Multiple Myeloma and Plasma Cell Neoplasm Clinical Trial
Official title:
A Phase I/II Study of Targeted Radiotherapy Using Holmium-166-DOTMP With Melphalan and Peripheral Blood Stem Cell Transplantation for Treatment of Multiple Myeloma
RATIONALE: Radiation therapy using holmium Ho 166 DOTMP may damage cancer cells. Drugs used
in chemotherapy use different ways to stop cancer cells from dividing so they stop growing
or die. Peripheral stem cell transplantation may be able to replace immune cells that were
destroyed by chemotherapy or radiation therapy used to kill cancer cells.
PURPOSE: Phase I/II trial to study the effectiveness of radiation therapy using holmium Ho
166 DOTMP plus melphalan and peripheral stem cell transplantation in treating patients who
have multiple myeloma.
OBJECTIVES: I. Determine the maximum tolerated dose of targeted radiotherapy using holmium
Ho 166 DOTMP when combined with melphalan and autologous or syngeneic peripheral blood stem
cell transplantation in patients with multiple myeloma. II. Determine the response rate and
time to progression in patients treated with this regimen.
OUTLINE: This is a dose escalation, multicenter study of targeted radiotherapy using holmium
Ho 166 DOTMP. Phase I: Autologous or syngeneic peripheral blood stem cells (PBSC) are
harvested and selected for CD34+ cells. Patients receive an initial test dose of holmium Ho
166 DOTMP IV. Patients with adequate skeletal uptake of the test dose then receive
therapeutic dose holmium Ho 166 DOTMP IV over 5-10 minutes for 1-3 days beginning 2 days
after test dose infusion and melphalan IV over 20-30 minutes on day -3. PBSC are reinfused
beginning a minimum of 24 hours after melphalan infusion and after ongoing radiation to bone
marrow falls to less than 1 rad/hour. Cohorts of 4-7 patients receive escalating doses of
targeted radiotherapy using holmium Ho 166 DOTMP until the maximum tolerated dose (MTD) is
determined. The MTD is defined as the dose preceding that at which 2 of 7 patients
experience dose limiting toxicity. Phase II: Patients receive holmium Ho 166 DOTMP at the
MTD from phase I of the study. Patients are followed every 3 months for 1 year.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study within 1 year.
;
Primary Purpose: Treatment
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