Multiple Myeloma Clinical Trial
Official title:
A Phase I/II Multicenter, Randomized, Open Label, Dose-Escalation Study To Determine The Maximum Tolerated Dose, Safety, And Efficacy Of CC-4047 Alone Or In Combination With Low-Dose Dexamethasone In Patients Wth Relapsed And Refractory Multiple Myeloma Who Have Received Prior Treatment That Includes Lenalidomide And Bortezomib
The purpose of this study is to determine the maximum tolerated dose and effectiveness of the study drug (CC-4047) Alone Or in Combination With Low-dose Dexamethasone as treatment for patients with relapsed and refractory multiple myeloma
Status | Completed |
Enrollment | 259 |
Est. completion date | September 2015 |
Est. primary completion date | April 2011 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Must be greater than or equal to 18 years at the time of signing the informed consent form - Must be able to adhere to the study visit schedule and other protocol requirements - Have a documented diagnosis of multiple myeloma and have relapsed and refractory disease. Patients must have received at least 2 prior therapies. Patients must have relapsed after having achieved at least stable disease for at least one cycle of treatment to at least one prior regimen and then developed PD. Patients must also have documented evidence of PD during or within 60 days (measured from the end of the last cycle) of completing treatment with the last anti-myeloma drug regimen used just prior to study entry (refractory disease) - Patients must have also undergone prior treatment with at least 2 cycles of lenalidomide and at least 2 cycles of bortezomib (either in separate regimens or within the same regimen) - Measurable levels of myeloma paraprotein in serum (greater than or equal to 0.5 g/dL) or urine (greater than or equal 0.2 g/dL excreted in a 24 hour collection sample) - Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2 - Females of childbearing potential (FCBP) [An FCBP is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., who has had menses at any time in the preceding 24 consecutive months)] must agree to refrain from becoming pregnant for 28 days prior to initiation of study drug, while on study drug and for 28 days after discontinuation of study drug and must agree to regular pregnancy testing during this timeframe. - All patients must also agree to refrain from donating blood while on study drug and for 28 days after discontinuation from this study - Males must agree to use a latex condom during any sexual contact with FCBP while participating in the study and for 28 days following discontinuation from this study even if he has undergone a successful vasectomy. Males must also agree to refrain from donating blood, semen or sperm during the above referenced timeframe. - All patients must agree not to share medication with another person. Exclusion Criteria: - Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the patient from signing the informed consent form. - Any serious concurrent medical conditions that may make the patient non-evaluable or put the patient's safety at risk. - Pregnant or lactating females - Any of the following laboratory abnormalities: - Absolute neutrophil count (ANC) < 1,000 cells/mm3 - Platelet count < 75,000/mm3 for patients in whom < 50% of bone marrow nucleated cells are plasma cells; or a platelet count < 30,000/mm3 for patients in whom = 50% of bone marrow nucleated cells are plasma cells - Serum creatinine > 3.0 mg/dL - Serum glutamic oxaloacetic transaminase/Aspartate transaminase (SGOT/AST) or Serum Glutamic Pyruvate Transaminase/Alanine transaminase (SGPT/ALT) > 3.0 X upper limit of normal (ULN) - Serum total bilirubin > 2.0 mg/dL - Prior history of malignancies, other than multiple myeloma, unless the patient has been free of the disease for = 3 years. Exceptions include the following: - Basal or squamous cell carcinoma of the skin - Carcinoma in situ of the cervix or breast - Incidental histologic finding of prostate cancer (TNM stage of T1a or T1b) - Known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and/or Hepatitis C Virus (HCV) infection - Hypersensitivity to thalidomide, lenalidomide, or dexamethasone - Peripheral neuropathy = Grade 2 - Use of any anti-myeloma drug therapy within 14 days of the initiation of study drug treatment or use of any experimental non-drug therapy within 28 days of the initiation of study drug treatment - Radiation therapy within 14 days of initiation of study drug treatment Inability or unwillingness to comply with birth control requirements |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Canada | Tom Baker Cancer Center | Calgary | Alberta |
Canada | Cross Cancer Institute | Edmonton | Alberta |
Canada | Royal Victoria Hosptial | Montreal | Quebec |
