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A Safety Confirmation Study on Lenalidomide With Dexamethasone In Japanese Patients With Previously Treated Multiple Myeloma

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
Lenalidomide
Dexamethasone
Sponsored by
Celgene
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Must understand and voluntarily sign the informed consent form
  • Age ≥ 20 years at the time of signing the informed consent form
  • Subjects with previously treated multiple myeloma defined as follows:

    • Subjects must have received at least 1 prior anti-myeloma drug treatment regimen; and
    • Considered to have progression of disease (PD) that occurred either during or following the completion of the last anti-myeloma treatment regimen utilized prior to enrollment into this study
  • Measurable levels of M-protein in serum (greater than or equal to 0.5 g/dL [5g/L]) or urine (greater than or equal to 0.2 g excreted in a 24-hour collection sample)
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 2
  • Must be able to adhere to the study visit schedule and other protocol requirements
  • Females of childbearing potential (FCBP) must agree to use one or more of the following forms of contraception or abstain from heterosexual contact completely and have the male partners use a condom on the occasion of heterosexual contact in the following periods below:

    • For at least 28 days before starting study drug (in particular, the subject must abstain from heterosexual contact for 2 weeks prior to prescribing lenalidomide).
    • During the treatment phase (including the dose withholding period) For at least 28 days after the discontinuation/completion of the study drug (Methods of contraception)
    • Birth control pills
    • Intrauterine device (IUD)
    • Bilateral tubal ligation (FCBP must be referred to a health care provider who is familiar with contraceptive methods, if needed).
  • Male subject must agree to use a condom during sexual contact with female irrespective of pregnancy potential
  • Subjects must agree that study drug must be immediately discontinued, if pregnancy or a positive pregnancy test does occur in a female study subject or the partner of a male study subject during study participation

Exclusion Criteria:

  • Pregnant or lactating females
  • Subjects with a history of acute myocardial infarction within the past 6 months before starting the study drugs
  • Subjects with any history or concurrent conditions of deep vein thrombosis or pulmonary embolus within the past 3 years before starting study drugs
  • Subjects with tuberculous diseases, herpes simplex keratitis, systemic mycosis or other active infectious diseases
  • Subjects with non-controlled diabetes, hypertension, digestive ulcer or glaucoma
  • Subjects with posterior subcapsular cataracts
  • Subjects with peripheral neuropathy of ≥Grade 2
  • Subjects with any history or concurrent conditions which the Principal Investigator / subinvestigators consider inappropriate for participation in this study, and subjects with a serious disease or a mental disease, which is considered to become more risky if the subjects participate in this study.
  • Subjects with a history of desquamative (blistering) rash while taking thalidomide
  • Subjects with a history of using lenalidomide
  • Subjects who have used thalidomide within 28 days before starting the study drugs
  • Subjects with a history of hypersensitivity to dexamethasone
  • Subjects who discontinued treatment due to grade 3 or 4 toxicity from high dose dexamethasone
  • Subjects with a surgical wound after a visceral surgery performed recently
  • Subjects who have undergone radiation therapy within 14 days before starting the study drugs
  • Subjects who have used a chemotherapeutic agent, an immunomodulating agent or a study drug (a drug not commercially available) intended for the treatment of multiple myeloma (MM) within 28 days before starting the study drug
  • Subjects with any history or concurrent conditions of malignancies, other than MM, unless the subject has been free of the disease for 3 years:

    • Basal cell carcinoma of the skin,
    • Squamous cell carcinoma of the skin,
    • Carcinoma in situ of the cervix,
    • Carcinoma in situ of the breast,
    • Incidental histologic finding of prostate cancer Tumor, Lymph Nodes, Metastasis (TNM) stage of T1a or T1b)
  • Known human immunodeficiency virus (HIV) infection or HIV-1 positivity
  • Subjects who have been diagnosed as an hepatitis b virus (HBV) carrier
  • Subjects who are applicable to any of the following abnormal laboratory findings:

