Multiple Myeloma and Plasma Cell Neoplasm Clinical Trial
Official title:
A Phase III Multicenter, Randomized, Open-Label Trial Evaluating High Dose Melphalan Plus Holmium-166-DOTMP Versus High Dose Melphalan Alone When Given In Conjuction With Peripheral Blood Stem Cell Transplantation In Patients With Multiple Myeloma
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Radioactive drugs such as holmium Ho 166 DOTMP can kill cancer
cells without harming healthy cells. Peripheral stem cell transplantation may be able to
replace immune cells that were destroyed by chemotherapy or radiation therapy used to kill
tumor cells.
PURPOSE: Randomized phase III trial to compare the effectiveness of melphalan with or
without holmium Ho 166 DOTMP followed by peripheral stem cell transplantation in treating
patients who have multiple myeloma.
OBJECTIVES: I. Compare the efficacy of melphalan with or without holmium Ho 166 DOTMP
followed by autologous peripheral blood stem cell transplantation in patients with multiple
myeloma. II. Compare the response rate and overall survival of these patients treated with
these regimens. III. Compare the hematologic recovery rate and time to granulocyte
engraftment of these patients treated with these regimens. IV. Compare the toxicity of these
regimens in this patient population.
OUTLINE: This is a randomized, open label, multicenter study. Patients are stratified
according to their beta 2 microglobulin (B2M) test at initial diagnosis (B2M no greater than
4 mg/L vs B2M greater than 4 mg/L vs unknown B2M). Patients are randomized to one of two
treatment arms. Prior to stratification and randomization, patients receive a diagnostic
dose of holmium Ho 166 DOTMP within days -31 to -10. Patients with adequate skeletal uptake
of the diagnostic dose are randomized for therapy. Arm I: Patients receive holmium Ho 166
DOTMP IV over no more than 10 minutes within days -10 to -7 (at least 1 week and no more
than 3 weeks after the diagnostic dose), melphalan IV over 20-30 minutes within days -3 to
-1 (at least 24 hours prior to autologous peripheral blood stem cell (PBSC)
transplantation), and autologous PBSC transplantation on day 0. Arm II: Patients receive
melphalan and autologous PBSC transplantation as in arm I. Following transplantation,
patients receive filgrastim (G-CSF) daily until blood counts recover. Patients are followed
at 1 year, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: Approximately 300 patients (150 per treatment arm) will be accrued for
this study within 9 months.
;
Primary Purpose: Treatment
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