Lenalidomide/Bortezomib/Dexamethasone & CNTO 328 in Transplant Eligible Newly Diagnosed Multiple Myeloma (MM)
The goal of this clinical research study is to find the highest tolerable dose of Siltuximab that can be given in combination with Velcade (bortezomib), Revlimid (lenalidomide), and dexamethasone to patients with MM. The safety of this drug combination will also be studied.
|Study Design:||Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||An Open Label, Single-Arm, Phase 1b/2 Study of the Safety and Efficacy of Combination Treatment With Lenalidomide, Bortezomib, Dexamethasone and Siltuximab (CNTO 328) in Subjects With Newly Diagnosed, Previously Untreated Multiple Myeloma Requiring Systemic Chemotherapy|
- Maximum Tolerated Dose (MTD) of Siltuximab [ Time Frame: 21 days ] [ Designated as safety issue: No ]Maximum tolerated dose (MTD) defined as follows: At first dose level, if greater than 1 out of 3 patients or greater than 1 out of 6 patients experience dose limiting toxicity (DLT), the dose level exceeds the maximum tolerated dose (MTD). Dose limiting toxicity (DLT) defined as toxicities graded in severity according to the guidelines outlined in the NCI-CTCAE version 4.0.
- Response Rate [ Time Frame: Evaluated after eight 21 day cycles. ] [ Designated as safety issue: No ]Overall response rate defined as (stringent) complete remission (CR)/near complete remission (nCR)/very good partial remission (VGPR)/partial remission (PR) after 8 cycles.
|Study Start Date:||May 2012|
|Estimated Primary Completion Date:||May 2019 (Final data collection date for primary outcome measure)|
Experimental: Siltuximab + Bortezomib + Lenalidomide
Induction: Lenalidomide 25 mg orally Days 1-14; Bortezomib 1.3 mg/m2 intravenous Days 1, 4, 8 and 11; Dexamethasone 20 mg orally Days 1, 2, 4, 5, 8, 9, 11, 12. Siltuximab 11 mg/kg intravenous Day 1.
If delayed transplant, induction therapy continued up to 2 cycles beyond achieving a CR/nCR (minimum of 4 cycles of therapy and a maximum of 8 cycles of therapy) and then transition to maintenance regimen described below.
Maintenance therapy: Lenalidomide at last tolerated dose Day 1-14 every 21 days Siltuximab 11 mg/kg intravenous every 21 days, or maximum tolerated dose from induction therapy. Bortezomib at last tolerated dose Day 1 and Day 8 Dexamethasone at last tolerated dose or 10 mg on days 1 , 8.
Induction and Maintenance Phase: 25 mg by mouth daily on Days 1-14.
Other Names:Drug: Bortezomib
Induction Phase: 1.3 mg/m2 by vein daily on Days 1, 4, 8 and 11.
Maintenance Phase: 1.3 mg/m2 by vein or last tolerated dose on Day 1 and Day 8.
Other Names:Drug: Siltuximab
Induction Phase Starting Dose: 11 mg/kg by vein on Day 1.
Maintenance Phase: Maximum tolerated dose from Induction Phase on Day 1.
Other Names:Drug: Dexamethasone
Induction Phase: 20 mg by mouth on Days 1, 2, 4, 5, 8, 9, 11, 12.
Maintenance Phase: 20 mg by mouth on Days 1, 2, 4, 5, 8, 9, 11, 12. If participant still on Dexamethasone, when entering Maintenance Phase, dose reduced to 10 mg on the day of Bortezomib.
Other Name: DecadronBehavioral: Questionnaires
M. D. Anderson Symptom Inventory Module (MDASI-MM) completed Day 1, Day 8 of Cycle 1 - 8, and on Day 1 of Cycle 9 and beyond.
Other Name: Surveys
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|United States, Texas|
|UT MD Anderson Cancer Center|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Jatin J. Shah, MD||UT MD Anderson Cancer Center|