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Phase II Trial Designed to Determine Efficacy and Safety of Bendamustine+Dexamethasone+Thalidomide in R/R MM

Primary Purpose

Multiple Myeloma

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
Bendamustine
Thalidomide
Dexamethasone
Sponsored by
Azienda Ospedaliera di Bolzano
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring relapsed or refractory multiple myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Understand and voluntarily sign an informed consent form.
  • Age 18 years at the time of signing the informed consent form.
  • Life expectancy of at least 3 months
  • Able to adhere to the study visit schedule and other protocol requirements
  • Relapsed or refractory active MM (according to the International Myeloma Working Group guidelines) after treatments containing bortezomib and lenalidomide or ineligible (intolerance or toxicity) to one of these drugs with detectable myeloma protein in blood or urine.
  • Disease free of prior malignancies for at least 5 years.
  • All previous multiple myeloma treatments, including radiation, cytostatic therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study, except corticosteroids therapy.
  • ECOG performance status <2 at study entry, unless it is due to MM.
  • At least the following laboratory findings at the day of treatment start:
  • Platelet count ≥ 75 x 10^9/L without transfusional support within 7 days.
  • Neutrophil count > 1.5 x 10^9/L without G-CSF.
  • Corrected calcium ≤ 14 mg/dL (3.5 mmol/L).
  • AST: ≤ 2.5 times the normal upper limit.
  • ALT: ≤ 2.5 times the normal upper limit.
  • Total bilirubin: ≤ 1.5 times the normal upper limit.
  • Measured or calculated creatinine clearance of ≥ 20 mL/minute
  • Women of child bearing potential and male patients whose partner is a woman of child bearing potential must be prepared to use two effective methods of contraception both before and during protocol treatment, or commit to absolute and continuous abstinence.The pregnancy test must be negative 14-28 days and 72 hours before treatment start. Only in case of hysterectomy or presence of menopause for at least 24 consecutive months pregnancy tests as well as contraception are not necessary. Men must not father a child for up to 6 months following cessation of treatment and must use condoms.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or breast feeding females.
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Patients with contraindications for treatment with bendamustine, dexamethasone and thalidomide.
  • Uncontrolled or severe cardiovascular disease, including myocardial infarction within 6 months before study entry, New York Heart Association Class III or IV heart failure, uncontrolled angina or severe uncontrolled ventricular arrhythmias (≥ Lown 3).
  • Use of any other experimental drug or therapy within 28 days of baseline.
  • Known hypersensitivity to thalidomide or purine analogues
  • Concurrent use of other anti-cancer agents or treatments other stated in this treatment plan.
  • Peripheral neuropathy grade ≥2 according to WHO
  • Known positive for HIV or infectious hepatitis, type A, B or C.
  • Major surgery less than 30 days before start of treatment

Sites / Locations

  • Division of Hematology and CBMT
  • Presidio Ospedaliero di Camposampiero
  • Ospedale S. Martino
  • Ospedale di Castelfranco Veneto
  • Ospedale Civile di Dolo
  • AULSS 2 Feltre
  • Azienda Ospedaliera Universitaria G. Martino
  • Ospedale dell'Angelo di Mestre
  • A.O di Padova Ematologia e Immunologia Clinica
  • A.O di Padova Ematologia
  • AULLS 18 di Rovigo
  • Ospedale di Trento - P.O. S. Chiara
  • Ospedale Ca Foncello
  • A.O.U Ospedali Riuniti di Trieste Medicina II
  • A.O.U Ospedali Riuniti di Trieste
  • A.O.U S. Maria della Misericordia
  • Ospedale Policlinico G.B Rossi (Borgo Roma) Ematologia
  • Ospedale Policlinico G.B Rossi (Borgo Roma) Medicina II
  • AULSS 6 Vicenza

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment with BDT

Arm Description

Bendamustine + Dexamethasone + Thalidomide in patients with multiple myeloma (MM) patients after treatment with lenalidomide and bortezomib or which are ineligible to one of these drugs.

