Bortezomib, Cyclophosphamide, Dexamethasone, and Thalidomide in Treating Patients With Newly Diagnosed, Previously Untreated Multiple Myeloma

The recruitment status of this study is unknown because the information has not been verified recently.
Verified March 2009 by National Cancer Institute (NCI).
Recruitment status was  Active, not recruiting
Sponsor:
Collaborator:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00438841
First received: February 20, 2007
Last updated: March 12, 2009
Last verified: March 2009
  Purpose

RATIONALE: Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cyclophosphamide and dexamethasone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Thalidomide may stop the growth of cancer cells by blocking blood flow to the cancer. Giving bortezomib together with cyclophosphamide, dexamethasone, and thalidomide may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving bortezomib together with cyclophosphamide, dexamethasone, and thalidomide works in treating patients with newly diagnosed, previously untreated multiple myeloma.


Condition Intervention Phase
Multiple Myeloma and Plasma Cell Neoplasm
Drug: bortezomib
Drug: cyclophosphamide
Drug: dexamethasone
Drug: thalidomide
Phase 2

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Trial With VELCADE® (PS-341), Cytoxan (Cyclophosphamide), Dexamethasone and Thalomid® (VEL-CTD) in Previously Untreated Multiple Myeloma Patients

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Response rate [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Safety and tolerability [ Designated as safety issue: Yes ]

Estimated Enrollment: 43
Study Start Date: August 2006
Estimated Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the response rate in patients with newly diagnosed, previously untreated multiple myeloma treated with bortezomib, cyclophosphamide, dexamethasone, and thalidomide.

Secondary

  • Determine the safety and tolerability of this regimen in these patients.

OUTLINE: This is an open-label, multicenter study.

Patients receive bortezomib IV on days 1, 4, 8, and 11; cyclophosphamide IV on days 1 and 8 of courses 1-3; oral thalidomide once daily on days 1-21 beginning in course 4; and dexamethasone IV or orally once daily on days 1, 2, 4, 5, 8, 9, 11, and 12. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 43 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of multiple myeloma meeting 1 of the following criteria:

    • Monoclonal immunoglobulin spike on serum electrophoresis (IgG > 3.5 g/dL or IgA > 2.0 g/dL) and kappa or lambda light chain excretion > 1 g/day by 24-hour urine protein electrophoresis AND meets any of the following criteria:

      • Bone marrow plasmacytosis (10-30% plasma cells)
      • Lytic bone lesions
    • Monoclonal immunoglobulin of lesser magnitude present and bone marrow plasmacytosis (10-30% plasma cells) AND meets any of the following criteria:

      • Lytic bone lesions
      • IgM < 50 mg/dL, IgA < 100 mg/dL, or IgG < 600 mg/dL
    • Bone marrow plasmacytosis (> 30% plasma cells) or plasmacytoma on tissue biopsy AND meets any of the following criteria:

      • Monoclonal immunoglobulin of lesser magnitude present
      • Lytic bone lesions
      • IgM < 50 mg/dL, IgA < 100 mg/dL, or IgG < 600 mg/dL
    • FreeLite testing abnormal and kappa:lambda light chain ratio abnormal
  • Symptomatic disease requiring treatment

    • Documented related organ or tissue involvement, if present
  • Measurable disease, defined as 1 of the following:

    • Monoclonal immunoglobulin spike on serum electrophoresis ≥ 1 g/dL and/or urine monoclonal immunoglobulin spike ≥ 200 mg/day
    • Abnormal FreeLite testing (for nonsecretors)
    • Patients with nonsecretory disease must meet either of the following criteria for measurability:

      • Has measurable protein by FreeLite testing
      • Untreated soft tissue plasmacytoma and/or evaluable disease in bone marrow
  • Newly diagnosed, previously untreated disease
  • No POEMS syndrome (i.e., plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein [M-protein], and skin changes)
  • No plasma cell leukemia

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 50-100%
  • Platelet count ≥ 100,000/mm³ (≥ 50,000/mm³ if bone marrow is extensively infiltrated)

