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Phase 1b Study of Weekly Carfilzomib in Combination With Lenalidomide and Dexamethasone in Subjects With Multiple Myeloma

15 octobre 2020 mis à jour par: Amgen

Phase 1b Study of Carfilzomib Administered Once Weekly in Combination With Lenalidomide and Dexamethasone in Subjects With Multiple Myeloma

The purpose of the study is to assess the safety, tolerability and activity of a once-weekly regimen of carfilzomib in combination with lenalidomide and dexamethasone for the treatment of multiple myeloma.

Aperçu de l'étude

Type d'étude

Interventionnel

Inscription (Réel)

107

Phase

  • La phase 1

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • California
      • Bakersfield, California, États-Unis, 93309
        • Research Site
      • Bakersfield, California, États-Unis
        • CBCC Global Research, Inc. at Comprehensive Blood and Cancer Center
      • Burbank, California, États-Unis, 91505
        • Research Site
      • Burbank, California, États-Unis
        • Providence Saint Joseph Medical Center
      • Fountain Valley, California, États-Unis, 92708
        • Research Site
      • Fountain Valley, California, États-Unis
        • Compassionate Care Research Group, Inc.
      • Los Angeles, California, États-Unis, 90017
        • Research Site
      • Los Angeles, California, États-Unis, 90095-1686
        • Research Site
      • Los Angeles, California, États-Unis
        • Los Angeles Hematology / Oncology Medical Group
      • Whittier, California, États-Unis, 90603
        • Research Site
    • Colorado
      • Aurora, Colorado, États-Unis, 80045
        • Research Site
      • Aurora, Colorado, États-Unis
        • University of Colorado
    • District of Columbia
      • Washington, District of Columbia, États-Unis, 20057
        • Research Site
      • Washington, District of Columbia, États-Unis
        • Lombardi Cancer Center, Pediatric Hematology Oncology
    • Florida
      • Fort Myers, Florida, États-Unis
        • Florida Cancer Specialists
      • Fort Myers, Florida, États-Unis, 33905
        • Research Site
      • Tampa, Florida, États-Unis, 33612
        • Research Site
      • Tampa, Florida, États-Unis
        • H. Lee Moffitt Cancer Center & Research Institute
      • West Palm Beach, Florida, États-Unis, 33401
        • Research Site
      • West Palm Beach, Florida, États-Unis
        • Florida Cancer Specialists
    • Illinois
      • Chicago, Illinois, États-Unis
        • University Of Chicago Medical Center
    • Massachusetts
      • Boston, Massachusetts, États-Unis, 02114
        • Research Site
      • Boston, Massachusetts, États-Unis
        • Dana Farber Partners Cancer Care
    • Michigan
      • Ann Arbor, Michigan, États-Unis, 48109
        • Research Site
    • New Jersey
      • Hackensack, New Jersey, États-Unis, 07601
        • Research Site
      • Hackensack, New Jersey, États-Unis
        • John Theurer Cancer Center at Hackensack University Medical Center
    • New York
      • New York, New York, États-Unis, 10021
        • Research Site
      • New York, New York, États-Unis, 10065
        • Research Site
      • New York, New York, États-Unis
        • Memorial Sloan Kettering
      • New York, New York, États-Unis
        • Weill Cornell Medical College
      • New York, New York, États-Unis
        • Clinical Research Alliance
      • New York, New York, États-Unis
        • Morton Coleman, MD
      • Stony Brook, New York, États-Unis, 11794
        • Research Site
      • Stony Brook, New York, États-Unis
        • Stony Brook University Medical Center
    • North Carolina
      • Durham, North Carolina, États-Unis, 27705
        • Research Site
      • Durham, North Carolina, États-Unis
        • Durham Veterans Affairs Medical Center
    • Ohio
      • Cincinnati, Ohio, États-Unis, 45242
        • Research Site
      • Cincinnati, Ohio, États-Unis
        • Sarah Cannon Research Institute
    • Oregon
      • Bend, Oregon, États-Unis, 97701
        • Research Site
      • Bend, Oregon, États-Unis
        • Bend Memorial Clinic
    • South Carolina
      • Charleston, South Carolina, États-Unis, 29424
        • Research Site
      • Charleston, South Carolina, États-Unis
        • Medical University of South Carolina, Hollings Cancer Center
      • Greenville, South Carolina, États-Unis, 29607
        • Research Site
      • Greenville, South Carolina, États-Unis
        • Greenville Health System
      • Greenville, South Carolina, États-Unis
        • Saint Francis Hospital Cancer Center
    • South Dakota
      • Sioux Falls, South Dakota, États-Unis, 57105
        • Research Site
      • Sioux Falls, South Dakota, États-Unis
        • Avera Cancer Institute
    • Tennessee
      • Germantown, Tennessee, États-Unis, 38138
        • Research Site
      • Memphis, Tennessee, États-Unis
        • The West Clinic, PC
      • Nashville, Tennessee, États-Unis, 37203
        • Research Site
      • Nashville, Tennessee, États-Unis, 37232
        • Research Site
      • Nashville, Tennessee, États-Unis
        • Vanderbilt University Medical Center
      • Nashville, Tennessee, États-Unis
        • Tennessee Oncology, PLLC / The Sarah Cannon Research lnstitute
    • Utah
      • Salt Lake City, Utah, États-Unis, 84112
        • Research Site
      • Salt Lake City, Utah, États-Unis
        • Huntsman Cancer Institute
    • Washington
      • Seattle, Washington, États-Unis, 98104
        • Research Site
      • Seattle, Washington, États-Unis
        • Swedish Cancer Institute
    • Wisconsin
      • Milwaukee, Wisconsin, États-Unis
        • Aurora Health Care, Aurora Cancer Care
      • Wauwatosa, Wisconsin, États-Unis, 53226
        • Research Site