Canada | Princess Margaret Hospital and University of Toronto | Toronto | Ontario |
Canada | Vancouver General Hospital | Vancouver | British Columbia |
United States | University of Michigan Comprehensive Cancer CenterDivision of Hematology/Oncology | Ann Arbor | Michigan |
United States | Winship Cancer Institute of Emory University | Atlanta | Georgia |
United States | Dana-Farber Cancer Institute | Boston | Massachusetts |
United States | Mass General Hospital | Boston | Massachusetts |
United States | Roswell Park Cancer Institute Department of Medicine | Buffalo | New York |
United States | Ohio State University Arthur G. James Cancer Hospital | Columbus | Ohio |
United States | Colorado Blood Cancer Institute | Denver | Colorado |
United States | The Cancer Center at Hackensack University Medical Center | Hackensack | New Jersey |
United States | Mt. Sinai Hospital | New York | New York |
United States | University of Pittsburgh | Pittsburgh | Pennsylvania |
United States | Mayo Clinic - Arizona | Rochester | Minnesota |
United States | Mayo Clinic Arizona | Scottsdale | Arizona |
United States | Washington University School of Medicine | St. Louis | Missouri |
United States | Moffitt Cancer Center | Tampa | Florida |
Lead Sponsor | Collaborator |
---|---|
Celgene Corporation |
United States, Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Phase 1: Participants With Dose-Limiting Toxicities (DLT) in Cycle 1 | The maximum tolerated dose was defined as the highest dose level at which no more than 1 of 6 participants experiences a DLT within the first 28-day cycle. DLTs were defined as: Grade 4 neutropenia or thrombocytopenia Febrile neutropenia Grade 3 or 4 nausea, vomiting or diarrhea despite optimal symptomatic treatment Serum transaminase > 20 * upper limit of normal (ULN) Serum transaminase > 5 * ULN for >= 7 days Delay of the start of cycle 2 by >7 days due to pomalidomide-related adverse event |
Up to Day 28 (Cycle 1) | Yes |
Primary | Phase 2: Kaplan-Meier Estimates of Progression-free Survival (PFS) as of the 01 April 2011 Cut-off | Progression free survival (PFS) is the time from randomization to the first documentation of disease progression or death from any cause during study, whichever occurs earlier. Disease progression was assessed by the Independent Response Adjudication Committee (IRAC). For the primary PFS analysis, participants who withdrew for any reason or received another antimyeloma therapy (except adding dexamethasone to the Phase 2: Pomalidomide arm) without documented PD (as determined by the IRAC review) were censored on the date of their last adequate response assessment, prior to receiving any other anti-myeloma therapy. Subjects who were still active at the time of the data cut-off date without PD (as determined by the IRAC) were censored on the date of their last adequate response assessment. Data collection is ongoing and future data results will be included as available. |
up to 67 weeks | No |
Primary | Phase 2: Percentage of Participants With Progression-Free Survival (PFS) Events as of the 01 April 2011 Cut-off | Percentage of participants with the progression-free survival events: disease progression and death. Disease progression was assessed by the Independent Response Adjudication Committee (IRAC). Data collection is ongoing and future data results will be included as available. |
up to 67 weeks | No |
Secondary | Phase 1: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) While on Single-Agent Pomalidomide as of the 01 April 2011 Cut-off | Relation to study drug was assessed by the Investigator as either suspected or not suspected. Counts represent the suspected relationship. Severity was assessed using National Cancer Institute Common Toxicity Terminology Criteria for Adverse Events version 3.0 (NCI CTCAE v3.0): 1= Mild 2= Moderate 3= Severe 4= Life-threatening and 5= Death related to AE. Serious AEs (SAEs) are those that resulted in death, were life-threatening, required or prolonged inpatient hospitalization, resulted in persistent or significant disability/incapacity, congenital anomaly, or resulted in an important medical event that may have jeopardized the patient or required medical or surgical intervention to prevent one of the outcomes listed above. Data collection is ongoing and future data results will be included as available. |
Up to week 104 | Yes |