    • Absolute neutrophil count : < 1,000 /μL (1.0×10^9 /L)
    • Platelet count: <75,000 /μL (75×10^9 /L)
    • Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) or alanine aminotransferase (ALT)/serum glutamic-pyruvic transaminase (SGPT): > 3.0 times the upper limit of the standard range
    • Creatinine clearance: < 30 mL/min

Sites / Locations

  • Nagoya Medical Center
  • Nagoya City University Hospital
  • Fukuoka University Hospital
  • Kyoto Prefectural University of Medicine
  • Niigata Cancer Center Hospital
  • Osaka Red Cross Hospital
  • Tokushima University
  • Keio University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lenalidomide and Dexamethasone

Arm Description

Lenalidomide 25mg by mouth (PO) once daily (QD) on Days 1-21 of each 28 day cycle; When creatinine (CrCl) clearance <60 mL/min, the initial dose was 10mg and the dose could be increased to 15mg after 2 cycles if the investigator judged therapeutic effect was insufficient and tolerability was acceptable. Dexamethasone 40 mg by PO once QD on days 1-4, 9-12 and 17-20 of each 28 day cycle for the first 4 cycles and Days 1-4 for the remaining cycles beginning at Cycle 5.

Outcomes

Primary Outcome Measures

Number of Participants Experiencing Treatment-Emergent Adverse Events (TEAE)
A TEAE was defined as any AE that started on or after the first dose of study drug, and within End of Study (EOS) (28 days after the last dose of study drug received). A serious AE (SAE) = any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability; is a congenital anomaly/birth defect; or constitutes an important medical event. The intensity of AEs were graded 1 to 5 according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0. For all other AEs not described in the CTCAE criteria, the intensity was assessed by the investigator as mild grade (Grade 1), moderate (grade 2), severe (grade 3), life-threatening (grade 4) or death (grade 5)

Secondary Outcome Measures

Myeloma Response Rate
Overall myeloma response rate was determined by the investigator using the Myeloma Response Determination Criteria adapted from Bladé criteria. A responder is any patient who showed at least a partial response. Overall myeloma response rate is defined as the percentage of participants who achieved a Complete Response (CR), plus a Remission Response (RR), plus a Partial Response (PR). A CR is the disappearance of monoclonal paraprotein and maintained for ≥ 6 weeks. RR is a 75-99% reduction in the level of the serum monoclonal paraprotein compared to baseline; 90-99% reduction in 24-hr urinary light chain excretion. PR is a 50-74% reduction in the level of monoclonal paraprotein compared to baseline; 50-89% reduction in 24-hr urinary light chain excretion.
Kaplan-Meier Estimates of Duration of Response (DoR)
Duration of response was defined as the time from the first observation of a response (CR, RR or PR) to the first documented disease progression or relapse. For participants who did not progress during the study, duration of response was censored at the last adequate response assessment showing evidence of no disease progression. Disease progression is defined as an increase in M-protein serum monoclonal paraprotein and/or urine paraprotein or evidence of bone marrow plasmacytosis and plasma cells, an appearance of new or existing soft tissue plasmacytomas, an appearance of new or existing lytic bone lesions and/or hypercalcemia >11.5mg/dL

Full Information

First Posted
June 9, 2009
Last Updated
November 7, 2019
Sponsor
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT00928486
Brief Title
A Safety Confirmation Study on Lenalidomide With Dexamethasone In Japanese Patients With Previously Treated Multiple Myeloma
Official Title
A Safety Confirmation Study On Lenalidomide With Dexamethasone In Japanese Patients With Previously Treated Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
April 28, 2009 (Actual)
Primary Completion Date
September 10, 2010 (Actual)
Study Completion Date
September 10, 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Celgene

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate the safety and efficacy of lenalidomide with dexamethasone in Japanese patients with previously treated multiple myeloma.

