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Study of Vorinostat Plus Melphalan and Prednisone (Zmp) in Advanced, Refractory Multiple Myeloma Patients

Primary Purpose

Multiple Myeloma

Status
Terminated
Phase
Phase 1
Locations
Italy
Study Type
Interventional
Intervention
Vorinostat
Sponsored by
Tiziana Marangon
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Refractory or relapsed patients, dose-finding, Vorinostat

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥ 18 years
  • Patient is, in the investigator(s) opinion, willing and able to comply with the protocol requirements.
  • Patient has given voluntary written informed consent before performance of any study related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care.
  • Female patient is either post-menopausal for 24 consecutive months or surgically sterilized or agree to continuous abstinence from heterosexual sexual contact or willing to use effective contraception for 4 weeks prior to beginning study drug therapy, during study drug therapy (including dose interruption) and for 4 weeks after discontinuation of therapy; female patients not pregnant or nursing; female with a negative pregnancy test.
  • Male patient agrees to use an acceptable method for contraception during study drug therapy (including dose interruption) and for 4 weeks after discontinuation of Vorinostat therapy.
  • Patient was previously diagnosed with symptomatic MM based on standard criteria, and has measurable disease.
  • Patient is relapsed or refractory after a minimum of 3 weeks from prior therapies (patients must have recovered from toxicities related to prior therapies).
  • Patient has a Karnofsky performance status ≥ 60%.
  • Patient has a life-expectancy > 3 months.

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness or social situation that would prevent the subject from signing the informed consent form or limit the compliance with study medications and requirements.
  • Pregnant or beast feeding females.
  • Use of any other concomitant standard/experimental anti-myeloma drug or therapy.
  • Known positive for HIV or active infectious hepatitis, type B or C.
  • Known congenital long QT syndrome.
  • Ongoing therapy with anti-arrhythmic drugs or other medicinal products which led to QT prolongation and cumulative high dose of anthracycline.
  • Any clinically significant illness that would, in the investigator's opinion, increase the patient's risk for toxicity. Patients has not plasmacell leukaemia defined as the presence of more than 20% plasma cells in the peripheral blood and an absolute plasma cell count of at least 2000/uL.
  • Patients has not a currently active malignancy, except non melanoma skin cancer and carcinoma in situ of the cervix. Patients should not be considered to have a currently active second malignancy if they have completed therapy for a prior malignancy and are disease free from prior malignancies for >5 years and are considered by their physicians to be at less then 30% risk of relapse
  • History of allergic reactions related to study drugs.
  • Prior exposure to HDACi. Patients exposed to valproic acid could be eligible with a wash out period of at least 30 days.
  • Patients scheduled to undergo autologous or allogenic bone marrow transplant within 4 week of the initiation of Vorinostat administration.

Sites / Locations

  • Dipartimento Medicina Clinica e Sperimentale
  • A.O.U. S. Giovanni Battista
  • Policlinico Universitario di Udine
  • Azienda Ospedaliera di Verona - Policlinico G.B. Rossi

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ZMP

Arm Description

Combination with Vorinostat, Melphalan and Prednisone

Outcomes

Primary Outcome Measures

The dose limiting toxicity (DLT)of Vorinostat with MP
The maximum tolerated dose (MTD) of Vorinostat in association with MP
A significant number of PR or higher (>40%) following the proposed ZMP therapy

Secondary Outcome Measures

Duration of Progression Free Survival
Duration of Overall Survival

Full Information

First Posted
March 4, 2009
Last Updated
September 5, 2017
Sponsor
Tiziana Marangon
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1. Study Identification

Unique Protocol Identification Number
NCT00857324
Brief Title
Study of Vorinostat Plus Melphalan and Prednisone (Zmp) in Advanced, Refractory Multiple Myeloma Patients
Official Title
A Phase I/II, Multi-Center, Open Label Study of Vorinostat Plus Melphalan and Prednisone (ZMP) in Advanced, Refractory Multiple Myeloma Patients
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Terminated
Why Stopped
The Phase I of the study was completed, but Phase 2 has not been activated
Study Start Date
March 2009 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
May 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Tiziana Marangon

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether the association of ZMP is safe and provides benefits in patients with relapsed/refractory MM.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Refractory or relapsed patients, dose-finding, Vorinostat

