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Phase 1/2 Study of VELCADE® in Combination With Other Drugs to Treat Previously Untreated Multiple Myeloma Patients (EVOLUTION)
This study is currently recruiting participants.
Verified by Millennium Pharmaceuticals, Inc., March 2008
First Received: July 25, 2007   Last Updated: March 31, 2008   History of Changes
Sponsors and Collaborators: Millennium Pharmaceuticals, Inc.
Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Information provided by: Millennium Pharmaceuticals, Inc.
ClinicalTrials.gov Identifier: NCT00507442
  Purpose

The purpose of this Phase 1/2 study is to evaluate the efficacy and safety of treatment with VELCADE, dexamethasone, and Revlimid® (VDR) as well as VELCADE, dexamethasone, cyclophosphamide, and Revlimid (VDCR) in patients with multiple myeloma who have received no prior treatment. This study will evaluate whether the addition of Revlimid to VELCADE and Dexamethasone will increase the CR/ very good partial response (VGPR) rate.


Condition Intervention Phase
Multiple Myeloma
Drug: bortezomib + dexamethasone + lenalidomide
Drug: bortezomib + dexamethasone + cyclophosphamide + lenalidomide
Drug: bortezomib + dexamethasone + cyclophosphamide
Phase I
Phase II

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: Phase 1/2 Study of VELCADE®, Dexamethasone, and Revlimid® Versus VELCADE, Dexamethasone, Cyclophosphamide, and Revlimid Versus VELCADE, Dexamethasone and Cylophosphamide in Subjects With Previously Untreated Multiple Myeloma

Resource links provided by NLM:


Further study details as provided by Millennium Pharmaceuticals, Inc.:

Primary Outcome Measures:
  • Combined complete response and very good partial response. [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Evaluate the safety and tolerability of the combination therapy [ Time Frame: 48 weeks ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 156
Study Start Date: June 2007
Estimated Study Completion Date: September 2010
Estimated Primary Completion Date: April 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
VDR: Experimental
bortezomib, dexamethasone, and lenalidomide
Drug: bortezomib + dexamethasone + lenalidomide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

lenalidomide: 25 mg PO on days 1 to 14 of a 3-week cycle for 8 cycles then stop.

Drug: bortezomib + dexamethasone + cyclophosphamide + lenalidomide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

cyclophosphamide: MTD from the phase I part PO on days 1 and 8 of a 3-week cycle for 8 cycles, then stop.

lenalidomide: 15 mg PO on days 1 to 14 of a 3-week cycle for 8 cycles then stop. Dose may be 20 mg or 25 mg if escalation of lenalidomide is performed in Phase 1, following dose escalation of cyclophosphamide to 500 mg/m2

Drug: bortezomib + dexamethasone + cyclophosphamide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

cyclophosphamide: 400 mg/m2, or MTD from the Phase 1 part if the MTD is higher, PO on days 1 and 8 of a 3-week cycle for 8 cycles, then stop.

VDCR: Experimental
VELCADE, DEXAMETHASONE, CYCLOPHOSPHAMIDE, REVLIMID
Drug: bortezomib + dexamethasone + lenalidomide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

lenalidomide: 25 mg PO on days 1 to 14 of a 3-week cycle for 8 cycles then stop.

Drug: bortezomib + dexamethasone + cyclophosphamide + lenalidomide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

cyclophosphamide: MTD from the phase I part PO on days 1 and 8 of a 3-week cycle for 8 cycles, then stop.

lenalidomide: 15 mg PO on days 1 to 14 of a 3-week cycle for 8 cycles then stop. Dose may be 20 mg or 25 mg if escalation of lenalidomide is performed in Phase 1, following dose escalation of cyclophosphamide to 500 mg/m2

Drug: bortezomib + dexamethasone + cyclophosphamide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

cyclophosphamide: 400 mg/m2, or MTD from the Phase 1 part if the MTD is higher, PO on days 1 and 8 of a 3-week cycle for 8 cycles, then stop.