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 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lenalidomide and Dexamethasone
Arm Type
Experimental
Arm Description
Lenalidomide 25mg by mouth (PO) once daily (QD) on Days 1-21 of each 28 day cycle; When creatinine (CrCl) clearance <60 mL/min, the initial dose was 10mg and the dose could be increased to 15mg after 2 cycles if the investigator judged therapeutic effect was insufficient and tolerability was acceptable. Dexamethasone 40 mg by PO once QD on days 1-4, 9-12 and 17-20 of each 28 day cycle for the first 4 cycles and Days 1-4 for the remaining cycles beginning at Cycle 5.
Intervention Type
Drug
Intervention Name(s)
Lenalidomide
Other Intervention Name(s)
CC-5013, Revlimid
Intervention Description
Lenalidomide 25mg PO for (days 1 - 21) of a 28-day cycle
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Other Intervention Name(s)
Decadron
Intervention Description
Dexamethasone 40 mg by mouth (PO) daily (QD) on days 1-4, 9-12 and 17-20 of each 28 day cycle
Primary Outcome Measure Information:
Title
Number of Participants Experiencing Treatment-Emergent Adverse Events (TEAE)
Description
A TEAE was defined as any AE that started on or after the first dose of study drug, and within End of Study (EOS) (28 days after the last dose of study drug received). A serious AE (SAE) = any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability; is a congenital anomaly/birth defect; or constitutes an important medical event. The intensity of AEs were graded 1 to 5 according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0. For all other AEs not described in the CTCAE criteria, the intensity was assessed by the investigator as mild grade (Grade 1), moderate (grade 2), severe (grade 3), life-threatening (grade 4) or death (grade 5)
Time Frame
Day 1 of study drug through 28 days after the last dose of study drug; maximum treatment duration was 60.3 weeks
Secondary Outcome Measure Information:
Title
Myeloma Response Rate
Description
Overall myeloma response rate was determined by the investigator using the Myeloma Response Determination Criteria adapted from Bladé criteria. A responder is any patient who showed at least a partial response. Overall myeloma response rate is defined as the percentage of participants who achieved a Complete Response (CR), plus a Remission Response (RR), plus a Partial Response (PR). A CR is the disappearance of monoclonal paraprotein and maintained for ≥ 6 weeks. RR is a 75-99% reduction in the level of the serum monoclonal paraprotein compared to baseline; 90-99% reduction in 24-hr urinary light chain excretion. PR is a 50-74% reduction in the level of monoclonal paraprotein compared to baseline; 50-89% reduction in 24-hr urinary light chain excretion.
Time Frame
From the time of the first dose of study drug to study completion; median duration on study was 42.1 weeks
Title
Kaplan-Meier Estimates of Duration of Response (DoR)
Description
Duration of response was defined as the time from the first observation of a response (CR, RR or PR) to the first documented disease progression or relapse. For participants who did not progress during the study, duration of response was censored at the last adequate response assessment showing evidence of no disease progression. Disease progression is defined as an increase in M-protein serum monoclonal paraprotein and/or urine paraprotein or evidence of bone marrow plasmacytosis and plasma cells, an appearance of new or existing soft tissue plasmacytomas, an appearance of new or existing lytic bone lesions and/or hypercalcemia >11.5mg/dL
Time Frame
From the time of the first dose of study drug to study completion; the median duration on study was 42.1 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must understand and voluntarily sign the informed consent form Age ≥ 20 years at the time of signing the informed consent form Subjects with previously treated multiple myeloma defined as follows: Subjects must have received at least 1 prior anti-myeloma drug treatment regimen; and Considered to have progression of disease (PD) that occurred either during or following the completion of the last anti-myeloma treatment regimen utilized prior to enrollment into this study Measurable levels of M-protein in serum (greater than or equal to 0.5 g/dL [5g/L]) or urine (greater than or equal to 0.2 g excreted in a 24-hour collection sample) Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 2 Must be able to adhere to the study visit schedule and other protocol requirements Females of childbearing potential (FCBP) must agree to use one or more of the following forms of contraception or abstain from heterosexual contact completely and have the male partners use a condom on the occasion of heterosexual contact