Clinical Trial Details
— Status: Terminated
Administrative data
| NCT number |
NCT02394210 |
| Other study ID # |
CEL-MIE-2012-02 |
| Secondary ID |
|
| Status |
Terminated |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
May 14, 2013 |
| Est. completion date |
May 18, 2021 |
Study information
| Verified date |
August 2021 |
| Source |
Celgene |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Post-authorisation prospective follow-up study to assess the clinical impact on time to
progression (TTP) from the start of anti- multiple myeloma treatment at the onset of
asymptomatic relapse/biological progression versus start of treatment at the time of
symptomatic relapse.
Description:
National, observational, prospective, post-authorisation multicentre registry.
It will include patients with a diagnosis of MM who have received no more than two lines of
treatment and with at least one partial relapse (≥ PR) with their latest anti-MM treatment,
duly documented in accordance with the criteria of the IMW Consensus Panel 1:
1. Patients prior to relapse/biological progression, even without being in asymptomatic
relapse/biological progression are followed every one or two months at most, according to the
clinical judgment of the physician investigator, and provided there is an analysis
(proteinogram and/or immunofixation) in the two months (+/- 15 days) prior to inclusion in
which it can be documented that the patient was not in a situation of asymptomatic relapse or
progression.
Patients in first or second relapse/biological progression who initiate any of the treatments
currently approved and marketed in Spain for the treatment of relapsed MM, based on the
criteria of the International Myeloma Workshop (IMW) Consensus Panel 11 or patients without
treatment from relapse/biological progression to clinical relapse who initiate treatment
after clinical relapse, according to standard criteria for clinical practice, and according
to the clinical decision of each participating physician in the study, and provided there is
an analysis (proteinogram and/or immunofixation) in the two months (+/- 15 days) prior to
inclusion in which it can be documented that the patient was not in a situation of relapse or
asymptomatic progression.
Therefore, two groups are defined for inclusion in the registry for patients in 1st or 2nd
relapse/biological progression, depending on the treatment strategy adopted according to the
routine clinical practice of each site participating in the study.
Group 1: Patients in relapse/biological progression not receiving treatment until clinical
relapse.
Relapse/biological progression, under the criteria of the IMW (International Myeloma
Workshop) Consensus Panel 11, is understood to be an asymptomatic relapse (without CRAB
symptoms) defined by a ≥25% increase over the lowest value obtained during response, in any
of the following:
- Serum M-protein (absolute increase must be ≥0.5 g/dL) and/or
- Urine M-component (absolute increase must be ≥200 mg/24 hrs.) and/or
- Only for patients without measurable disease in serum and urine, a 25% increase from the
lowest difference in correlated and uncorrelated FLC (absolute increase >10 mg/dL)
- In patients with unmeasurable M-protein in serum and urine, and unmeasurable FLC levels,
a 25% increase in the percentage of plasma cells in bone marrow (the absolute percentage
must be ≥10%)
- In patients with asymptomatic relapse/biological progression from complete response,
recurrence of M protein in serum or urine by immunofixation or electrophoresis in two
consecutive samples[1]
- Patients in this group will be studied in two phases:
- Phase 1 (observation phase): Patients not initially receiving anti-myeloma
(anti-MM) treatment, thus patients not treated for myeloma between
relapse/biological progression and clinical relapse.
- Phase 2 (anti-MM treatment after clinical relapse): Patients receive conventional
anti-myeloma treatment after clinical relapse*.
Group 2: (anti-MM treatment at the time of relapse/biological progression): Patients in this
group may receive conventional anti-myeloma treatment as per routine clinical practice at the
participating site:
1. Upon relapse/biological progression, defined as per the criteria of the IMW
(International Myeloma Workshop) Consensus Panel Panel1, as an asymptomatic relapse
(without CRAB symptoms), defined by a ≥25% increase over the lowest value obtained
during remission, in any of the following:
- Serum M-protein (absolute increase must be ≥0.5 g/dL) and/or
- Urine M-component (absolute increase must be ≥200 mg/24 hrs.), and/or
- Only for patients without measurable disease in serum and urine, a 25% increase
over the lowest difference in correlated and uncorrelated FLC (absolute increase
>10 mg/dL)
- In patients with unmeasurable M-protein in serum and urine, and unmeasurable FLC
levels, a 25% increase in the percentage of plasma cells in bone marrow (the
absolute percentage must be ≥10%)
- In patients with asymptomatic relapse/biological progression from complete
response, recurrence of M protein in serum or urine by immunofixation or
electrophoresis in two consecutive samples[1] Or
2. Upon a significant relapse of paraprotein, defined as:
- Duplication of M-component in two consecutive readings taken ≤2 months apart; or
- An increase in absolute levels of serum M-protein ≥1 g/dL or M-protein in urine at
≥500 mg/24h, or
- Increase in light chain levels ≥20 mg/dL with an abnormal ratio in two consecutive
readings taken ≤2 months apart), which suggests the presence of biological
progression/relapse criteria, but without including any clinical details of those
involved in clinical relapse*.
- any change in treatment regimens, for example, discontinuation or addition of
a drug (except changes in dose for any of the initial drugs) will mark the end
of the anti-MM treatment phase and passing of the patient to the 36-month
post-treatment follow-up phase.
In case of temporary interruptions of the study drug, under 30 days, or of any duration
(except if the reason for the interruption is toxicity, the patient will continue in the
anti-MM treatment phase, provided the same treatment regimen is resumed.
Patients included in the registry prior to relapse/biological progression, will be assigned
to group 1 or 2 according to the strategy that the investigator decides once
relapse/biological progression occurs. Furthermore, to include these patients in the phase
prior to relapse/biological progression there must be an analysis (proteinogram and/or
immunofixation) in the two months (+/- 15 days) prior to inclusion in which it can be
documented that the patient was not in a situation of relapse or asymptomatic progression.
If patients included in the registry stage prior to relapse/biological progression relapse or
progress directly with CRAB criteria they will be considered non-evaluable for the purposes
of sample size, although they will be evaluated for the purposes of the secondary exploratory
objective defined in section 5.2. In that case, these patients will receive anti-MM
treatment/s for recurrence or progression according to clinical practice in the participating
sites.
Likewise, patients who after being included in the registry receive treatment within a
clinical trial will be deemed not evaluable.
From the time relapse/biological progression occurs, the investigator shall have a period of
two months to decide in which observation group to include the patient.
Follow-up is established for the duration of the anti-MM treatment phase. For all patients
included in the registry and whenever possible, the prospective follow-up period will be
extended an additional 36 months (data collected every 6 months), starting this phase from
the last dose of study medication.
Once patients have been included on the registry, they must be followed at a maximum of two
month intervals, until relapse or progression of the disease, with the inclusion of data in
the electronic case report form every 2 months (for patients included in the registry after
relapse/biological progression), or every 4 months (for patients included in the registry
prior to relapse/biological progression), in order to allow an exact calculation of TTP
(primary endpoint) and the time from relapse/biological progression to clinical relapse.
To this end, the proteinogram and/or immunofixation (in case of negative protein count) must
have been assessed every one or two months during or after completion of treatment prior to
inclusion.
However, given the observational nature of the study, patient follow-up will take place as
per routine clinical practice at each site.
