Stage III Multiple Myeloma Clinical Trial
Official title:
The Treatment of Multiple Myeloma Utilizing VBMCP Chemotherapy Alternating With High-Dose Cyclophosphamide and Alpha2b-Interferon Versus VBMCP: A Phase III Study for Previously Untreated Multiple Myeloma
This randomized phase III clinical trial studies combination chemotherapy with high dose cyclophosphamide and recombinant interferon alfa-2b to see how well it works compared to combination chemotherapy alone in treating patients with previously untreated stage I-III multiple myeloma. Drugs used in chemotherapy, such as vincristine sulfate, carmustine, melphalan, cyclophosphamide, and prednisone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Recombinant interferon alfa-2b may interfere with the growth of cancer cells. It is not yet know whether giving combination chemotherapy with or without alternating high-dose cyclophosphamide and recombinant interferon alfa-2b is more effective in treating multiple myeloma.
PRIMARY OBJECTIVES:
I. To compare response rate, time to response, duration of response, toxicity, and survival
in the two regimens (vincristine sulfate, carmustine, melphalan, cyclophosphamide,
prednisone [VBMCP] vs. VBMCP alternating with high-dose cyclophosphamide and then with
recombinant interferon alfa-2b [r alpha2b-IFN]) in patients with previously untreated
multiple myeloma.
II. To determine the value of the ancillary laboratory studies to predict response and
survival.
OUTLINE:
INDUCTION PHASE: Patients receive VBMCP comprising vincristine sulfate intravenously (IV) on
day 1, carmustine IV on day 1, melphalan orally (PO) on days 1-4, cyclophosphamide IV on day
1, and prednisone PO on days 1-7. Treatment repeats every 35 days for 2 courses in the
absence of disease progression or unacceptable toxicity.
CONSOLIDATION PHASE: Patients are randomized to 1 of 2 treatment arms.
ARM A: Patients receive VBMCP as in the induction phase. Courses repeat every 35 days in the
absence of disease progression or unacceptable toxicity.
ARM B: Patients receive vincristine sulfate, carmustine, and melphalan as in the induction
phase, high-dose cyclophosphamide IV on days 1-4 and prednisone PO on days 1-4 during
courses 3 and 5. Patients receive VBMCP as in the induction phase during even numbered
courses. Patients receive recombinant interferon alfa-2b subcutaneously (SC) on days 1, 3,
5, 8, 10, 12, 15, 17, 19, and 22 during odd courses beginning course 7. Treatment repeats
every 35 days for courses 3-5, every 21 days for even courses beginning course 6, and every
22 days for odd courses beginning course 7 in the absence of disease progression or
unacceptable toxicity.
In both arms, treatment continues for up to 2 years.
After completion of study treatment, patients are followed up for 1 year.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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