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High Throughput Drug Sensitivity and Genomics Data in Developing Individualized Treatment in Patients With Relapsed or Refractory Multiple Myeloma or Plasma Cell Leukemia

Primary Purpose

Plasma Cell Leukemia, Recurrent Plasma Cell Myeloma, Refractory Plasma Cell Myeloma

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Biospecimen Collection
High Throughput Screening
Laboratory Biomarker Analysis
Sponsored by
University of Washington
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Plasma Cell Leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of multiple myeloma with documented relapsed or refractory disease according to International Myeloma Working Group (IMWG) criteria, or relapsed/refractory plasma cell leukemia
  • Collection of a bone marrow, fluid or tissue sample that is expected to have enough cells to run the assay
  • Measurable disease defined by one of the following:

    • Serum monoclonal protein >= 0.5 g/dL by serum protein electrophoresis (SPEP)
    • >= 200 mg/monoclonal protein in urine on 24 hr urine protein electrophoresis (UPEP)
    • Involved serum free light chain (FLC) >= 10 mg/dL and abnormal involved:uninvolved ratio
    • Plasma cytomas that are palpable per exam or measurable per standard radiologic review
    • Circulating plasma cells >= 2,000 if diagnosis of plasma cell leukemia
  • Minimum of 3 prior lines of therapy including an immunomodulatory drug (IMiD) and a proteasome inhibitor (PI)
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-3
  • Female patients of child bearing potential and non-vasectomized male patients agree to practice appropriate methods of birth control
  • Ability to understand purpose and risks of the study and provide signed and dated informed consent, and authorization to use protected health information
  • Expected survival is > 100 days
  • Adequate organ function as determined by the investigator

Exclusion Criteria:

  • Mucosal or internal bleeding, or platelet transfusion refractory
  • Any medical conditions that would impose excessive risk to the patient, or would adversely affect his/her participation in the study
  • Known active infection requiring antibiotics within 7 days of initiation of study treatment, unless considered controlled in the opinion of the investigator
  • Other malignancy with life expectancy < 1 year due to the other malignancy
  • Pregnant or breast feeding women
  • Serious psychiatric illness, alcoholism, or drug addiction
  • Human immunodeficiency virus (HIV), or active hepatitis B or C infection
  • Previous treatments for multiple myeloma (MM) within 2 weeks of initiation of study treatment
  • Prior autologous or allogeneic stem cell transplantation (SCT) within 12 weeks of initiation of study treatment
  • Prior allogeneic hematopoietic cell transplantation (HCT) with active graft versus host disease (GVHD) on therapeutic dosing of immunosuppression or prednisone > 20 mg daily equivalent
  • Prior major surgical procedure or radiation treatment within 2 weeks of initiation of study treatment (not including limited radiation used for palliation of bone pain)

Sites / Locations

  • Fred Hutch/University of Washington Cancer ConsortiumRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Device feasibility (high-throughput assay, sequencing)

Arm Description

Patients undergo collection of bone marrow aspirate and blood for high-throughput drug sensitivity assay and mutational analysis using next generation sequencing. Patients and their treating physicians receive the results of the tests. Treatment decisions are then made by the patients and their treating physicians.

Outcomes

Primary Outcome Measures

Actionable assay result
The feasibility of this approach will be assessed in terms of obtaining an actionable response from the proposed assay in at least 50% of patients examined.

Secondary Outcome Measures

Overall response rate to the therapy chosen after performing the assay
Will be assessed by the International Myeloma Working Group (IMWG) response criteria. The response among all patients who received the assay as well as among patients who obtained an actionable result from the assay will be estimated.

Full Information

First Posted
December 11, 2017
Last Updated
September 13, 2023
Sponsor
University of Washington
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1. Study Identification

Unique Protocol Identification Number
NCT03389347
Brief Title
High Throughput Drug Sensitivity and Genomics Data in Developing Individualized Treatment in Patients With Relapsed or Refractory Multiple Myeloma or Plasma Cell Leukemia
Official Title
Individualized Treatment for Relapsed/Refractory Multiple Myeloma Based on High Throughput Drug Sensitivity and Genomics Data
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 14, 2018 (Actual)
Primary Completion Date
June 1, 2024 (Anticipated)
Study Completion Date
June 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Washington

