- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00536575
Sorafenib and Bortezomib Treatment for Relapsed or Refractory Multiple Myeloma Patients
Phase I/II Trial of Sorafenib and Weekly Bortezomib in the Treatment of Patients With Relapsed or Refractory Multiple Myeloma
This is a single-arm Phase I/II study of sorafenib and bortezomib with dose optimization in initial patients. The initial patients on the dose-finding portion of this study will be enrolled through a single institution. Following establishment of the Phase II dose the study will open enrollment throughout the Sarah Cannon Research Institute (SCRI) Oncology Research Consortium.
The purpose of this study is to develop the combination of bortezomib (which is proven to be clinically active in patients with multiple myeloma) with sorafenib (a potent inhibitor of angiogenesis). This regimen will be developed in a schedule that is convenient for patients, and that is as minimally toxic to patients as possible.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Primary Objective:
To evaluate the efficacy of sorafenib with weekly bortezomib, as measured by objective response rate and progression-free survival in patients with relapsed/refractory multiple myeloma.
Secondary Objective:
To evaluate the feasibility and toxicity of sorafenib with weekly bortezomib in the treatment of patients with relapsed/refractory multiple myeloma.
Studietype
Registrering (Faktiske)
Fase
- Fase 2
- Fase 1
Kontakter og plasseringer
Studiesteder
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Maryland
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Bethesda, Maryland, Forente stater, 20817
- Center for Cancer and Blood Disorders
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Tennessee
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Nashville, Tennessee, Forente stater, 37023
- Tennessee Oncology, PLLC
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Eligible participants must have been previously diagnosed using standard criteria and have received no more than 2 prior regimens for the treatment of multiple myeloma.
- Participant must be defined as Relapsed or Refractory Disease by one of the following criteria prior to enrollment: Relapsed Disease after high-dose therapy (autologous stem cell transplantation) as part of the first-line line treatment program. These patients may have received a maximum of 1 previous regimen, Refractory Disease or Relapsed Disease after > 1 prior therapy for multiple myeloma. Prior bortezomib treatment permitted if the patient achieved a documented response.
- ECOG performance status 0, 1, or 2.
- WBC >= 3000; ANC >= 1000; platelets >= 50,000 (Patients with platelets >= 30,000 are eligible if thrombocytopenia is felt to be due to extensive bone marrow involvement with myeloma).
- Serum creatinine < 2.0 mg/dL for a calculated or measured creatinine clearance > 30 mL/minute
- Total bilirubin < 1.5 x ULN
- ALT and AST < 2.5 x the ULN ( < 5 x ULN for patients with liver involvement)
- INR < 1.5 or a PT/PTT within normal limits. Patients receiving anti-coagulation treatment with an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly, or as defined by the local standard of care, until INR is stable.
- Patients must have measurable or evaluable disease. In patients with disease limited to bone and bone marrow, serial paraprotein measurements are acceptable for evaluable disease.
Exclusion Criteria:
- Patients with > grade 1 peripheral neuropathy.
- Thrombolic or embolic events such as a cerebrovascular accident, including transient ischemic attacks, within the past 6 months.
- Pulmonary hemorrhage/bleeding event > CTCAE Grade 2 within 4 weeks of first dose of study drug.
- Any other hemorrhage/bleeding event > CTCAE Grade 3 within 4 weeks of first dose of study drug.
- Known brain metastasis. Patients with neurological symptoms must undergo CT scan/MRI of the brain to exclude brain metastasis.
- Patients with other medical conditions that would potentially interfere with their participation in this trial.
- Patients with other active malignancies, or history of treatment for other invasive cancers, within 3 years of study entry.
- Patients with previous evidence of hypersensitivity to sorafenib, bortezomib, boron, or mannitol.
- Women who are pregnant or lactating are ineligible. All patients of childbearing potential are required to use adequate methods of contraception while receiving study treatment, and for at least 2 weeks after the last dose of sorafenib. Men should continue to use contraception until at least 3 months after their last dose of sorafenib.
- Evidence of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome.
- Cardiac disease: Congestive heart failure > class II NYHA (see Appendix D.) Patients must not have unstable angina (anginal symptoms at rest), new onset angina (began within the last 3 months), or myocardial infarction within the past 6 months.
- Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy.
- Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management.
- Known human immunodeficiency virus (HIV) infection or chronic Hepatitis B or C.
- Active clinically serious infection > CTCAE Grade 2.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
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Eksperimentell: Intervention
The trial was designed as a single-arm Phase I/II study of sorafenib and bortezomib with dose optimization in initial patients.
Phase I consisted of cohorts of 3 patients at each of three dose levels.
Patients received bortezomib (Dose Level 1 - 1.3 mg/m2; Dose Level 2 - 1.6 mg/m2) by IV bolus on days 1, 8, 15, and 22 of each 5-week cycle with continuous oral dosing of sorafenib at 200 mg twice daily.
Dose level 3 was planned as bortezomib 1.6 mg/m2 IV bolus on days 1, 8, 15, and 22 with sorafenib 400 mg by mouth twice daily throughout each 5-week cycle.