Outcomes

Primary Outcome Measures

Response rate
The proportion of patient with a Complete Response (CR) or Very Good Partial Response or partial response
Incidence of haematological toxicity of BDT
The incidence of haematological toxicities is the proportion of patients with haematological toxicity

Secondary Outcome Measures

Time to treatment Failure (TTF)
To evaluate time to treatment failure
Survival (OS)
To evaluate overall survival
Disease Free Survival (DFS)
To evaluate disease free survival

Full Information

First Posted
January 27, 2012
Last Updated
July 2, 2018
Sponsor
Azienda Ospedaliera di Bolzano
Collaborators
Mundipharma Pte Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01526694
Brief Title
Phase II Trial Designed to Determine Efficacy and Safety of Bendamustine+Dexamethasone+Thalidomide in R/R MM
Official Title
Phase II Multicenter Clinical Trial to Investigate the Efficacy and Safety of Bendamustine, Dexamethasone and Thalidomide in R/R MM Pts After Treatment With Lenalidomide and Bortezomib or Which Are Ineligible to One of These Drugs
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
July 2012 (Actual)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
April 8, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Azienda Ospedaliera di Bolzano
Collaborators
Mundipharma Pte Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a prospective, multicenter phase II trial designed to determine efficacy and safety of a combination chemotherapy consisting of Bendamustine + Dexamethasone + Thalidomide in patients with multiple myeloma (MM) after treatment with lenalidomide and bortezomib or which are ineligible to one of these drugs.
Detailed Description
Eligible patients will be treated according to the following scheme until the occurrence of maximum response, dose limiting toxicity or disease progression. Repeat cycles every 28 days for a maximum of 6 cycles and a minimum of 4. Bendamustine 60 mg/m2 i.v. days 1, 8, 15 Dexamethasone 20 mg p.o. days 1,8 , 15, 22 Thalidomide 100 mg daily p.o. days 1-28; initial dose of 50 mg/day, with an increment to 100 mg after the first 15 days of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
relapsed or refractory 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
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
treatment with BDT
Arm Type
Experimental
Arm Description
Bendamustine + Dexamethasone + Thalidomide in patients with multiple myeloma (MM) patients after treatment with lenalidomide and bortezomib or which are ineligible to one of these drugs.
Intervention Type
Drug
Intervention Name(s)
Bendamustine
Other Intervention Name(s)
Ribomustin
Intervention Description
Bifunctional alkylating agent consisting of a purine and amino acid antagonist (a benzimidazole ring) and an alkylating nitrogen mustard moiety.
Intervention Type
Drug
Intervention Name(s)
Thalidomide
Intervention Description
Thalidomide can directly inhibit the growth and survival of myeloma cells, by oxidative damage to DNA mediated by free radicals. The drug can induce apoptosis even in drug resistant myeloma cells. Thalidomide modulates cell adhesion molecule expression, so it may interfere with the mutually stimulatory interactions between myeloma cells and the bone marrow microenvironment.
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
It's a corticosteroid.
Primary Outcome Measure Information:
Title
Response rate
Description
The proportion of patient with a Complete Response (CR) or Very Good Partial Response or partial response
Time Frame
18 months
Title
Incidence of haematological toxicity of BDT
Description
The incidence of haematological toxicities is the proportion of patients with haematological toxicity
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Time to treatment Failure (TTF)
Description
To evaluate time to treatment failure
Time Frame
18 months
Title
Survival (OS)
Description
To evaluate overall survival
Time Frame
18 months
Title
Disease Free Survival (DFS)
Description
To evaluate disease free survival