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ZMP
Arm Type
Experimental
Arm Description
Combination with Vorinostat, Melphalan and Prednisone
Intervention Type
Drug
Intervention Name(s)
Vorinostat
Intervention Description
Patients will start induction treatment with a standard dose of MP and escalating doses of Vorinostat: Melphalan 0.18 mg/Kg for 4 days; Prednisone 1.5 mg/Kg for 4 days. Each cycle will be repeated every 28 days for a total of 6 courses In the first part of the study, the standard oral MP will be combined with escalating doses of Vorinostat. Level -1 Vorinostat = 100 mg daily on days 1-21 Melphalan = 0.18 mg/kg on days 1 - 4 Prednisone = 1.5 mg/kg on days 1 - 4 Level 0 Vorinostat = 200 mg daily on days 1-21 Melphalan = 0.18 mg/kg on days 1 - 4 Prednisone = 1.5 mg/kg on days 1 - 4 Level +1 Vorinostat = 300 mg daily on days 1-21 Melphalan = 0.18 mg/kg on days 1 - 4 Prednisone = 1.5 mg/kg on days 1 - 4 Level +2 Vorinostat = 400 mg daily on days 1-21 Melphalan = 0.18 mg/kg on days 1 - 4 Prednisone = 1.5 mg/kg on days 1 - 4
Primary Outcome Measure Information:
Title
The dose limiting toxicity (DLT)of Vorinostat with MP
Time Frame
one year
Title
The maximum tolerated dose (MTD) of Vorinostat in association with MP
Time Frame
1 year
Title
A significant number of PR or higher (>40%) following the proposed ZMP therapy
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Duration of Progression Free Survival
Time Frame
5 Years
Title
Duration of Overall Survival
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Patient is, in the investigator(s) opinion, willing and able to comply with the protocol requirements. Patient has given voluntary written informed consent before performance of any study related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care. Female patient is either post-menopausal for 24 consecutive months or surgically sterilized or agree to continuous abstinence from heterosexual sexual contact or willing to use effective contraception for 4 weeks prior to beginning study drug therapy, during study drug therapy (including dose interruption) and for 4 weeks after discontinuation of therapy; female patients not pregnant or nursing; female with a negative pregnancy test. Male patient agrees to use an acceptable method for contraception during study drug therapy (including dose interruption) and for 4 weeks after discontinuation of Vorinostat therapy. Patient was previously diagnosed with symptomatic MM based on standard criteria, and has measurable disease. Patient is relapsed or refractory after a minimum of 3 weeks from prior therapies (patients must have recovered from toxicities related to prior therapies). Patient has a Karnofsky performance status ≥ 60%. Patient has a life-expectancy > 3 months. Exclusion Criteria: Any serious medical condition, laboratory abnormality, or psychiatric illness or social situation that would prevent the subject from signing the informed consent form or limit the compliance with study medications and requirements. Pregnant or beast feeding females. Use of any other concomitant standard/experimental anti-myeloma drug or therapy. Known positive for HIV or active infectious hepatitis, type B or C. Known congenital long QT syndrome. Ongoing therapy with anti-arrhythmic drugs or other medicinal products which led to QT prolongation and cumulative high dose of anthracycline. Any clinically significant illness that would, in the investigator's opinion, increase the patient's risk for toxicity. Patients has not plasmacell leukaemia defined as the presence of more than 20% plasma cells in the peripheral blood and an absolute plasma cell count of at least 2000/uL. Patients has not a currently active malignancy, except non melanoma skin cancer and carcinoma in situ of the cervix. Patients should not be considered to have a currently active second malignancy if they have completed therapy for a prior malignancy and are disease free from prior malignancies for >5 years and are considered by their physicians to be at less then 30% risk of relapse History of allergic reactions related to study drugs. Prior exposure to HDACi. Patients exposed to valproic acid could be eligible with a wash out period of at least 30 days. Patients scheduled to undergo autologous or allogenic bone marrow transplant within 4 week of the initiation of Vorinostat administration.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mario Boccadoro, MD
Organizational Affiliation
University of Turin, Italy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dipartimento Medicina Clinica e Sperimentale
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
A.O.U. S. Giovanni Battista
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Policlinico Universitario di Udine
City
Udine
ZIP/Postal Code
33100
Country
Italy
Facility Name
Azienda Ospedaliera di Verona - Policlinico G.B. Rossi
City
Verona
ZIP/Postal Code
37134
Country
Italy

12. IPD Sharing Statement

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Study of Vorinostat Plus Melphalan and Prednisone (Zmp) in Advanced, Refractory Multiple Myeloma Patients

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