Multiple Myeloma Clinical Trial
Official title:
Sequential High-dose Dexamethasone and Response Adopted PAD (Bortezomib, Adriamycin, Dexamethasone) or VAD (Vincristine, Adriamycin, Dexamethasone) Induction Chemotherapy Followed by High-dose Chemotherapy With Autologous Stem Cell Transplantation for Newly Diagnosed Multiple Myeloma; Multicenter Phase 2 Study
Complete Response (CR) plus near CR rate of VAD (Vincristine, Adriamycin, Dexamethasone)
induction chemotherapy followed by ASCT in patients with newly diagnosed MM was about 50% and
CR plus near CR rate of PAD (Bortezomib, Adriamycin, Dexamethasone) induction chemotherapy
followed by ASCT in patients with newly diagnosed MM was about 60%. If the CR with near CR
rate of sequential high-dose dexamethasone and response adopted PAD or VAD induction
chemotherapy followed by ASCT is more than 60%, this combination will be accepted as active
regimen that may be worth for investigating in phase III trial. But, if the CR with near CR
rate of this regimen is lower than 50%, this has not a merit than VAD induction chemotherapy.
Based upon the above assumption, this trial was designed by using Simon's optimal two-stage
testing procedure. Assuming a target level of interest, p1=0.6, and a lower activity level,
p0=0.5. Initially 61 patients will be accrued. If 33 or more CR + near CR rate were observed,
the trial will be continued. Accrual will be planned to a total of 190 patients. If total 106
or more patients were assessed as CR with near CR, sequential high-dose dexamethasone and
response adopted PAD or VAD induction chemotherapy regimen will be accepted as active
regimen. This design provides probability 0.05 of accepting drugs worse than p0 and
probability 0.20 of rejecting drugs better than p1. If we assume that drop-out rate is 10%,
total accrual patient will be 210.
Patient characteristics and toxicity will be evaluated by descriptive methods. Progression
free survival and overall survival (median value, 95% confidence interval) will be calculated
by Kaplan-Meier method.
n/a
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