4. Oversight

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

5. Study Description

Brief Summary
This pilot clinical trial studies whether using high throughput drug sensitivity and genomics data is feasible in developing individualized treatment in patients with multiple myeloma or plasma cell leukemia that has come back or does not respond to treatment. High throughput screen tests many different drugs that kill multiple myeloma cells in individual chambers at the same time. Matching a drug or drug combination to a patient using high throughput screen and genetic information may improve the ability to help patients by choosing drugs that work well for their disease.
Detailed Description
OUTLINE: Patients undergo collection of bone marrow aspirate and blood for high-throughput drug sensitivity assay and mutational analysis using next generation sequencing. Patients and their treating physicians receive the results of the tests. Treatment decisions are then made by the patients and their treating physicians. After completion of study, patients are followed up every 3 months for 2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasma Cell Leukemia, Recurrent Plasma Cell Myeloma, Refractory Plasma Cell Myeloma

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Device feasibility (high-throughput assay, sequencing)
Arm Type
Experimental
Arm Description
Patients undergo collection of bone marrow aspirate and blood for high-throughput drug sensitivity assay and mutational analysis using next generation sequencing. Patients and their treating physicians receive the results of the tests. Treatment decisions are then made by the patients and their treating physicians.
Intervention Type
Procedure
Intervention Name(s)
Biospecimen Collection
Intervention Description
Undergo collection of bone marrow aspirate and blood
Intervention Type
Device
Intervention Name(s)
High Throughput Screening
Other Intervention Name(s)
High Throughput Assay
Intervention Description
Anti-tumor drugs are tested against myeloma cells in the laboratory, in a high-throughput drug sensitivity assay
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Actionable assay result
Description
The feasibility of this approach will be assessed in terms of obtaining an actionable response from the proposed assay in at least 50% of patients examined.
Time Frame
Up to 21 days
Secondary Outcome Measure Information:
Title
Overall response rate to the therapy chosen after performing the assay
Description
Will be assessed by the International Myeloma Working Group (IMWG) response criteria. The response among all patients who received the assay as well as among patients who obtained an actionable result from the assay will be estimated.
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of multiple myeloma with documented relapsed or refractory disease according to International Myeloma Working Group (IMWG) criteria, or relapsed/refractory plasma cell leukemia Collection of a bone marrow, fluid or tissue sample that is expected to have enough cells to run the assay Measurable disease defined by one of the following: Serum monoclonal protein >= 0.5 g/dL by serum protein electrophoresis (SPEP) >= 200 mg/monoclonal protein in urine on 24 hr urine protein electrophoresis (UPEP) Involved serum free light chain (FLC) >= 10 mg/dL and abnormal involved:uninvolved ratio Plasma cytomas that are palpable per exam or measurable per standard radiologic review Circulating plasma cells >= 2,000 if diagnosis of plasma cell leukemia Minimum of 3 prior lines of therapy including an immunomodulatory drug (IMiD) and a proteasome inhibitor (PI) Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-3 Female patients of child bearing potential and non-vasectomized male patients agree to practice appropriate methods of birth control Ability to understand purpose and risks of the study and provide signed and dated informed consent, and authorization to use protected health information Expected survival is > 100 days Adequate organ function as determined by the investigator Exclusion Criteria: Mucosal or internal bleeding, or platelet transfusion refractory Any medical conditions that would impose excessive risk to the patient, or would adversely affect his/her participation in the study Known active infection requiring antibiotics within 7 days of initiation of study treatment, unless considered controlled in the opinion of the investigator Other malignancy with life expectancy < 1 year due to the other malignancy Pregnant or breast feeding women Serious psychiatric illness, alcoholism, or drug addiction Human immunodeficiency virus (HIV), or active hepatitis B or C infection Previous treatments for multiple myeloma (MM) within 2 weeks of initiation of study treatment Prior autologous or allogeneic stem cell transplantation (SCT) within 12 weeks of initiation of study treatment Prior allogeneic hematopoietic cell transplantation (HCT) with active graft versus host disease (GVHD) on therapeutic dosing of immunosuppression or prednisone > 20 mg daily equivalent Prior major surgical procedure or radiation treatment within 2 weeks of initiation of study treatment (not including limited radiation used for palliation of bone pain)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Andrew J. Cowan
Phone
206-606-7348
Email
ajcowan@seattlecca.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrew J. Cowan
Organizational Affiliation
Fred Hutch/University of Washington Cancer Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fred Hutch/University of Washington Cancer Consortium
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrew J. Cowan
Phone
206-606-7348
Email
ajcowan@seattlecca.org
First Name & Middle Initial & Last Name & Degree
Andrew J. Cowan

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

High Throughput Drug Sensitivity and Genomics Data in Developing Individualized Treatment in Patients With Relapsed or Refractory Multiple Myeloma or Plasma Cell Leukemia

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