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Dose Level 1: Bortezomib 1.3mg/m2 IV bolus on days 1, 8, 15, and 22 of each 5-week cycle. Dose Level 2: Bortezomib 1.6 mg/m2 IV bolus on days 1, 8, 15, and 22 of each 5-week cycle. Dose Level 3: Bortezomib 1.6mg/m2 IV bolus on days 1, 8, 15, and 22 of each 5-week cycle.
Andre navn:
Dose Levels 1 and 2: 200 mg by mouth twice daily Dose Level 3: 400 mg by mouth twice daily
Andre navn:
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Objective Response Rate (ORR), the Percentage of Patients Who Experience an Objective Benefit From Treatment
Tidsramme: 24 months
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The percentage of patients who experience an objective benefit from treatment, determined by the treating physician after reviewing key laboratory values from blood and urine.
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24 months
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Samarbeidspartnere og etterforskere
Samarbeidspartnere
Etterforskere
- Studiestol: Ian W. Flinn, M.D., SCRI Development Innovations, LLC
Publikasjoner og nyttige lenker
Hjelpsomme linker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Kardiovaskulære sykdommer
- Vaskulære sykdommer
- Sykdommer i immunsystemet
- Neoplasmer etter histologisk type
- Neoplasmer
- Lymfoproliferative lidelser
- Immunproliferative lidelser
- Hematologiske sykdommer
- Hemoragiske lidelser
- Hemostatiske lidelser
- Paraproteinemier
- Blodproteinforstyrrelser
- Multippelt myelom
- Neoplasmer, plasmacelle
- Molekylære mekanismer for farmakologisk virkning
- Enzymhemmere
- Antineoplastiske midler
- Proteinkinasehemmere
- Sorafenib
- Bortezomib
Andre studie-ID-numre
- SCRI MM 14
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Kliniske studier på Multippelt myelom
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National Cancer Institute (NCI)Aktiv, ikke rekrutterendeMyelom-multippel | Myelom, plasmacelleForente stater
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National Cancer Institute (NCI)FullførtMyelom-multippel | Myelom, plasmacelleForente stater
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National Cancer Institute (NCI)FullførtMyelom-multippel | Myelom, plasmacelleForente stater
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National Cancer Institute (NCI)AvsluttetMyelom, multippel | Myelom-multippelForente stater
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Tel-Aviv Sourasky Medical CenterFullførtPlasmacellemyelom | Myelom-multippel | Myelom multippel | Myelom, plasmacelleIsrael
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National Cancer Institute (NCI)Georgetown University; Hackensack Meridian HealthAvsluttetMyelom-multippel | Myelom, plasmacelle | MyelomatoseForente stater
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University of ChicagoNational Cancer Institute (NCI)Aktiv, ikke rekrutterendeStage I Myelom | Stadium II multippelt myelom | Stadium III multippelt myelomForente stater, Canada
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Sidney Kimmel Cancer Center at Thomas Jefferson...FullførtStage I Myelom | Stadium II multippelt myelom | Stadium III multippelt myelomForente stater
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University of Southern CaliforniaNational Cancer Institute (NCI); Celgene CorporationAvsluttetStage I Myelom | Stadium II multippelt myelom | Stadium III multippelt myelomForente stater
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Case Comprehensive Cancer CenterNational Cancer Institute (NCI)TilbaketrukketStage I Myelom | Stadium II multippelt myelom | Stadium III multippelt myelom
Kliniske studier på Bortezomib
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The First Affiliated Hospital of Soochow UniversityUkjentMultippelt myelom påvist ved laboratorietesterKina
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Baylor College of MedicineMillennium Pharmaceuticals, Inc.FullførtProstata neoplasmerForente stater
-
NCIC Clinical Trials GroupFullført
-
University Hospital, Clermont-FerrandLaboratoires TakedaUkjentMultippelt myelom | Voksen | Bortezomib-regimeFrankrike
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National Cancer Institute (NCI)AvsluttetMage-tarmkreft | Avansert primær leverkreft hos voksne | Lokalisert ikke-opererbar primær leverkreft hos voksne | Tilbakevendende primær leverkreft hos voksne | Tilbakevendende ekstrahepatisk gallekanalkreft | Tilbakevendende galleblærenkreft | Ikke-opererbar ekstrahepatisk gallekanalkreft | Ikke-opererbar... og andre forholdForente stater
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Janssen-Cilag International NVFullførtMultippelt myelomTyrkia, Hellas, Tsjekkisk Republikk, Østerrike, Tyskland, Sverige, Storbritannia, Danmark
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University Health Network, TorontoNational Cancer Institute (NCI)FullførtBlærekreft | Overgangscellekreft i nyrebekkenet og urinlederenForente stater, Canada
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Janssen Korea, Ltd., KoreaFullført
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Southwest Oncology GroupNational Cancer Institute (NCI)Fullført
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Memorial Sloan Kettering Cancer CenterNational Cancer Institute (NCI)FullførtLymfom | Myelodysplastiske syndromer | Leukemi | Multippelt myelom og plasmacelleteoplasmaForente stater