VDC: Experimental
VELCADE, DEXAMETHASONE, CYCLOPHOSPHAMIDE
Drug: bortezomib + dexamethasone + lenalidomide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

lenalidomide: 25 mg PO on days 1 to 14 of a 3-week cycle for 8 cycles then stop.

Drug: bortezomib + dexamethasone + cyclophosphamide + lenalidomide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

cyclophosphamide: MTD from the phase I part PO on days 1 and 8 of a 3-week cycle for 8 cycles, then stop.

lenalidomide: 15 mg PO on days 1 to 14 of a 3-week cycle for 8 cycles then stop. Dose may be 20 mg or 25 mg if escalation of lenalidomide is performed in Phase 1, following dose escalation of cyclophosphamide to 500 mg/m2

Drug: bortezomib + dexamethasone + cyclophosphamide

bortezomib: 1.3mg/m2/dose IV on days 1,4,8,and 11 of a 3-week cycle for 8 cycles, then on days 1,8,15 and 22 of a 6-week cycle for 4 cycles (maintenance). dexamethasone: 40 mg oral on day 1,8, and 15 of a 3-week cycle for 8 cycles, then stop.

cyclophosphamide: 400 mg/m2, or MTD from the Phase 1 part if the MTD is higher, PO on days 1 and 8 of a 3-week cycle for 8 cycles, then stop.


  Eligibility

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

Inclusion Criteria:

  1. Voluntary written informed consent must be given before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
  2. Male or female subject 18 years of age or older
  3. A Karnofsky Performance Status score of ≥50% (Eastern Cooperative Oncology Group Performance Status score ≤2)
  4. Subjects must have symptomatic myeloma or asymptomatic myeloma with myeloma-related organ damage
  5. Multiple myeloma diagnosed according to the following standard criteria:

    Major criteria

    • 1. Plasmacytomas on tissue biopsy
    • 2. Bone marrow plasmacytosis (>30% plasma cells)
    • 3. Monoclonal immunoglobulin spike on SPEP, immunoglobulin G (IgG) >3.5 g/dL or immunoglobulin A (IgA) >2.0 g/dL; kappa or lambda light chain excretion >1 g/day on 24-hour urine protein electrophoresis (UPEP)

    Minor criteria

    • a. Bone marrow plasmacytosis (10% to 30% plasma cells)
    • b. Monoclonal immunoglobulin present but of lesser magnitude than given under major criteria
    • c. Lytic bone lesions
    • d. Normal IgM (<50 mg/dL), IgA (<100 mg/dL), or IgG (<600 mg/dL)

    Any of the following sets of criteria will confirm the diagnosis of multiple myeloma

    • Any 2 of the major criteria
    • Major criterion 1 plus minor criteria b, c, or d
    • Major criterion 3 plus minor criteria a or c
    • Minor criteria a, b, and c or a, b, and d.
  6. Subjects must have measurable disease requiring systemic therapy. Measurable disease is defined by at least 1 of the following 3 measurements:

    • Serum M-protein ≥1 g/dL (≥10 g/L)
    • Urine M-protein ≥200 mg/24 hours
    • Serum free light chain assay: involved free light chain level ≥10 mg/dL (≥100 mg/L) provided the serum free light chain ratio is abnormal
  7. Subjects must not have been treated previously with any systemic therapy for multiple myeloma. Prior treatment with corticosteroids or radiation therapy does not disqualify the subject (the maximum dose of corticosteroids should not exceed the equivalent of 160 mg of dexamethasone1 in a 2-week period).
  8. Two weeks must have elapsed since the date of the last radiotherapy treatment. Enrollment of subjects who require concurrent radiotherapy (which must be localized in its field size) should be deferred until the radiotherapy is completed and 2 weeks have elapsed since the last date of therapy.
  9. Women of childbearing potential must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 to 14 days prior to therapy and repeated within 24 hours before starting study drug. They must commit to continued abstinence from heterosexual intercourse or begin 2 acceptable methods of birth control (1 highly effective method and 1 additional effective method) used at the same time, beginning at least 4 weeks before initiation of Revlimid treatment. Women must also agree to ongoing pregnancy testing. (See section 7.4.8.1 for further details regarding the frequency of pregnancy testing and acceptable methods of birth control.)
  10. Men must agree to not father a child and agree to use a latex condom during therapy and for 4 weeks after the last dose of study drug, even if they have had a successful vasectomy, if their partner is of childbearing potential.
  11. All subjects must agree to comply with the requirements of the RevAssistSM program.

