Lenalidomide and Vaccine Therapy in Treating Patients With Relapsed or Refractory Multiple Myeloma
Revlimid to Augment Efficacy of Prevnar Vaccines in Patients With Relapsed or Refractory Myeloma
RATIONALE: Biological therapies, such as lenalidomide, may stimulate the immune system in different ways and stop cancer cells from growing. Vaccines may help the body build an effective immune response to kill cancer cells. Giving lenalidomide together with vaccine therapy may make a stronger immune response and kill more cancer cells.
PURPOSE: This phase II trial is studying how well giving lenalidomide together with vaccine therapy works in treating patients with relapsed or refractory multiple myeloma.
調査の概要
詳細な説明
OBJECTIVES:
Primary
- Determine whether lenalidomide can augment the efficacy of pneumococcal polyvalent vaccine as it correlates with lenalidomide-induced antitumor efficacy in patients with relapsed or refractory multiple myeloma.
Secondary
- Determine the antibody responses to pneumococcal serotypes in patients treated with this regimen.
- Determine T-cell responses to the carrier protein CRM 197 in patients treated with this regimen.
- Determine the ability of lenalidomide to augment in vivo immune responsiveness as measured by cutaneous delayed-type hypersensitivity (DTH) reactions to Candida and tetanus in these patients.
- Determine the ability of lenalidomide to prime and/or boost systemic vaccine responses in both peripheral blood lymphocytes and marrow lymphocytes in these patients.
OUTLINE: Patients are assigned to 1 of 2 treatment groups.
- Group 1: Patients receive oral lenalidomide on days 1-21. Treatment repeats every 28 days for up to 7 courses in the absence of disease progression or unacceptable toxicity. Patients receive pneumococcal polyvalent vaccine intramuscularly (IM) 14 days prior to beginning lenalidomide and again in approximately 2 months (after the first dose of the vaccine).
- Group 2: Patients receive lenalidomide as in group 1. Patients receive pneumococcal polyvalent vaccine IM approximately 45 days after beginning lenalidomide and again in approximately 2 months (after the first dose of the vaccine).
After completion of study treatment, patients are followed at 30 days.
PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
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-
Maryland
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Baltimore、Maryland、アメリカ、21231-2410
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Diagnosis of multiple myeloma (MM) meeting all of the following criteria:
- Relapsed or refractory disease
- Previously received ≥ 2 courses of antimyeloma treatment
- Measurable levels of myeloma paraprotein in serum (> 0.5 g/dL) or urine (> 0.2 g/24-hour urine collection) OR serum-free light-chain disease
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Absolute neutrophil count ≥ 1,000/mm^3
- Platelet count ≥ 75,000/mm^3
- Creatinine ≤ 2.5 mg/dL
- Bilirubin ≤ 2.0 mg/dL
- AST and ALT ≤ 3 times upper limit of normal
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use 2 methods of highly effective contraception ≥ 4 weeks before, during, and for 4 weeks after completion of study therapy
- No other malignancy within the past 5 years except treated basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast
- No serious medical condition, laboratory abnormality, or psychiatric illness that would preclude study treatment or put patient at unacceptable risk
No known hypersensitivity to thalidomide or lenalidomide
- No development of erythema nodosum in the presence of a reaction characterized by a desquamating rash while taking thalidomide or similar drugs
- No known hypersensitivity to any component of the pneumococcal polyvalent vaccine, including diphtheria toxin or CRM 197
- No known HIV positivity
- No infectious hepatitis type A, B, or C
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No more than 3 prior treatment regimens for MM
- More than 6 months since prior lenalidomide
- More than 28 days since prior experimental drug or therapy
- More than 1 month since prior systemic antimyeloma therapy
- More than 1 month since prior and no concurrent systemic corticosteroids
- No other concurrent anticancer agents or treatments or investigational agents
- No concurrent thalidomide
- No concurrent radiotherapy
- No other concurrent immune therapy or immunomodulatory agents
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Group 1
Patients receive oral lenalidomide on days 1-21.
Treatment repeats every 28 days for up to 7 courses in the absence of disease progression or unacceptable toxicity.
Patients receive pneumococcal polyvalent vaccine intramuscularly (IM) 14 days prior to beginning lenalidomide and again in approximately 2 months (after the first dose of the vaccine).
|
経口投与
筋肉内投与
|
|
実験的:Group 2
Patients receive lenalidomide as in group 1. Patients receive pneumococcal polyvalent vaccine IM approximately 45 days after beginning lenalidomide and again in approximately 2 months (after the first dose of the vaccine).
|
経口投与
筋肉内投与
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
6B Antibody Response to Prevnar Vaccine in Peripheral Blood
時間枠:basline and 8 weeks after second vaccination
|
Serum IgG levels against the PVC serotype were measured by ELISA
|
basline and 8 weeks after second vaccination
|
|
14F Antibody Response to Prevnar Vaccine in Peripheral Blood
時間枠:basline and 8 weeks after second vaccination
|
Serum IgG levels against the PVC serotype were measured by ELISA
|
basline and 8 weeks after second vaccination
|
|
19F Antibody Response to Prevnar Vaccine in Peripheral Blood
時間枠:basline and 8 weeks after second vaccination
|
Serum IgG levels against the PVC serotype were measured by ELISA
|
basline and 8 weeks after second vaccination
|
|
23F Antibody Response to Prevnar Vaccine in Peripheral Blood
時間枠:basline and 8 weeks after second vaccination
|
Serum IgG levels against the PVC serotype were measured by ELISA
|
basline and 8 weeks after second vaccination
|
協力者と研究者
捜査官
- スタディチェア:Ivan Borrello, MD、Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- J06102 CDR0000532944
- P30CA006973 (米国 NIH グラント/契約)
- JHOC-J06102
- JHOC-NA_00006008
- CELGENE-CC-5013
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