Multiple Myeloma and Plasma Cell Neoplasm Clinical Trial
Official title:
Phase II Randomized Trial of Bevacizumab Versus Bevacizumab and Thalidomide for Relapsed/Refractory Multiple Myeloma
RATIONALE: Monoclonal antibodies, such as bevacizumab, can block cancer growth in different
ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells
and help kill them or deliver cancer-killing substances to them. Thalidomide may stop the
growth of cancer cells by stopping blood flow to the tumor. It is not yet known whether
bevacizumab works better with or without thalidomide for multiple myeloma.
PURPOSE: This randomized phase II trial is to see if bevacizumab works better with or
without thalidomide in treating patients who have relapsed or refractory multiple myeloma.
OBJECTIVES:
- Compare the response rate and time to progression in patients with relapsed or
refractory multiple myeloma treated with bevacizumab with or without thalidomide.
- Compare the toxicity of these regimens in these patients.
- Compare the effects of these regimens on histological and molecular biomarkers of
angiogenesis, tumor invasion, and cell death in these patients.
- Correlate plasma and urine vascular endothelial growth factor and basic fibroblast
growth factor levels and other potential markers of angiogenesis and myeloma cell
proliferation with outcome in patients treated with these regimens.
- Determine the pharmacokinetics of thalidomide in these patients.
- Compare the effects of these regimens on the psychological/physical well being of these
patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior
treatment with thalidomide (yes vs no).
Patients who have received no prior treatment with thalidomide are randomized to 1 of 2
treatment arms.
- Arm I: Patients receive bevacizumab IV over 30-90 minutes on days 1, 15, 29, and 43.
Patients also receive oral thalidomide once daily.
- Arm II: Patients receive bevacizumab as in arm I. Patients who have received prior
treatment with thalidomide receive bevacizumab as in arm I.
Courses repeat every 56 days in the absence of disease progression or unacceptable toxicity.
Patients are followed monthly for 3 months and then every 3-4 months for 3 years.
PROJECTED ACCRUAL: A total of 55-103 patients (16-32 who have received prior thalidomide,
16-32 in arm I, and 23-39 in arm II) will be accrued for this study within 2.5 years.
;
Allocation: Randomized, Primary Purpose: Treatment
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