CC-5013 With or Without Dexamethasone in Treating Patients With Primary Systemic Amyloidosis
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Purpose
RATIONALE: Drugs such as CC-5013 and dexamethasone may be effective in treating primary systemic amyloidosis.
PURPOSE: This phase II trial is studying CC-5013 to see how well it works with or without dexamethasone in treating patients with primary systemic amyloidosis.
| Condition | Intervention | Phase |
|---|---|---|
|
Multiple Myeloma and Plasma Cell Neoplasm |
Drug: dexamethasone Drug: lenalidomide |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Trial of the Immunomodulatory Drug CC-5013 for Patients With AL Amyloidosis |
- Tolerability and objective hematologic response with CC-5013 every 3 months [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
- Organ response with CC-5013 every 3 months [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Hematologic response in patients who do not achieve a response to CC-5013 alone and are subsequently treated with CC-5013 and dexamethasone every 3 months after dexamethasone is added [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Organ response in patients who do not achieve a response to CC-5013 alone and are subsequently treated with CC-5013 and dexamethasone every 3 months after dexamethasone is added [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Toxicity of CC-5013 and dexamethasone every 3 months after dexamethasone is added [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
| Enrollment: | 82 |
| Study Start Date: | January 2004 |
| Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: revlimid
lenalidomide 15 mg/day, for 21 days with 7 days rest (28 day cycle) with or without dexamethasone 20 mg daily (10 mg BID) on Days 1-4, 9-12, and 17-20 of every other 28-day cycle.
|
Drug: dexamethasone Drug: lenalidomide |
Detailed Description:
OBJECTIVES:
Primary
- Determine the tolerability of CC-5013 in patients with primary systemic (AL) amyloidosis.
- Determine the objective hematologic response rate in patients treated with this drug.
- Determine amyloid organ disease response in patients treated with this drug.
Secondary
- Determine hematologic and amyloid organ disease response in patients who do not achieve a response to CC-5013 alone and are subsequently treated with CC-5013 and dexamethasone.
- Determine the toxicity of CC-5013 in combination with dexamethasone in these patients.
OUTLINE: Patients receive oral CC-5013 once daily on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients not achieving a hematologic response continue to receive CC-5013 as before and also receive oral dexamethasone twice daily on days 1-4, 9-12, and 17-20 of every other 28-day course for up to 6 courses of combination therapy. Patients who maintain a hematologic response after 6 courses of combination therapy may receive CC-5013 alone in the absence of disease progression or unacceptable toxicity. Patients not achieving a hematologic response after the initiation of dexamethasone are removed from the study.
Patients are followed annually.
PROJECTED ACCRUAL: A total of 15-25 patients will be accrued for this study within 5-12.5 months.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed primary systemic (AL) amyloidosis
- Tissue amyloid deposits or positive fat aspirate
Meets 1 of the following criteria for AL type disease:
- Serum or urine monoclonal protein by immunofixation electrophoresis
- Plasmacytosis of bone marrow by monoclonal staining for kappa- or lambda-light chain isotype
- No secondary or familial amyloidosis
- No multiple myeloma, defined as ≥ 30% plasma cells in bone marrow biopsy specimen OR lytic bone lesions
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- SWOG 0-2
Life expectancy
- Not specified
Hematopoietic
- WBC > 3,000/mm^3
- Hemoglobin > 8 g/dL
- Platelet count > 100,000/mm^3
- Absolute neutrophil count > 1,000/mm^3
Hepatic
- Bilirubin ≤ 2 times upper limit of normal (ULN)
- AST and ALT ≤ 2 times ULN
Renal
- No dialysis
Cardiovascular
- No symptomatic cardiac arrhythmia
- No oxygen-dependent restrictive cardiomyopathy
Other
- No untreated or uncontrolled infection
- No other malignancy except basal cell skin cancer or carcinoma in situ of the cervix or breast
- No other serious medical illness that would preclude study participation
- No history of hypersensitivity reaction to thalidomide
- HIV negative
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior CC-5013
- Prior thalidomide for AL amyloidosis allowed
Chemotherapy
- More than 4 weeks since prior cytotoxic chemotherapy
Endocrine therapy
- Prior steroids for AL amyloidosis allowed
Radiotherapy
- More than 4 weeks since prior radiotherapy
Surgery
- Prior surgery allowed
Other
- Recovered from all prior therapy
Contacts and Locations| United States, Massachusetts | |
| Cancer Research Center at Boston Medical Center | |
| Boston, Massachusetts, United States, 02118 | |
| Principal Investigator: | David C. Seldin, MD, PhD | Boston Medical Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | David Seldin, MD, Principal Investigator, Boston Medical Center |
| ClinicalTrials.gov Identifier: | NCT00091260 History of Changes |
| Other Study ID Numbers: | CDR0000385687, BUMC-2004-009, BUMC-H-23235, CELGENE-RV-AMYL-PI-003 |
| Study First Received: | September 7, 2004 |
| Last Updated: | March 19, 2013 |
| Health Authority: | United States: Federal Government United States: Food and Drug Administration |
Keywords provided by Boston Medical Center:
|
primary systemic amyloidosis |
Additional relevant MeSH terms:
|
Amyloidosis Neoplasms Multiple Myeloma Neoplasms, Plasma Cell Plasmacytoma Proteostasis Deficiencies Metabolic Diseases Neoplasms by Histologic Type Hemostatic Disorders Vascular Diseases Cardiovascular Diseases Paraproteinemias Blood Protein Disorders Hematologic Diseases Hemorrhagic Disorders |
Lymphoproliferative Disorders Immunoproliferative Disorders Immune System Diseases Dexamethasone acetate Dexamethasone Dexamethasone 21-phosphate Lenalidomide BB 1101 Anti-Inflammatory Agents Therapeutic Uses Pharmacologic Actions Antiemetics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 16, 2013