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Understand and voluntarily sign an informed consent form. Age 18 years at the time of signing the informed consent form. Life expectancy of at least 3 months Able to adhere to the study visit schedule and other protocol requirements Relapsed or refractory active MM (according to the International Myeloma Working Group guidelines) after treatments containing bortezomib and lenalidomide or ineligible (intolerance or toxicity) to one of these drugs with detectable myeloma protein in blood or urine. Disease free of prior malignancies for at least 5 years. All previous multiple myeloma treatments, including radiation, cytostatic therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study, except corticosteroids therapy. ECOG performance status <2 at study entry, unless it is due to MM. At least the following laboratory findings at the day of treatment start: Platelet count ≥ 75 x 10^9/L without transfusional support within 7 days. Neutrophil count > 1.5 x 10^9/L without G-CSF. Corrected calcium ≤ 14 mg/dL (3.5 mmol/L). AST: ≤ 2.5 times the normal upper limit. ALT: ≤ 2.5 times the normal upper limit. Total bilirubin: ≤ 1.5 times the normal upper limit. Measured or calculated creatinine clearance of ≥ 20 mL/minute Women of child bearing potential and male patients whose partner is a woman of child bearing potential must be prepared to use two effective methods of contraception both before and during protocol treatment, or commit to absolute and continuous abstinence.The pregnancy test must be negative 14-28 days and 72 hours before treatment start. Only in case of hysterectomy or presence of menopause for at least 24 consecutive months pregnancy tests as well as contraception are not necessary. Men must not father a child for up to 6 months following cessation of treatment and must use condoms. Exclusion Criteria: Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. Pregnant or breast feeding females. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Patients with contraindications for treatment with bendamustine, dexamethasone and thalidomide. Uncontrolled or severe cardiovascular disease, including myocardial infarction within 6 months before study entry, New York Heart Association Class III or IV heart failure, uncontrolled angina or severe uncontrolled ventricular arrhythmias (≥ Lown 3). Use of any other experimental drug or therapy within 28 days of baseline. Known hypersensitivity to thalidomide or purine analogues Concurrent use of other anti-cancer agents or treatments other stated in this treatment plan. Peripheral neuropathy grade ≥2 according to WHO Known positive for HIV or infectious hepatitis, type A, B or C. Major surgery less than 30 days before start of treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Mian, MD
Organizational Affiliation
Azienda Ospedaliera di Bolzano
Official's Role
Principal Investigator
Facility Information:
Facility Name
Division of Hematology and CBMT
City
Bolzano
State/Province
BZ
ZIP/Postal Code
39100
Country
Italy
Facility Name
Presidio Ospedaliero di Camposampiero
City
Camposampiero
State/Province
Padova
ZIP/Postal Code
35012
Country
Italy
Facility Name
Ospedale S. Martino
City
Belluno
ZIP/Postal Code
32100
Country
Italy
Facility Name
Ospedale di Castelfranco Veneto
City
Castelfranco Veneto
ZIP/Postal Code
31033
Country
Italy
Facility Name
Ospedale Civile di Dolo
City
Dolo
ZIP/Postal Code
30031
Country
Italy
Facility Name
AULSS 2 Feltre
City
Feltre
ZIP/Postal Code
32032
Country
Italy
Facility Name
Azienda Ospedaliera Universitaria G. Martino
City
Messina
ZIP/Postal Code
98125
Country
Italy
Facility Name
Ospedale dell'Angelo di Mestre
City
Mestre
ZIP/Postal Code
30170
Country
Italy
Facility Name
A.O di Padova Ematologia e Immunologia Clinica
City
Padova
ZIP/Postal Code
35127
Country
Italy
Facility Name
A.O di Padova Ematologia
City
Padova
ZIP/Postal Code
35127
Country
Italy
Facility Name
AULLS 18 di Rovigo
City
Rovigo
ZIP/Postal Code
45100
Country
Italy
Facility Name
Ospedale di Trento - P.O. S. Chiara
City
Trento
ZIP/Postal Code
38100
Country
Italy
Facility Name
Ospedale Ca Foncello
City
Treviso
ZIP/Postal Code
31100
Country
Italy
Facility Name
A.O.U Ospedali Riuniti di Trieste Medicina II
City
Trieste
ZIP/Postal Code
34142
Country
Italy
Facility Name
A.O.U Ospedali Riuniti di Trieste
City
Trieste
ZIP/Postal Code
34142
Country
Italy
Facility Name
A.O.U S. Maria della Misericordia
City
Udine
ZIP/Postal Code
33100
Country
Italy
Facility Name
Ospedale Policlinico G.B Rossi (Borgo Roma) Ematologia
City
Verona
ZIP/Postal Code
37134
Country
Italy
Facility Name
Ospedale Policlinico G.B Rossi (Borgo Roma) Medicina II
City
Verona
ZIP/Postal Code
37134
Country
Italy
Facility Name
AULSS 6 Vicenza
City
Vicenza
ZIP/Postal Code
36100
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase II Trial Designed to Determine Efficacy and Safety of Bendamustine+Dexamethasone+Thalidomide in R/R MM

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