Exclusion Criteria:

  1. History of allergy to any of the study medications, their analogues, or excipients in the various formulations
  2. ≥Grade 2 peripheral neuropathy on clinical examination
  3. Serum creatinine ≥2.5 mg/dL
  4. Absolute neutrophil count (ANC)<1000 per µL
  5. Platelet count <70,000 per µL
  6. Aspartate transaminase (AST [SGOT]) and alanine transaminase (ALT [SGPT]) >2 × the upper limit of normal (ULN)
  7. Total bilirubin >3 × ULN
  8. Myocardial infarction within 6 months prior to enrollment or New York Heart Association Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or clinically significant conduction system abnormalities.
  9. Female subject who is pregnant or breast-feeding
  10. Clinically relevant active infection or serious comorbid medical conditions
  11. Any condition, including laboratory abnormalities, that in the opinion of the Investigator places the subject at unacceptable risk if he/she were to participate in the study. This includes but is not limited to serious medical or psychiatric illness likely to interfere with participation in this clinical study.
  12. Active prior malignancy diagnosed or treated within the last 3 years
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00507442

Contacts
Contact: Christine Colby, Pharm.D. 1-866-835-2233 medical@mlnm.com

Locations
United States, Minnesota
Mayo Clinic Recruiting
Rochester, Minnesota, United States, 55904-0001
Sponsors and Collaborators
Millennium Pharmaceuticals, Inc.
Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
  More Information

No publications provided

Responsible Party: Millennium Pharmaceuticals, Inc. ( Clinical Study Medical Monitor )
Study ID Numbers: C05008
Study First Received: July 25, 2007
Last Updated: March 31, 2008
ClinicalTrials.gov Identifier: NCT00507442     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Millennium Pharmaceuticals, Inc.:
Treatment for patients with multiple myeloma
who have received no prior treatment

Study placed in the following topic categories:
Anti-Inflammatory Agents
Dexamethasone
Immunologic Factors
Blood Protein Disorders
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Paraproteinemias
Cyclophosphamide
Hemostatic Disorders
Hormones
Hemorrhagic Disorders
Alkylating Agents
Dexamethasone acetate
Immunoproliferative Disorders
Antineoplastic Agents, Hormonal
Hematologic Diseases
Blood Coagulation Disorders
Bortezomib
Vascular Diseases
Lenalidomide
Immunosuppressive Agents
Glucocorticoids
Protease Inhibitors
Multiple Myeloma
Antineoplastic Agents, Alkylating
Peripheral Nervous System Agents
Lymphoproliferative Disorders
Antirheumatic Agents
Neoplasms, Plasma Cell

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Dexamethasone
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Blood Protein Disorders
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Paraproteinemias
Cyclophosphamide
Hemostatic Disorders
Hormones
Hemorrhagic Disorders
Therapeutic Uses
Cardiovascular Diseases
Alkylating Agents
Dexamethasone acetate
Immunoproliferative Disorders
Neoplasms by Histologic Type
Antineoplastic Agents, Hormonal
Immune System Diseases
Hematologic Diseases
Bortezomib
Gastrointestinal Agents
Vascular Diseases
Lenalidomide
Enzyme Inhibitors
Glucocorticoids
Immunosuppressive Agents

ClinicalTrials.gov processed this record on July 06, 2009