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Key Inclusion Criteria:

  1. Newly diagnosed or relapsed multiple myeloma
  2. Measureable disease by serum M protein, or urine M protein, or serum free light chain (SFLC) and an abnormal serum kappa lambda ratio (for subjects without detectable serum or urine M-protein), or serum quantitative immunoglobulin A (glgA) (for immunoglobulin (Ig) A subjects whose disease can only be reliable measured by qlgA).
  3. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 to 2
  4. Left ventricular ejection fraction (LVEF) ≥ 40%

Key Exclusion Criteria:

  1. Waldenström macroglobulinemia
  2. For newly diagnosed multiple myeloma: multiple myeloma of IgM subtype
  3. For relapsed disease:

    1. If treated with a lenalidomide and dexamethasone combination, progression during the first 3 months after initiating treatment.
    2. Any progression during treatment if the lenalidomide and dexamethasone regimen was the most recent line of therapy.
    3. Any prior treatment with carfilzomib
  4. POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
  5. Plasma cell leukemia (> 2.0 × 10^9/L circulating plasma cells by standard differential)
  6. Myelodysplastic syndrome
  7. Amyloidosis
  8. Prior treatment with carfilzomib or oprozomib

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: RRMM Dose-evaluation: Carfilzomib 56 mg/m²

Participants with relapsed or refractory multiple myeloma (RRMM) received treatment with carfilzomib, lenalidomide, and dexamethasone (KRd) for up to eighteen 28-day cycles, or until disease progression, patient withdrawal, stem cell transplant, or death.

Participants received carfilzomib on days 1, 8, and 15 of each cycle. The dose was 20 mg/m² on cycle 1, day 1, and 56 mg/m² thereafter. Participants also received lenalidomide 25 mg once daily on days 1-21 and dexamethasone 40 mg (oral or IV) on days 1, 8, and 15 of each cycle, and on day 22 of cycles 1 to 8.

Administered once weekly by 30-minute intravenous (IV) infusion on days 1, 8, and 15 of each 28-day cycle.
Autres noms:
  • PR-171
  • PR171
  • Kyprolis® (carfilzomib) pour injection
Administered orally once daily on days 1-21 of each 28-day cycle.
Autres noms:
  • Revlimid®
Administered by mouth or IV at 40 mg on days 1, 8, and 15 of each 28-day cycle and on day 22 of cycles 1 to 8.
Expérimental: RRMM Dose-evaluation: Carfilzomib 70 mg/m²

Participants with RRMM received treatment with carfilzomib, lenalidomide, and dexamethasone (KRd) for up to eighteen 28-day cycles, or until disease progression, patient withdrawal, stem cell transplant, or death.

