood support is permitted Serum bilirubin ≤ 2 x upper limit of normal (ULN) ALT or AST ≤ 2.5 x ULN Serum creatinine ≤ 2 x ULN Corrected calcium ≤ 2.8 mmol/l Negative HIV and viral (B and C) hepatitis test result within 14 days prior to dose allocation Able to give informed consent and willing to follow trial protocol Aged 18 years or over All participants must agree to follow the Celgene Pregnancy Prevention Programme (PPP) and participate in the counselling associated with this: Females of childbearing potential (FCBP) must agree to utilise two reliable forms of contraception simultaneously or practice complete abstinence for at least for 28 days prior to starting trial treatment, during the trial and for at least 28 days after trial treatment discontinuation, and even in case of dose interruption, and must agree to Celgene PPP pregnancy testing during this timeframe Females must agree to abstain from breastfeeding during trial participation and 28 days after trial drug discontinuation Males must agree to use a latex condom during any sexual contact with FCBP (or must practice complete abstinence) during the trial, including during dose interruptions and for 28 days following discontinuation from this trial even if he has undergone a successful vasectomy Males must also agree to refrain from donating semen or sperm while on pomalidomide including during any dose interruptions and for 28 days after discontinuation from this trial All participants must agree to refrain from donating blood while on trial drug including during dose interruptions and for 28 days after discontinuation from this trial Exclusion Criteria: Non-secretory multiple myeloma Pregnant (positive pregnancy test) in line with the Celgene Pregnancy Prevention Programme or breast feeding Previous anti-tumour therapies including experimental agents, other than lenalidomide or pomalidomide, within 28 days of the start of protocol treatment. Steroid therapy is permitted, but must be stopped 48 hours prior to cycle 1 day 1 Concurrent or previous malignancies (<12 months post end of treatment) at other sites, with the exception of appropriately treated localised epithelial skin or cervical cancer, or incidental histologic findings of prostate cancer (TNM stage T1a or 1b). Participants with histories (≥12 months) of other tumours, in remission and not currently on therapy, may be entered System corticosteroid therapy for comorbidities (i.e. medical conditions other than multiple myeloma) that cannot be stopped for the duration of the trial. Topical corticosteroid therapy is not an exclusion criterion. Any history of known hypersensitivity to any of the trial medications or excipients Active symptomatic fungal, bacterial, and/or viral infection Poorly controlled or serious medical or psychiatric illness that, in the Investigator's opinion, is likely to interfere with participation and/or compliance in this clinical trial Patients with significant cardiovascular disease (e.g. history of congestive heart failure requiring therapy (≥ NYHA Class III), presence of severe valvular heart disease, presence of an atrial or ventricular arrhythmia requiring treatment, uncontrolled hypertension, or history of QTc abnormalities) Radiotherapy or major surgery within 4 weeks prior to registration Greater than or equal to grade 2 neuropathy, with or without pain
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gordon Cook
Organizational Affiliation
St. James's University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
St James's University Hospital
City
Leeds
Country
United Kingdom
Facility Name
Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital
City
Sheffield
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Viral Immunotherapy in Relapsed/Refractory Multiple Myeloma

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