Recurrent Plasma Cell Myeloma Clinical Trial
Official title:
Randomized Phase 2 Trial of Retreatment With Pomalidomide or Lenalidomide With Dexamethasone for Patients With Relapsed Myeloma
This randomized phase II trial studies how well pomalidomide and dexamethasone work compared to lenalidomide and dexamethasone in treating patients with multiple myeloma that has returned after a period of improvement (relapsed) or did not respond to previous treatment with lenalidomide (refractory). Pomalidomide and lenalidomide may help the immune system kill cancer cells and may also prevent the growth of new blood vessels that tumors need to grow. Drugs used in chemotherapy, such as dexamethasone, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Dexamethasone may also help pomalidomide and lenalidomide work better by making cancer cells more sensitive to the drugs. It is not yet known whether pomalidomide and dexamethasone or lenalidomide and dexamethasone are effective in treating patients with relapsed or refractory multiple myeloma.
PRIMARY OBJECTIVES:
I. To assess the confirmed response rate of the combination of lenalidomide and dexamethasone
in patients with relapsed myeloma who have previously become refractory to lenalidomide. (Arm
A) II. To assess the confirmed response rate of the combination of pomalidomide and
dexamethasone in patients with relapsed myeloma who have previously become refractory to
lenalidomide. (Arm B)
SECONDARY OBJECTIVES:
I. To assess the toxicity in each arm in patients with relapsed myeloma who have previously
received lenalidomide.
II. To assess the response rates with pomalidomide and dexamethasone in patients relapsing on
lenalidomide and dexamethasone. (Arm A) III. To assess time to progression and overall
survival with each approach.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM A: Patients receive lenalidomide orally (PO) daily on days 1-21 and dexamethasone PO on
days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or
unacceptable toxicity. Patients experiencing progressive disease may crossover to arm B.
ARM B: Patients receive pomalidomide PO daily on days 1-21 and dexamethasone as in arm A.
Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up periodically.
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