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Lenalidomide & Adriamycin & Dexamethasone (RAD) in Newly Diagnosed, Multiple Myeloma Patients (RAD)

14 octobre 2016 mis à jour par: Meletios A. Dimopoulos

Phase II Open Label Study for the Assessment of the Efficacy and Safety of Lenalidomide & Adriamycin & Low Dose Dexamethasone (RAD) in Newly Diagnosed, Symptomatic Multiple Myeloma Patients

This study is to assess the efficacy and safety of lenalidomide in combination with adriamycin and low dose dexamethasone in newly diagnosed patients with symptomatic multiple myeloma as well as to collect information regarding the effect of this regimen on angiogenesis and bone remodeling of the study population.

Aperçu de l'étude

Description détaillée

This is a Phase II, non randomized, non- comparative, open label trial which assess the efficacy and safety of lenalidomide, adriamycin and low dose dexamethasone combination (RAD) in 45 newly diagnosed patients with symptomatic multiple myeloma as well as to collect information regarding the effect of this regimen on angiogenesis and bone remodeling of the study population. The recruitment period is estimated for 5 months while the treatment period and the follow up period 4 months and 1 month respectively. During the treatment initiation visit the response to the combination RAD according the International Myeloma Working Group (IMWG) criteria will be evaluated, biochemical markers of bone metabolism and angiogenic cytokines will be measured as well. IMWG Response evaluation will be repeated the day 1 of each treatment cycle as well as at the response evaluation visit. Finally biochemical markers of bone metabolism and angiogenic cytokines will be measured once more at the end of treatment visit.

Type d'étude

Interventionnel

Inscription (Réel)

45

Phase

  • Phase 2

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

      • Patra, Grèce, 26504
        • University General Hospital of Patras
      • Thessaloniki, Grèce, 54007
        • Theageneio Anticancer Hospital of Thessaloniki
    • Attica
      • Athens, Attica, Grèce, 11528
        • General Hospital of Athens "Alexandra"
      • Athens, Attica, Grèce, 11527
        • General Hospital of Athens "G. Gennimatas"

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 à 70 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Subjects able to read and understand the Informed Consent Form (ICF).
  2. Subjects willing to participate in the study and comply with its procedures.
  3. Subjects who have signed the ICF
  4. Newly diagnosed patients with symptomatic MM according to the criteria of IMWG
  5. Subjects eligible for autologous stem cell transplantation
  6. Age 18-70 years, of either sex
  7. karnofsky ≥ 60
  8. Platelets ≥ 100x109/L
  9. Neutrophils ≥ 1.5x109/L
  10. Alanine transaminase (ALT) & Aspartate transaminase (AST) ≤ 3-fold of upper normal limit
  11. Bilirubin ≤ 2-fold of upper normal limit
  12. Creatinine clearance ≥60 ml/min
  13. Expected survival ≥ 6 months as per PI's clinical judgment
  14. Subjects able to tolerate aspirin, low molecular weight heparin or coumarinic agents as prophylactic anticoagulation
  15. Female subject of childbearing potential must have 2 negative serum pregnancy tests (hCG) at Screening (once within 10-14 days and once 24 h before the study drug administration) and if sexually active must be using two medically acceptable, highly effective, adequate forms of birth control (ie, failure rate <1% per year when used consistently and correctly) prior to Screening and and for time period at least 28 days before the study drug administration and agree to continue using it while being in the study (Screening and Treatment Periods including dose interruptions). A female subject should continue using a highly effective method of birth control for 30 days following the end of treatment.
  16. A male subject must agree to use an adequate form of contraception for the duration of the study, while taking the study drug, during dose interruptions at for at least 28 days after the last dose of study drug even if he has had a successful vasectomy and agree to have sexual relations only with women who use a highly effective birth control method.
  17. Subjects must be free of any clinically significant disease (other than MM) that would interfere with study evaluations

Exclusion Criteria:

  1. Pregnancy, breastfeeding οr intention of pregnancy during the trial
  2. Suspected or known hypersensitivity to any of the study drugs
  3. Ongoing severe infection requiring intravenous antibiotic treatment
  4. Prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer, or other cancer from which the subject has been disease-free for at least 5 years. Concurrent prostate cancer for which the patient is receiving therapy will not be considered an exclusion if the Prostatic specific antigen (PSA) has been stable for 3 years
  5. Solitary bone or solitary extramedullary plasmacytoma as the only evidence of plasma cell dyscrasia
  6. Myocardial infraction within 6 months before enrollment, New York Heart Association (NYHA) Class II or greater heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmia, clinically significant pericardial disease, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities
  7. Uncontrolled medical problems such as diabetes, coronary artery disease, hypertension, unstable angina, arrhythmia, pulmonary, hepatic and renal diseases unless renal insufficiency is considered to be secondary to MM
  8. Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the ICF
  9. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she will participate in the study or confounds the ability to interpret data from the study
  10. Subjects with any clinical condition that would affect study's outcome
  11. Participation in another interventional clinical trial in the 4 weeks preceding enrollment or planning to participate in another interventional clinical trial during the planned period of this study, except of the clinical trials that implicate drugs of supportive treatment

