Pomalidomide, Bortezomib, and Dexamethasone in Treating Patients With Relapsed or Refractory Multiple Myeloma
MC1082: A Phase I/II Trial of Pomalidomide (CC-4047), Bortezomib, and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma
調査の概要
詳細な説明
PRIMARY OBJECTIVES:
I. Determine the maximum tolerated dose (MTD) of bortezomib in combination with pomalidomide and dexamethasone.
II. To evaluate the hematologic response rate (PR, VGPR, or CR) of pomalidomide, bortezomib and dexamethasone in patients with relapsed or refractory myeloma.
SECONDARY OBJECTIVES:
I. Time to progression.
II. To assess the toxicity of pomalidomide, bortezomib and dexamethasone in this patient population.
OUTLINE : This is a phase I, dose-escalation study of bortezomib followed by a phase II study. Patients receive oral pomalidomide on days 1-21; bortezomib IV on days 1, 8,15, 22; and oral dexamethasone on days 1, 8, 15, 22 . Treatment repeats every 28 days for 8 courses. Patients then receive maintenance therapy comprising oral pomalidomide on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6 months.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
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Arizona
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Scottsdale、Arizona、アメリカ
- Mayo Clinic in Arizona
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Florida
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Jacksonville、Florida、アメリカ
- Mayo Clinic in Florida
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Minnesota
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Rochester、Minnesota、アメリカ、55905
- Mayo Clinic
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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
Inclusion Criteria:
- Serum Creatinine =< 3 mg/dL
- Absolute neutrophil count >= 1000/uL
- Platelet count >= 75,000/uL
Measurable disease of multiple myeloma as defined by at least ONE of the following:
- serum monoclonal protein >= 1.0 g/dL
- > 200 mg of monoclonal protein in the urine on 24 hour electrophoresis
- serum immunoglobulin free light chain >= 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
- monoclonal bone marrow plasmacytosis >= 30% (evaluable disease)
- measurable plasmacytoma that has not been radiated
- ECOG Performance status (PS) 0, 1, or 2
- Previously treated relapsed or refractory multiple myeloma
Patients must have received at least one prior therapy but no more than 4 therapies.
- one or more of the prior regimens must have included lenalidomide and it has been determined the patient is refractory, resistant, or relapsed this therapy
- prior bortezomib not required but if prior exposure, patients should not be refractory (Refractory means progression on therapy or within 60 days from the last dose of bortezomib.)
- Provide informed written consent
- Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to and again within 24 hours of starting pomalidomide and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking pomalidomide; FCBP must also agree to ongoing pregnancy testing
- Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a vasectomy
- All patients must be counseled at a minimum of every 28 days about pregnancy precautions and risks of fetal exposure
- Willing and able to take aspirin or alternate prophylactic anticoagulation
- All previous cancer therapy, including chemotherapy, high dose corticosteroids, immune modulatory drugs or proteosome inhibitors must have been discontinued >= 2 weeks prior to study registration
- Any prior treatment with investigational agents must be discontinued >= 28 days prior to study registration
- Willing to abstain from donating blood during study participation and for 28 days after discontinuation of study drug
- Men must agree to abstain from donating semen or sperm during study participation and for 28 days after discontinuation of study drug
- Willingness to return to enrolling institution for follow-up
Exclusion Criteria:
- Concomitant high dose corticosteroids (concurrent use of corticosteroids); EXCEPTION: Patients may be on chronic steroids (maximum dose 20 mg/day prednisone equivalent) if they are being given for disorders other than myeloma, i.e., adrenal insufficiency, rheumatoid arthritis, etc
- Another malignancy undergoing active treatment with the exception of non melanoma skin cancer or in situ cervical or breast cancer
- Pregnant women or women of reproductive ability who are unwilling to use effective contraception
- Nursing women
- Men who are unwilling to use a condom (even if they have undergone a prior vasectomy) while having intercourse with any woman, while taking the drug and for 4 weeks after stopping treatment
- Other co-morbidity which would interfere with patient's ability to participate in trial, e.g. uncontrolled infection, uncompensated heart or lung disease
- Other concurrent chemotherapy, radiotherapy, or any ancillary therapy considered investigational: NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment
- Active DVT or PE that has not been therapeutically anticoagulated
- Known positive for HIV or active hepatitis infection
- Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study
- Known hypersensitivity to thalidomide or lenalidomide including development of erythema nodosum if characterized by a desquamating rash
- > grade 2 peripheral neuropathy
- Any prior use of pomalidomide
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:なし
- 介入モデル:単一グループの割り当て
- 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 |
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実験的:Arm I
Patients receive oral pomalidomide on days 1-21; bortezomib IV on days 1, 8, 15, 22; and oral dexamethasone on days 1, 8, 15, 22. Treatment repeats every 28 days for 8 courses.
Patients then receive maintenance therapy comprising oral pomalidomide on days 1-21.
Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
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経口投与
他の名前:
オプションの相関研究
与えられた IV
他の名前:
経口投与
他の名前:
Optional correlative studies
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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 |
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Find Maximum Tolerated Dose (MTD) of Bortezomib in Combination With Pomalidomide and Dexamethasone Out to 2.5 Years, by Count of Patients With Dose Limiting Toxicities.
時間枠:2.5 years
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MTD is defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least one-third of patients (at least 2 of a maximum of 6 new patients).
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2.5 years
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Number of Participants With a Hematologic Response (PR, VGPR, or CR)
時間枠:2.5 years
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The number of participants who achieve PR, VGPR, or CR as defined by The International Myeloma Working Group uniform response criteria(2011).
sCR: CR as defined below plus normal FLC ratio and absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence.
CR: Negative immunofixation on the serum and urine and disappearance of any soft tissue plasmacytomas and < 5% plasma cells in bone marrow.
VGPR: Serum and urine M-protein detectable by immunofixation but not on electrophoresis or > 90% reduction in serum M-protein plus urine M-protein level < 100 mg/24 h.
PR: > 50% reduction of serum M-protein and reduction in 24 hours urinary M-protein by >90% or to < 200 mg/24 h.
MR: NA.
SD: Not meeting criteria for CR, VGPR, PR, or progressive disease.
PD: Increase of > 25% from lowest response value in any one or more of the following: Serum M-component and/or (the absolute increase must be > 0.5 g/dL), Urine M-component and/or (the absolute increase must be > 200 mg/24 h)
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2.5 years
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Progression Free Survival
時間枠:2.5 years
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The progression-free survival (PFS) time is defined as the time from registration to progression or death due to any cause.
The distribution of progression-free survival will be estimated using the method of Kaplan-Meier.
PD: Increase of > 25% from lowest response value in any one or more of the following: Serum M-component and/or (the absolute increase must be > 0.5 g/dL), Urine M-component and/or (the absolute increase must be > 200 mg/24 h)
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2.5 years
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Number of Participants With Adverse Events
時間枠:2.5 years
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Reported in Adverse Events section of the results
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2.5 years
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協力者と研究者
スポンサー
捜査官
- スタディチェア:Martha Lacy, M.D.、Mayo Clinic
- 主任研究者:Joseph R. Mikhael, M.D.、Mayo Clinic
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 (実際)
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 (実際)
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
追加の関連 MeSH 用語
その他の研究ID番号
- MC1082 (その他の識別子:Mayo Clinic Cancer Center)
- NCI-2010-01967 (レジストリ識別子:NCI's CTRO)
- 10-001545 (その他の識別子:Mayo Clinic IRB)
- PO-MM-PI-0019 (その他の識別子:Celgene Protocol)
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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