Lenalidomide Plus Melphalan as a Preparative Regimen for Autologous Stem Cell Transplantation in Relapsed Multiple Myeloma: A Phase 1 / 2 Study
This study is currently recruiting participants.
Verified March 2011 by Weill Medical College of Cornell University
Information provided by:
Weill Medical College of Cornell University
First received: January 19, 2010
Last updated: March 8, 2011
Last verified: March 2011
A) Phase 1: To determine the maximal tolerated dose (MTD) of lenalidomide that can be safely added to high-dose melphalan prior to autologous stem cell transplantation (ASCT).
B) Phase 2: To determine whether the addition of high-dose lenalidomide to ASCT followed by maintenance standard-dose lenalidomide improves the response rate and duration of response for relapsed multiple myeloma (RMM).
||Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
||Lenalidomide Plus Melphalan as a Preparative Regimen for Autologous Stem Cell Transplantation in Relapsed Multiple Myeloma: A Phase 1 / 2 Study
Primary Outcome Measures:
- to determine MTD of lenalidomide that can be added to melphalan [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
Secondary Outcome Measures:
- to determine response rate and duration of response [ Time Frame: 24 months ] [ Designated as safety issue: No ]
| Estimated Enrollment:
| Study Start Date:
| Estimated Study Completion Date:
| Estimated Primary Completion Date:
||December 2013 (Final data collection date for primary outcome measure)
Experimental: all patients
subjects will receive daily doses of lenalidomide starting on Day -5 of transplant and melphalan on Days -2 and -1.
daily dose dependent on dose-escalation schedule
Other Name: Revlimid
100 mg/m2 given Days -2 and -1
|Ages Eligible for Study:
||18 Years and older
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
- Patients must have histologically or cytologically confirmed relapsed, primary refractory, or relapsed and refractory multiple myeloma.
Patients must have measurable disease as defined by the International Uniform Response Criteria,defined as any of the following:
- serum M-protein of > = 500mg/dL
- urine M-protein of > = 200mg/ 24 hours
- involved free light chain > = 10mg/dL provided serum free light chain ratio is abnormal
- Patients must have received at least one prior line of therapy.
- Age > = 18 years.
- Life expectancy of greater than 12 weeks.
- ECOG performance status > = 2.
- All study participants must be registered into the mandatory RevAssist program, and be willing and able to comply with the requirements of RevAssist.
Patients must have normal organ and marrow function as defined below:
- ANC > = 1,000/uL
- platelets > = 50,000/uL
- total bilirubin < = 1.5 X upper limit of normal
- AST(SGOT)/ALT(SGPT) < = 2.5 X upper limit of normal
- Cardiac Ejection Fraction > = 45 %
- Creatinine clearance > 60 cc/min
- Patients must have an adequate number of CD34+ stem cells collected to allow for transplantation. This number is defined as ≥ 2 x 106 CD34+ cells / kg body weight. If not previously collected and stored, the patient must be willing to undergo stem cell mobilization and collection as per standard practice.
- The effects of lenalidomide on the developing human fetus at the recommended therapeutic dose are unknown; however, it has been shown to be teratogenic other primates. Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days and again within 24 hours prior to prescribing lenalidomide (prescriptions must be filled within 7 days) and must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control, one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before she starts taking lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. The treating physician will follow the adverse reporting guidelines as outlined in further detail below for pregnancies.
- Lenalidomide has been shown to carry a risk of thromboembolic events, especially when used in combination with either corticosteroids or alkylating chemotherapeutic agents. All patients who participate in this study must be willing and able to tolerate prophylactic anticoagulation with low-molecular weight heparin (LMWH) for the required dates in treatment protocol. Patients also must be able to tolerate low-dose aspirin, 81 mg daily, during the maintenance phase of the treatment protocol.
- Ability to understand and the willingness to sign a written informed consent document.
- Patients who have had myeloma therapy within 14 days prior to entering the study or those who have not recovered from adverse events due to agents administered more than 2 weeks earlier. Patients may have received bisphosphonate therapy as part of routine myeloma care at any time prior to study entry.
- Patients may not be receiving any other investigational agents.
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to lenalidomide (including thalidomide) or melphalan.
- Known positive for HIV or infectious hepatitis, type B or C.
- Uncontrolled illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Pregnant and lactating women are excluded from the study because the risks to an unborn fetus or potential risks in nursing infants are unknown.
- History of thrombosis or thromboembolic event within last 60 days prior to study entry.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01054196
|Weill Cornell Medical College
|New York, New York, United States, 10021 |
|Contact: Tomer Mark, MD 212-746-3964 |
|Principal Investigator: Tomer Mark, MD |
Weill Medical College of Cornell University
||Tomer Mark, MD
||Weill Medical College of Cornell University
No publications provided
||Dr. Tomer Mark, Weill Cornell Medical College
History of Changes
|Other Study ID Numbers:
|Study First Received:
||January 19, 2010
||March 8, 2011
||United States: Institutional Review Board
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on May 22, 2013
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Blood Protein Disorders
Immune System Diseases
Physiological Effects of Drugs
Antineoplastic Agents, Alkylating
Molecular Mechanisms of Pharmacological Action