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: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Lenalidomide, adriamycin & dexamethasone
Lenalidomide 25 mg administered orally for the first 21 days of each 28-day-cycle, plus Adriamycin i.v. on days 1,2,3 & 4 of every cycle, plus Dexamethasone 40 mg orally on days 1, 8, 15 & 22 of every cycle for 4 cycles
Lenalidomide 25 mg by mouth for the first 21 days of a 28-day-cycle for 4 cycles
Autres noms:
  • Combination of Lenalidomide, adriamycin & dexamethasone
Adriamycin as intravenous bolus infusion at a dose of 9 mg/m2, on days 1-4 of a 28-day cycle for 4 cycles
Autres noms:
  • Combination of Lenalidomide, adriamycin & dexamethasone
Dexamethasone by mouth at a dose of 40 mg, on days 1, 8, 15, and 22 of a 28-day cycle for 4 cycles
Autres noms:
  • Combination of Lenalidomide, adriamycin & dexamethasone

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Overall response rate
Délai: 142 days
Assessment of the overall response rate of study population to RAD regimen (including stringent complete response, complete response, very good partial response, partial response and stable disease) according to the uniform criteria of IMWG (International Myeloma Working Group) regarding the response to multiple myeloma therapy
142 days

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Progression-free survival (PFS)
Délai: 142 days
142 days
Time to progression (TTP)
Délai: 142 days
142 days
Time to Next Therapy (TtNT)
Délai: 142 days
142 days
Number and severity of Adverse events as a measure of safety and toxicity profile
Délai: 142 days
Adverse events will be assessed at each visit and graded according to the National Cancer Institute Common Toxicity Criteria (version 2.0)
142 days

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Number of stem cell collected before Autologous Stem Cell Transplantation (ASCT)
Délai: 142 days
142 days
Dickkopf-1 (DKK-1)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Dickkopf-1 (DKK-1)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
C-telopeptide of type-I collagen (CTX)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
C-telopeptide of type-I collagen (CTX)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Tartrate-resistant acid phosphatase isoform-5b (TRACP-5b)
Délai: 1 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 days
Tartrate-resistant acid phosphatase isoform-5b (TRACP-5b)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Bone-alkaline phosphatase (bALP)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Bone-alkaline phosphatase (bALP)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Osteocalcin (OC)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Osteocalcin (OC)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
C-terminal propeptide of procollagen type-I (CICP)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
C-terminal propeptide of procollagen type-I (CICP)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Soluble and total RANKL (sRANKL, tRANKL)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Soluble and total RANKL (sRANKL, tRANKL)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Osteoprotegerin (OPG)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Osteoprotegerin (OPG)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Osteopontin (OPN)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Osteopontin (OPN)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Macrophage inflammatory protein 1-alpha (MIP-1α)
Délai: 1 day
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Macrophage inflammatory protein 1-alpha (MIP-1α)
Délai: 112 days
Biochemical markers of bone remodeling will be measured in the serum of patients at therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Angiopoietin-1 & -2
Délai: 1 day
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Angiopoietin-1 & -2
Délai: 112 days
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
Angiogenin
Délai: 1 day
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Angiogenin
Délai: 112 days
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
VEGF
Délai: 1 day
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
Vascular endothelial growth factor (VEGF)
Délai: 112 days
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
VEGF-A
Délai: 1 day
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
VEGF-A
Délai: 112 days
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days
basic fibroblast growth factor (bFGF)
Délai: 1 day
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
1 day
basic fibroblast growth factor (bFGF)
Délai: 112 days
Angiogenic cytokines, which will be evaluated in the serum of patients during therapy commencement on Day 1 of cycle 1 and at therapy completion on day 28 of cycle 4. 28-days-cycle
112 days

Collaborateurs et enquêteurs

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

Les enquêteurs

  • Chercheur principal: Meletios Dimopoulos, Doctor, General Hospital of Athens "Alexandra"
  • Chercheur principal: Eirini Katodritou, Doctor, Theageneio Anticancer Hospital of Thessaloniki
  • Chercheur principal: Nikolaos Anagnostopoulos, Doctor, General Hospital of Athens "G. Gennimatas''
  • Chercheur principal: Argirios Symeonidis, Doctor, University General Hospital of Patras

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

1 novembre 2014

Achèvement primaire (Réel)

1 juillet 2016

Achèvement de l'étude (Réel)

1 juillet 2016

Dates d'inscription aux études

Première soumission

5 juin 2015

Première soumission répondant aux critères de contrôle qualité

10 juin 2015

Première publication (Estimation)

15 juin 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

17 octobre 2016

Dernière mise à jour soumise répondant aux critères de contrôle qualité

14 octobre 2016

Dernière vérification

1 octobre 2016

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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