- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00060203
Brostallicin in Treating Patients With Recurrent or Refractory Multiple Myeloma
A Phase I/II Study of the Safety and Efficacy of Brostallicin (PNU-166196A) in Adult Patients With Multiple Myeloma That Has Progressed on Prior Chemotherapy
RATIONALE: Drugs used in chemotherapy such as brostallicin use different ways to stop cancer cells from dividing so they stop growing or die.
PURPOSE: Phase I/II trial to study the effectiveness of brostallicin in treating patients who have recurrent or refractory multiple myeloma.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Determine the objective tumor response rate (confirmed complete response and confirmed partial response) of brostallicin in patients with recurrent or refractory multiple myeloma.
- Determine the maximum tolerated dose of this drug in these patients.
- Determine the time to and duration of response, time to treatment failure, time to tumor progression, and survival in patients treated with this drug.
- Determine the safety and tolerability of this drug in these patients.
- Determine the pharmacokinetics of this drug in these patients.
- Correlate baseline whole blood levels and activity of glutathione with clinical outcome in patients treated with this drug.
OUTLINE: This is an open-label, multicenter, dose-escalation study.
- Phase I: Patients receive brostallicin IV over 10-30 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of brostallicin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 6 patients experience dose-limiting toxicity.
- Phase II: Additional patients are accrued and treated at the MTD of brostallicin as in phase I.
Patients are followed every 2 months.
PROJECTED ACCRUAL: A total of 23-52 patients will be accrued for this study.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Ohio
-
Cleveland, Ohio, United States, 44106-5065
- Ireland Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Confirmed diagnosis of multiple myeloma based on prior or current demonstration of the following criteria*:
Major criteria:
- Plasmacytoma on tissue biopsy
- Bone marrow plasmacytosis with at least 30% plasma cells
- Monoclonal globulin spike on serum electrophoresis exceeding 3.5 g/dL for IgG peaks or 2.0 g/dL for IgA peaks; greater than 1,000 mg/24hr of kappa or gamma light chain excretion on urine electrophoresis in the absence of amyloidosis
Minor criteria:
- Bone marrow plasmacytosis with 10% to 30% plasma cells
- Monoclonal globulin spike present but less than levels in major criterion III above
- Lytic bone lesions
- Residual normal immunoglobulin M (IgM) no greater than 0.5 g/dL, IgA no greater than 0.1 g/dL, or IgG no greater than 0.6 g/dL NOTE: *Diagnosis of multiple myeloma requires a minimum of 1 major and 1 minor criterion (I and a together is not sufficient; must be I and b, I and c, I and d; II and b, II and c, II and d; III and a, III and c, III and d) or 3 minor criteria that must include a and b (a, b, and c; a, b, and d)
Measurable disease defined by 1 of the following values:
- Serum myeloma (M) protein (IgG or IgA) level greater than 1.0 g/dL
- Urine M protein (light chain disease) at least 300 mg/24hr
- Soft tissue plasmacytoma with bidimensional measurement at least 20 x 20 mm (10 x 10 mm if spiral CT scan is used)
- Must have progressed during or within 12 months of discontinuing prior myelosuppressive chemotherapy (e.g., vincristine, doxorubicin, and dexamethasone (VAD) or melphalan) OR not responded after 2 courses of prior myelosuppressive chemotherapy
- No indolent or smoldering myeloma or localized plasmacytoma
- No known brain or leptomeningeal disease unless such lesions were previously irradiated, are currently not being treated with corticosteroids, and are associated with no clinical symptoms
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Eastern Cooperative Oncology Group (ECOG) 0-2
Life expectancy
- At least 12 weeks
Hematopoietic
- Absolute neutrophil count at least 1,500/mm^3 (at least 1,000/mm^3 if neutropenia due to replacement of the normal bone marrow cells by myeloma cells)
- Platelet count at least 100,000/mm^3 (at least 50,000/mm^3 if thrombocytopenia due to replacement of the normal bone marrow cells by myeloma cells)
- Hemoglobin at least 8.0 g/dL (no transfusion allowed)
- No hyperviscosity syndrome
Hepatic
- Bilirubin no greater than 1.5 times upper limit of normal (ULN)
- Serum glutamate oxaloacetate transaminase (SGOT) no greater than 2.5 times ULN
- Alkaline phosphatase no greater than 2.5 times ULN
Renal
- Creatinine no greater than 3.0 times ULN
- Calcium no greater than 12 mg/dL
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Willing and able to comply with scheduled visits, treatment plan, laboratory tests, and sampling for study analysis
- HIV negative
- No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or carcinoma in situ of the cervix
- No AIDS-related illness
- No active infectious process or other severe concurrent disease that would make the patient inappropriate for study entry
- No mental incapacity or psychiatric illness that would preclude giving informed consent or completing follow-up
PRIOR CONCURRENT THERAPY:
Biologic therapy
- See Chemotherapy
- No concurrent anticancer biological response modifiers
- No concurrent immunotherapy
- No concurrent sargramostim (GM-CSF)
Chemotherapy
- See Disease Characteristics
- More than 2 years since prior high-dose chemotherapy with autologous bone marrow transplantation or stem cell support
- More than 4 weeks since prior myelosuppressive chemotherapy
- No other concurrent anticancer chemotherapy
Endocrine therapy
- See Disease Characteristics
- No concurrent anticancer hormonal therapy
No concurrent chronic steroids
- Acute pulse dosing required for treatment of a concurrent medical condition is allowed, provided treatment duration is no greater than 2 weeks
- No concurrent corticosteroids (e.g., dexamethasone)
Radiotherapy
- More than 14 days since prior radiotherapy
- No prior radiotherapy to more than 25% of bone marrow
- No plans for radiotherapy within the next 6 months
- Concurrent palliative radiotherapy for skeletal pain allowed
Surgery
- More than 14 days since prior surgery
- No plans for surgery within the next 6 months
Other
Acute toxic effects of prior therapy (except for alopecia and neurotoxicity) must have resolved to grade 0, 1, or the patient's baseline
- Treatment-related neurotoxicity must have resolved to the patient's baseline, not to exceed grade 2
- Chronic bisphosphonates for bone pain allowed only for maintenance doses
- More than 2 weeks since prior nonmyelosuppressive antimyeloma therapy
- More than 2 weeks since prior macrolide antibiotics
- No other concurrent investigational agents
- No concurrent macrolide antibiotics
- No concurrent participation in another treatment clinical study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Brostallicin
|
Patients receive brostallicin IV over 10-30 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of brostallicin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 6 patients experience dose-limiting toxicity. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective Tumor Response Rate
Time Frame: 1 year
|
• Determine the objective tumor response rate (confirmed complete response and confirmed partial response) of brostallicin in patients with recurrent or refractory multiple myeloma
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Overall Survival
Time Frame: 1 year
|
1 year
|
Time to tumor progression
Time Frame: 1 year
|
1 year
|
Duration of Response
Time Frame: 1 year
|
1 year
|
Maximum Tolerated Dose of brostallicin
Time Frame: 1 year
|
1 year
|
Time to response
Time Frame: 1 year
|
1 year
|
Time to treatment failure
Time Frame: 1 year
|
1 year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Hillard M. Lazarus, MD, Case Comprehensive Cancer Center
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Hematologic Diseases
- Hemorrhagic Disorders
- Hemostatic Disorders
- Paraproteinemias
- Blood Protein Disorders
- Multiple Myeloma
- Neoplasms, Plasma Cell
- Plasmacytoma
Other Study ID Numbers
- PHAR1A02
- CWRU-PHAR-1A02
- PHARMACIA-196-ONC-0100-006
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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