Participants received carfilzomib on days 1, 8, and 15 of each cycle. The dose was 20 mg/m² on cycle 1, day 1, and 70 mg/m² thereafter. Participants also received lenalidomide 25 mg once daily on days 1-21 and dexamethasone 40 mg (oral or IV) on days 1, 8, and 15 of each cycle, and on day 22 of cycles 1 to 8.

Administered once weekly by 30-minute intravenous (IV) infusion on days 1, 8, and 15 of each 28-day cycle.
Autres noms:
  • PR-171
  • PR171
  • Kyprolis® (carfilzomib) pour injection
Administered orally once daily on days 1-21 of each 28-day cycle.
Autres noms:
  • Revlimid®
Administered by mouth or IV at 40 mg on days 1, 8, and 15 of each 28-day cycle and on day 22 of cycles 1 to 8.
Expérimental: RRMM Dose-expansion: Carfilzomib 70 mg/m²

Participants with RRMM received treatment with carfilzomib, lenalidomide, and dexamethasone (KRd) for up to eighteen 28-day cycles, or until disease progression, patient withdrawal, stem cell transplant, or death.

Participants received carfilzomib on days 1, 8, and 15 of each cycle. The dose was 20 mg/m² on cycle 1, day 1, and 70 mg/m² thereafter. Participants also received lenalidomide 25 mg once daily on days 1-21 and dexamethasone 40 mg (oral or IV) on days 1, 8, and 15 of each cycle, and on day 22 of cycles 1 to 8.

Administered once weekly by 30-minute intravenous (IV) infusion on days 1, 8, and 15 of each 28-day cycle.
Autres noms:
  • PR-171
  • PR171
  • Kyprolis® (carfilzomib) pour injection
Administered orally once daily on days 1-21 of each 28-day cycle.
Autres noms:
  • Revlimid®
Administered by mouth or IV at 40 mg on days 1, 8, and 15 of each 28-day cycle and on day 22 of cycles 1 to 8.
Expérimental: NDMM Dose-evaluation: Carfilzomib 56/70 mg/m²

Participants with newly diagnosed multiple myeloma (NDMM) received treatment with carfilzomib, lenalidomide, and dexamethasone (KRd) for up to eighteen 28-day cycles, or until disease progression, patient withdrawal, stem cell transplant, or death.

Participants received carfilzomib on days 1, 8, and 15 of each cycle. The dose was 20 mg/m² on cycle 1 day 1, 56 mg/m² on cycle 1 days 8 and 15, and then 70 mg/m² thereafter. Participants also received lenalidomide 25 mg once daily on days 1-21 and dexamethasone 40 mg (oral or IV) on days 1, 8, and 15 of each cycle, and on day 22 of cycles 1 to 8.

Administered once weekly by 30-minute intravenous (IV) infusion on days 1, 8, and 15 of each 28-day cycle.
Autres noms:
  • PR-171
  • PR171
  • Kyprolis® (carfilzomib) pour injection
Administered orally once daily on days 1-21 of each 28-day cycle.
Autres noms:
  • Revlimid®
Administered by mouth or IV at 40 mg on days 1, 8, and 15 of each 28-day cycle and on day 22 of cycles 1 to 8.
Expérimental: NDMM Dose-expansion: Carfilzomib 70 mg/m²

Participants with NDMM received treatment with carfilzomib, lenalidomide, and dexamethasone (KRd) for up to eighteen 28-day cycles, or until disease progression, patient withdrawal, stem cell transplant, or death.

Participants received carfilzomib on days 1, 8, and 15 of each cycle. The dose was 20 mg/m² on cycle 1, day 1, and 70 mg/m² thereafter. Participants also received lenalidomide 25 mg once daily on days 1-21 and dexamethasone 40 mg (oral or IV) on days 1, 8, and 15 of each cycle, and on day 22 of cycles 1 to 8.