    • Extensive infiltration is defined as > 50% myeloma cells or plasma cells
  • Hemoglobin ≥ 8.5 g/dL
  • Absolute neutrophil count ≥ 1,500/mm³
  • AST and ALT ≤ 2 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN (unless clearly related to the disease)
  • Creatinine clearance ≥ 20 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use 2 methods of effective contraception ≥ 4 weeks prior to beginning treatment, during, and for ≥ 4 weeks after completion of study treatment
  • No impaired kidney function requiring dialysis
  • No uncontrolled infection
  • No HIV positivity
  • No known active hepatitis B or C
  • No cardiovascular disease including, but not limited to, any of the following:

    • Myocardial infarction within the past 6 months
    • New York Heart Association class II-IV heart failure
    • Uncontrolled angina
    • Severe uncontrolled ventricular arrhythmias
    • Clinically significant pericardial disease
    • Acute ischemic or active conduction system abnormalities by EKG
  • No history of allergic reactions to compounds containing mannitol, bortezomib, or cyclophosphamide
  • No second malignancy requiring concurrent treatment
  • No other serious medical or psychiatric illness that would preclude study compliance
  • No peripheral neuropathy ≥ grade 1

PRIOR CONCURRENT THERAPY:

  • No prior chemotherapy, immunotherapy, vaccine therapy, therapeutic doses of steroids, or other agents for the treatment of active myeloma

    • Drugs given to prevent onset of myeloma allowed
    • Bisphosphonates for hypercalcemia or short course corticosteroids for hypercalcemia or cord compromise allowed
  • Prior local radiotherapy with or without a brief exposure to steroids allowed
  • More than 4 weeks since prior and no concurrent radiotherapy

    • Spot radiotherapy to ≤ 3 vertebrae allowed
  • No concurrent steroids at > 10 mg of prednisone daily (or the equivalent) for other medical conditions (e.g., asthma, systemic lupus erythematosus, or rheumatoid arthritis)
  • No other concurrent chemotherapy or investigational agents
  • Concurrent daily acetylsalicylic acid required during course 4-6 of study treatment
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00438841

Locations
United States, California
Alta Bates Summit Comprehensive Cancer Center
Berkeley, California, United States, 94704
Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center
Los Angeles, California, United States, 90048
Desert Regional Medical Center Comprehensive Cancer Center
Palm Springs, California, United States, 92262
Sutter Cancer Center
Sacramento, California, United States, 95816
United States, Florida
Eugene M. and Christine E. Lynn Cancer Institute at Boca Raton Community Hospital - Main Campus
Boca Raton, Florida, United States, 33486
United States, New York
St. Vincent's Comprehensive Cancer Center - Manhattan
New York, New York, United States, 10011
United States, Oregon
Oregon Health and Science University Cancer Institute
Portland, Oregon, United States, 97239
United States, Texas
Lone Star Oncology - Austin
Austin, Texas, United States, 78759
United States, Washington
Fred Hutchinson Cancer Research Center
Seattle, Washington, United States, 98109-1024
Seattle Cancer Care Alliance
Seattle, Washington, United States, 98109-1023
Sponsors and Collaborators
Fred Hutchinson Cancer Research Center
Investigators
Principal Investigator: William I. Bensinger, MD Fred Hutchinson Cancer Research Center
  More Information

Additional Information:
No publications provided

Responsible Party: Phyllis Potts, Aptium Oncology
ClinicalTrials.gov Identifier: NCT00438841     History of Changes
Other Study ID Numbers: CDR0000536219, FHCRC-2123.00
Study First Received: February 20, 2007
Last Updated: March 12, 2009
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage I multiple myeloma
stage II multiple myeloma
stage III multiple myeloma

Additional relevant MeSH terms:
Neoplasms
Multiple Myeloma
Neoplasms, Plasma Cell
Plasmacytoma
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
Cyclophosphamide
Thalidomide
Bortezomib
Dexamethasone
Dexamethasone acetate
Dexamethasone 21-phosphate
BB 1101
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antirheumatic Agents
Therapeutic Uses
Antineoplastic Agents, Alkylating
Alkylating Agents

ClinicalTrials.gov processed this record on August 28, 2014