in the following periods below: For at least 28 days before starting study drug (in particular, the subject must abstain from heterosexual contact for 2 weeks prior to prescribing lenalidomide). During the treatment phase (including the dose withholding period) For at least 28 days after the discontinuation/completion of the study drug (Methods of contraception) Birth control pills Intrauterine device (IUD) Bilateral tubal ligation (FCBP must be referred to a health care provider who is familiar with contraceptive methods, if needed). Male subject must agree to use a condom during sexual contact with female irrespective of pregnancy potential Subjects must agree that study drug must be immediately discontinued, if pregnancy or a positive pregnancy test does occur in a female study subject or the partner of a male study subject during study participation Exclusion Criteria: Pregnant or lactating females Subjects with a history of acute myocardial infarction within the past 6 months before starting the study drugs Subjects with any history or concurrent conditions of deep vein thrombosis or pulmonary embolus within the past 3 years before starting study drugs Subjects with tuberculous diseases, herpes simplex keratitis, systemic mycosis or other active infectious diseases Subjects with non-controlled diabetes, hypertension, digestive ulcer or glaucoma Subjects with posterior subcapsular cataracts Subjects with peripheral neuropathy of ≥Grade 2 Subjects with any history or concurrent conditions which the Principal Investigator / subinvestigators consider inappropriate for participation in this study, and subjects with a serious disease or a mental disease, which is considered to become more risky if the subjects participate in this study. Subjects with a history of desquamative (blistering) rash while taking thalidomide Subjects with a history of using lenalidomide Subjects who have used thalidomide within 28 days before starting the study drugs Subjects with a history of hypersensitivity to dexamethasone Subjects who discontinued treatment due to grade 3 or 4 toxicity from high dose dexamethasone Subjects with a surgical wound after a visceral surgery performed recently Subjects who have undergone radiation therapy within 14 days before starting the study drugs Subjects who have used a chemotherapeutic agent, an immunomodulating agent or a study drug (a drug not commercially available) intended for the treatment of multiple myeloma (MM) within 28 days before starting the study drug Subjects with any history or concurrent conditions of malignancies, other than MM, unless the subject has been free of the disease for 3 years: Basal cell carcinoma of the skin, Squamous cell carcinoma of the skin, Carcinoma in situ of the cervix, Carcinoma in situ of the breast, Incidental histologic finding of prostate cancer Tumor, Lymph Nodes, Metastasis (TNM) stage of T1a or T1b) Known human immunodeficiency virus (HIV) infection or HIV-1 positivity Subjects who have been diagnosed as an hepatitis b virus (HBV) carrier Subjects who are applicable to any of the following abnormal laboratory findings: Absolute neutrophil count : < 1,000 /μL (1.0×10^9 /L) Platelet count: <75,000 /μL (75×10^9 /L) Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) or alanine aminotransferase (ALT)/serum glutamic-pyruvic transaminase (SGPT): > 3.0 times the upper limit of the standard range Creatinine clearance: < 30 mL/min
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Masaaki Takatoku, MD
Organizational Affiliation
Celgene KK
Official's Role
Study Director
Facility Information:
Facility Name
Nagoya Medical Center
City
Nagoya-city
State/Province
Aichi
ZIP/Postal Code
460-0001
Country
Japan
Facility Name
Nagoya City University Hospital
City
Nagoya-city
State/Province
Aichi
ZIP/Postal Code
467-8602
Country
Japan
Facility Name
Fukuoka University Hospital
City
Fukuoka-city
State/Province
Fukuoka
ZIP/Postal Code
814-0180
Country
Japan
Facility Name
Kyoto Prefectural University of Medicine
City
Kyoto-city
State/Province
Kyoto
ZIP/Postal Code
602-8566
Country
Japan
Facility Name
Niigata Cancer Center Hospital
City
Niigata-city
State/Province
Niigata
ZIP/Postal Code
951-5866
Country
Japan
Facility Name
Osaka Red Cross Hospital
City
Osaka-city
State/Province
Osaka
ZIP/Postal Code
543-8555
Country
Japan
Facility Name
Tokushima University
City
Tokushima-city
State/Province
Tokushima
ZIP/Postal Code
770-8503
Country
Japan
Facility Name
Keio University Hospital
City
Tokyo
ZIP/Postal Code
160-8582
Country
Japan

12. IPD Sharing Statement

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A Safety Confirmation Study on Lenalidomide With Dexamethasone In Japanese Patients With Previously Treated Multiple Myeloma

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