Administered once weekly by 30-minute intravenous (IV) infusion on days 1, 8, and 15 of each 28-day cycle.
Autres noms:
  • PR-171
  • PR171
  • Kyprolis® (carfilzomib) pour injection
Administered orally once daily on days 1-21 of each 28-day cycle.
Autres noms:
  • Revlimid®
Administered by mouth or IV at 40 mg on days 1, 8, and 15 of each 28-day cycle and on day 22 of cycles 1 to 8.
Expérimental: NDMM Dose-expansion: Carfilzomib 56 mg/m²

Participants with NDMM received treatment with carfilzomib, lenalidomide, and dexamethasone (KRd) for up to eighteen 28-day cycles, or until disease progression, patient withdrawal, stem cell transplant, or death.

Participants received carfilzomib on days 1, 8, and 15 of each cycle. The dose was 20 mg/m² on cycle 1, day 1, and 56 mg/m² thereafter. Participants also received lenalidomide 25 mg once daily on days 1-21 and dexamethasone 40 mg (oral or IV) on days 1, 8, and 15 of each cycle, and on day 22 of cycles 1 to 8.

Administered once weekly by 30-minute intravenous (IV) infusion on days 1, 8, and 15 of each 28-day cycle.
Autres noms:
  • PR-171
  • PR171
  • Kyprolis® (carfilzomib) pour injection
Administered orally once daily on days 1-21 of each 28-day cycle.
Autres noms:
  • Revlimid®
Administered by mouth or IV at 40 mg on days 1, 8, and 15 of each 28-day cycle and on day 22 of cycles 1 to 8.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Number of Participants With Adverse Events (AEs)
Délai: From the first dose of any study drug up to 30 days after the last dose of any study drug; median (range) duration of treatment with carfilzomib was 32 (1.1, 76.7) weeks in RRMM participants and 26 (1.0, 94.4) weeks in NDMM participants.

Safety and tolerability were evaluated according to the type, incidence, and severity of adverse events.

An AE is defined as any untoward medical occurrence in a clinical trial subject. The event does not necessarily have a causal relationship with study treatment.

A serious adverse event is defined as an AE that meets at least 1 of the following serious criteria:

  • fatal
  • life threatening
  • requires in-patient hospitalization or prolongation of existing hospitalization
  • results in persistent or significant disability/incapacity
  • congenital anomaly/birth defect
  • other medically important serious event

The severity of each AE was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03 where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening, and Grade 5 = Death.

From the first dose of any study drug up to 30 days after the last dose of any study drug; median (range) duration of treatment with carfilzomib was 32 (1.1, 76.7) weeks in RRMM participants and 26 (1.0, 94.4) weeks in NDMM participants.
Change From Baseline in Hemoglobin Levels
Délai: Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Change From Baseline in Platelet Count
Délai: Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Change From Baseline in Neutrophil Count
Délai: Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Change From Baseline in Bilirubin
Délai: Baseline and Cycle 2 day 1
Baseline and Cycle 2 day 1
Change From Baseline in Creatinine
Délai: Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15
Baseline and Cycle 1, days 8 and 15 and Cycle 2 days 1, 8, and 15

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Maximum Plasma Concentration of Carfilzomib on Day 8 of Cycle 1 by Dose Group
Délai: Day 8 of Cycle 1 at predose, 15 minutes after the start of infusion, at the end of infusion, and 15 and 60 minutes after the end of infusion
Day 8 of Cycle 1 at predose, 15 minutes after the start of infusion, at the end of infusion, and 15 and 60 minutes after the end of infusion
Time to Maximum Plasma Concentration of Carfilzomib on Day 8 of Cycle 1 by Dose Group
Délai: Day 8 of Cycle 1 at predose, 15 minutes after the start of infusion, at the end of infusion, and 15 and 60 minutes after the end of infusion
Day 8 of Cycle 1 at predose, 15 minutes after the start of infusion, at the end of infusion, and 15 and 60 minutes after the end of infusion
Area Under the Curve From Time Zero to Time of Last Quantifiable Concentration of Carfilzomib on Day 8 of Cycle 1 by Dose Group
Délai: Day 8 of Cycle 1 at predose, 15 minutes after the start of infusion, at the end of infusion, and 15 and 60 minutes after the end of infusion
Day 8 of Cycle 1 at predose, 15 minutes after the start of infusion, at the end of infusion, and 15 and 60 minutes after the end of infusion
Overall Response Rate (ORR)
Délai: Response assessments were performed on day 1 of each treatment cycle from cycle 2 and then every 8 weeks during follow-up until disease progression. Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.

