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Clinical Trial Summary

The median overall survival (OS) of relapsed/refractory multiple myeloma (MM) is less than nine months. However, phase II data with the proteasome inhibitor bortezomib (Velcade®) has been heartening, with 35% overall response rates and median survival of 16 months. In-vitro data has shown that this agent dramatically increases the sensitivity to chemotherapeutic agents. Liposomal doxorubicin (Doxil), melphalan, and bortezomib all have different mechanisms of action and toxicity profiles. Clinical studies employing two drug combinations with these agents in patients with refractory MM have found favorable efficacy (nearly no progression of disease) and tolerance data. Thus, the investigators are initiating a phase I/II study to examine the safety and efficacy of combining all three agents into the regimen DMV (Doxil® + melphalan + Velcade).


Clinical Trial Description

Dose Level 1: Doxil 10 mg/m2, Melphalan 5 mg/m2, Velcade 0.7 mg/m2

Dose Level 2: Doxil 10 mg/m2, Melphalan 10 mg/m2, Velcade 0.7 mg/m2

Dose Level 3: Doxil 20 mg/m2, Melphalan 10 mg/m2, Velcade 0.7 mg/m2

Dose Level 4: Doxil 20 mg/m2, Melphalan 10 mg/m2, Velcade 1.0 mg/m2

Adjunctive therapy with a bisphosphonate, either pamidronate or zoledronic acid, will be given monthly.

Dose Escalation Schedule: Dose escalation will occur only after patients have completed at least two cycles at a given dose level.

1. If 0/3 experience DLT (as defined in attachment Section 6.0), the next three patients will be escalated by one dose level.

2. If 1/3 experience DLT, 3 additional patients enrolled at this dose level.

- If 0, 1, or 2 of these additional patients experience DLT (i.e. total 3/6), the dose will be escalated.

- If 3/3 experience DLT (i.e. total 4/6) then the next lower dose will be considered the MTD..

3. If 2/3 experience DLT, 3 additional patients enrolled at this dose level.

- If 0 or 1 of these additional patients experience DLT (i.e. total 3/6), the dose will be escalated.

- If 2 or more/3 experience DLT (i.e. total more than 3/6) then the next lower dose level is MTD ;


Study Design


Related Conditions & MeSH terms


NCT number NCT00985907
Study type Interventional
Source University of California, San Francisco
Contact
Status Terminated
Phase Phase 1/Phase 2
Start date October 28, 2004
Completion date January 12, 2010

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