Secondary | Phase 1: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) While on Both Pomalidomide and Dexamethasone as of the 01 April 2011 Cut-off | TEAEs that occurred during Phase 1 after dexamethasone was added to pomalidomide treatment. Relation to study drug was assessed by the Investigator as either suspected or not suspected. Counts represent the suspected relationship. Severity was assessed using National Cancer Institute Common Toxicity Terminology Criteria for Adverse Events version 3.0 (NCI CTCAE v3.0): 1= Mild 2= Moderate 3= Severe 4= Life-threatening and 5= Death related to AE. Serious AEs (SAEs) are those that resulted in death, were life-threatening, required or prolonged inpatient hospitalization, resulted in persistent or significant disability/incapacity, congenital anomaly, or resulted in an important medical event that may have jeopardized the patient or required medical or surgical intervention to prevent one of the outcomes listed above. Data collection is ongoing and future data results will be included as available. |
Up to week 126 | Yes |
Secondary | Phase 2: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) as of the 01 April 2011 Cut-off | Relation to study drug was assessed by the Investigator as either suspected or not suspected. Counts represent the suspected relationship. Severity was assessed using National Cancer Institute Common Toxicity Terminology Criteria for Adverse Events version 3.0 (NCI CTCAE v3.0): 1= Mild 2= Moderate 3= Severe 4= Life-threatening and 5= Death related to AE. Serious AEs (SAEs) are those that resulted in death, were life-threatening, required or prolonged inpatient hospitalization, resulted in persistent or significant disability/incapacity, congenital anomaly, or resulted in an important medical event that may have jeopardized the patient or required medical or surgical intervention to prevent one of the outcomes listed above. Data collection is ongoing and future data results will be included as available. |
Up to week 70 | Yes |
Secondary | Phase 2: Summary of Best Myeloma Response As Assessed by Independent Response Adjudication Committee (IRAC) Using European Group for Blood and Bone Marrow Transplant (EBMT) Criteria as of the 01 April 2011 Cut-off | IRAC used EBMT criteria to assess myeloma response: Complete Response (CR)-absence of serum and urine monoclonal paraprotein for 6 weeks, plus no increase in size or number of lytic bone lesions, plus other factors) Partial Response (PR)-not all CR criteria, plus >=50% reduction in serum monoclonal paraprotein plus others Minimal Response (MR)- 25-49% reduction in serum monoclonal paraprotein plus others Stable Disease (SD)- not MR or progressive disease (PD) Progressive Disease (PD)- reappearance of monoclonal paraprotein, lytic bone lesions, other Not Evaluable (NE). Data collection is ongoing and future data results will be included as available. |
up to 70 weeks | No |
Secondary | Phase 2: Kaplan-Meier Estimates of Duration of Response as of the 01 April 2011 Cut-off | Duration of myeloma response is defined as the time from when the response criteria are first met for partial response (PR) or better, until the first date the response criteria are met for progressive disease (PD) or until the participant dies from any cause, whichever occurs first. Duration of response for participants last known to be alive with no progression after a complete response (CR) or PR was censored at the date of last adequate response assessment. Participants with confirmed responses that occur after receiving any other anti-myeloma therapy (except for adding dexamethasone to the pomalidomide treatment arm), including radiation therapy initiated after baseline, was censored at the last adequate assessment prior to the initiation of such treatment. Response was assessed by the Independent Response Adjudication Committee (IRAC) using European Group for Blood and Bone Marrow Transplant (EBMT) criteria as described in the previous outcome. |
up to 70 weeks | No |
Secondary | Phase 2: Time to Response as of the 01 April 2011 Cut-off | Time to myeloma response is defined as the time from randomization to the time the response criteria for complete response (CR) or partial response (PR) are first met. Response was assessed by the Independent Response Adjudication Committee (IRAC) using European Group for Blood and Bone Marrow Transplant (EBMT) criteria as described previously. Data collection is ongoing and future data results will be included as available. |
up to 70 weeks | No |
Secondary | Phase 2: Kaplan-Meier Estimates of Overall Survival as of the 01 April 2011 Cut-off | Overall survival was defined as the time between randomization and death. Participants who die, regardless of the cause of the death, were considered to have had an event. All participants who were lost to follow-up prior to the end of the trial or who were withdrawn from the trial were censored at the time of last contact. Participants who were still being treated were censored at the last available date the subject was known to be alive, or clinical cut-off date if it was earlier. Data collection is ongoing and future data results will be included as available. |
up to 70 weeks | No |
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