CURATE.AI Optimized Modulation for Multiple Myeloma
Multiple Myeloma
About this trial
This is an interventional treatment trial for Multiple Myeloma
Eligibility Criteria
Inclusion Criteria:
- Adults diagnosed with multiple myeloma diagnosed according to standard criteria, without prior anti-myeloma treatment at study entry
Patients must have evaluable multiple myeloma with at least one of the following (within 21 days of starting treatment)a.
- Serum M-protein = 0.5g/dL,or
- b. In subjects without detectable serum M-protein, Urine M-protein = 200mg/24 hour, or serum free light chai (sFLC) > 100mg/L (involved light chain) and an abnormal kappa/Lambda ratio
- Males and females = 21 years of age or > country's legal age for adult Consent
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2
Patients must meet the following clinical laboratory criteria with 21 days of starting treatment:
- Absolute neutrophil count (ANC) = 1,000/mm3 and platelet = 50,000/mm3 (= 30,000/mm3 if myeloma involvement in the bone marrow is >50%)
- Total bilirubin = 1.5 x the upper limit of the normal range (ULN). Alanine aminotransferase (ALT) and aspartate aminotransferase (AST = 3 xULN.
- Calculated creatinine clearance = 45mL/min or creatinine < 3mg/dL.
- Written informed consent in accordance with federal, local and institutional guidelines
Exclusion Criteria:
- Female patients who are lactating or pregnant
- Multiple Myeloma of immunoglobulin M subtype
- Glucocorticoid therapy (prednisolone > 30mg/day or equivalent) within 14 days prior to informed consent obtained
- POEMS syndrome
- Plasma cell leukemia or circulating plasma cells = 2 x 109/L
- Waldenstrom's Macroglobulinaemia
- Patients with known amyloidosis
- Chemotherapy with approved or investigation anticancer therapeutics within 21 days prior to starting pomalidomide treatment
- Focal radiation therapy within 7 days prior to start of treatment. Radiation therapy to an extended field involving a significant volume of bone marrow within 21 days prior to start of treatment
- Immunotherapy (excluding steroids) 21 days prior to start of treatment
- Major surgery (excluding kyphoplasty) within 28 days prior to start of treatment
- Active congestive heart failure (New York Heart Association [NYHA] Class III or IV), symptomatic ischaemia, or conduction abnormalities uncontrolled by conventional intervention. Myocardial infarction within 4 months prior to informed consent obtained
- Known HIV seropositive, hepatitis C infection, and/or hepatitis B (except for patients with hepatitis B surface antigen or core antibody receiving and responding to antiviral therapy directed at hepatitis B: these patients are allowed)
- Patients with known cirrhosis
Second malignancy within the past 3 years except:
- Adequately treated basal cell or squamous cell skin cancer,
- Carcinoma in situ of the cervix.
- Breast carcinoma in situ with full surgical resection
- Patients with myelodysplastic syndrome
- Patients with steroid, bortezomib, cyclophosphamide or thalidomide hypersensitivity
- Prior treatment with Bortezomib
- Ongoing graft-versus-host disease
- Patients with pleural effusions requiring thoracentesis or ascites requiring aracentesis within 14 days prior to starting treatment
- Contraindication to any of the required concomitant drugs or supportive treatments
- Any clinically significant medical disease or psychiatric condition that, in the investigator's opinion, may interfere with protocol adherence or a patient's ability to give informed consent.
Sites / Locations
- National University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Standard of Care
CURATE.AI-guided dosing
Dosing of VCD(bortezomib, cyclophosphamide,dexamethasone), VTD (bortezomib,thalidomide, dexamethasone), or VRD (Bortezomib, Lenalidomide, Dexamethasone) combinations according to standard of care
CURATE.AI optimized modulation of bortezomib and cyclophosphamide dosages in the VCD (bortezomib, cyclophosphamide, dexamethasone), bortezomib and thalidomide in the VTD (bortezomib, thalidomide, dexamethasone) or bortezomib and lenalidomide in the VRD (bortezomib, lenalidomide, dexamethasone) combinations