Response was determined by the investigator based on the International Myeloma Working Group Uniform Response Criteria (IMWG URC). ORR was defined as the percentage of participants who achieved a best response of stringent complete response (sCR), complete response (CR), very good partial response (VGPR) or partial response (PR). Responses must have been confirmed in 2 consecutive assessments at any time prior to initiation of any new therapy.

Disease assessments included serum protein electrophoresis (SPEP) with immunofixation, urine protein electrophoresis (UPEP; 24-hour assessment) with immunofixation, serum free light chain (SFLC), quantitative immunoglobulins, bone marrow aspirates to determine percent plasma cell involvement, and skeletal imaging for plasmacytoma evaluation.

Response assessments were performed on day 1 of each treatment cycle from cycle 2 and then every 8 weeks during follow-up until disease progression. Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.
Complete Response Rate (CRR)
Délai: Response assessments were performed on day 1 of each treatment cycle from cycle 2 and then every 8 weeks during follow-up until disease progression. Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.

Complete Response Rate (CRR) is defined as the percentage of participants who achieved a best overall response of either stringent complete response (sCR) or complete response (CR) in accordance with International Myeloma Working Group-Uniform Response Criteria (IMWG-URC).

sCR: As for CR, and absence of clonal plasma cells in bone marrow (BM) CR: Negative serum and urine immunofixation, disappearance of any soft tissue plasmacytomas, < 5% plasma cells in BM, and normal SFLC ratio in participants with measurable disease only by SFLC.

Response assessments were performed on day 1 of each treatment cycle from cycle 2 and then every 8 weeks during follow-up until disease progression. Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.
Progression-free Survival (PFS)
Délai: From first dose of study drug until the end of follow-up; Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.

PFS is defined as the time from the first day of study treatment to the earlier of disease progression or death due to any cause.

Disease progression was determined by the investigator according to IMWG-URC. Progressive Disease (PD): Increase of 25% from lowest value in serum M-component (absolute increase ≥ 0.5 g/dL), urine M-component (absolute increase ≥ 200 mg per 24 hours) and/or the difference between involved and uninvolved FLC levels (absolute increase >10 mg/dL) in patients without measurable serum and urine M-protein levels, and/or any new or increase in size of bone lesions or soft tissue plasmacytomas, or development of hypercalcemia.

PFS was analyzed using Kaplan-Meier methods. Participants who were alive with no documented PD, started new anticancer therapy before documentation of PD or death, had death or PD immediately after > 1 consecutively missed assessment visit, were lost to follow-up or withdrew consent were censored at the date of last disease assessment.

From first dose of study drug until the end of follow-up; Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.
Duration of Response (DOR)
Délai: From first dose of study drug until the end of follow-up; Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.
Duration of response (DOR) was calculated for participants who achieved a confirmed PR or better based on Investigator assessment and according to the IMWG URC. Duration of overall response is defined as the time from first documentation of response to disease progression or death due to any cause. DOR was analyzed using Kaplan-Meier methods. Participants who were alive with no documented PD, started new anticancer therapy before documentation of PD or death, had death or PD immediately after > 1 consecutively missed disease assessment visit, were lost to follow-up, or withdrew consent were censored at the date of last disease assessment.
From first dose of study drug until the end of follow-up; Median time on follow-up was 10.6 months in RRMM participants and 6.9 months in NDMM participants.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Les enquêteurs

  • Directeur d'études: Amy Kimball, MD, Amgen

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

30 avril 2015

Achèvement primaire (Réel)

28 octobre 2019

Achèvement de l'étude (Réel)

28 octobre 2019

Dates d'inscription aux études

Première soumission

23 décembre 2014

Première soumission répondant aux critères de contrôle qualité

7 janvier 2015

Première publication (Estimation)

12 janvier 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

6 novembre 2020

Dernière mise à jour soumise répondant aux critères de contrôle qualité

15 octobre 2020

Dernière vérification

1 septembre 2020

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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