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Melphalan, Prednisone, and CC-5013 (Revlimid) as Induction Therapy in Multiple Myeloma

This study has been completed.
Information provided by:
University of Turin, Italy Identifier:
First received: November 2, 2006
Last updated: November 29, 2006
Last verified: November 2006
The purpose of this study is to evaluate the safety and efficacy of the association of Melphalan/Prednisone/Revlimid (MPR) as induction treatment for newly diagnosed myeloma patients over age 65 or those under 65 years who refuse or are not eligible for high dose therapy. This association might further increase the response rate achieved by the standard oral MP regimen.

Condition Intervention Phase
Multiple Myeloma
Drug: Revlimid (CC-5013)
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multicenter, Open Label Study of Oral Melphalan, Prednisone, and CC-5013 (Revlimid) (MPR) as Induction Therapy in Elderly Newly Diagnosed Multiple Myeloma Patients

Resource links provided by NLM:

Further study details as provided by University of Turin, Italy:

Primary Outcome Measures:

Secondary Outcome Measures:

Estimated Enrollment: 54
Study Start Date: January 2005
Estimated Study Completion Date: January 2008
Detailed Description:

In Multiple Myeloma patients, the standard treatment is the oral combination of Melphalan and Prednisone (MP). This approach induces a partial response (PR) rate of approximately 50% and a complete remission (CR) rate of 1-5%, with a median remission duration of 18-20 months and a median overall survival of 3 years.

Recently, the combination of oral MP plus thalidomide increased response rate to 80% and complete remission rate to 20%, marked cytoreduction is the first step toward a sustained remission period.

CC-5013 (Revlimid) is a thalidomide analogue, 50000 times more potent than thalidomide in inhibiting TNF-alfa secretion, a potent growth factor for myeloma cells. Revlimid represents a novel class of anti-cancer drugs, it is active in patients with multiple myeloma who are refractory to conventional and high-dose chemotherapy with a response rate of approximately 30%. The association Revlimid plus dexamethasone further increases the response rate induced by Revlimid by an additional 30%.

This study will evaluate the safety and efficacy of the association of Melphalan/Prednisone/Revlimid (MPR) as induction treatment for newly diagnosed myeloma patients over age 65 or those under 65 years who refuse or are not eligible for high dose therapy. This association might further increase the response rate achieved by the standard oral MP regimen.

In the first part of the study (phase I component), different doses of oral Melphalan (0.18-0.25 mg/Kg) associated with Prednisone (MP) will be combined with escalating doses of Revlimid (from 5 mg/day) and administered together. This phase will define the MTD of the association. In the second part of the study (phase II component), 30 patients will be treated with MPR at dose/s defined from phase I component to verify data of response and toxicity.


Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient is of a legally consenting age as defined by local regulations.
  • Age > 65 years or age < 65 years in patients who refuse or are not eligible for high-dose therapy.
  • Patient is, in the investigator(s) opinion willing and able to comply with the protocol requirements.
  • Patient has given voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care.
  • Female patient is either post-menopausal for 24 consecutive months or surgically sterilised or agree to continuous abstinence from heterosexual sexual contact or willing to use two acceptable method of birth control at the same time (one highly effective method and one additional effective method)(Highly Effective Methods: Intrauterine device -IUD-; Hormonal -birth control pills, injections, implants-; tubal ligation; partner’s vasectomy; Additional Effective Methods: Latex condom; Diaphragm; Cervical Cap) for 4 weeks prior to beginning study drug therapy, during study drug therapy (including dose interruption) and for 4 weeks after discontinuation of Lenalomide therapy - Male patient agrees to use an acceptable method for contraception (i.e., condom or abstinence) during study drug therapy (including dose interruption) and for 4 weeks after discontinuation of Lenalomide therapy.
  • Patient was previously diagnosed with symptomatic multiple myeloma based on standard criteria, and has measurable disease, defined as follows: any quantifiable serum monoclonal protein value (generally, but not necessarily, greater than 1 g/dL of IgG M-Protein and greater than 0.5 g/dL of IgA M-Protein) and, where applicable, urine light-chain excretion of >200 mg/24 hours; measurable plasmacytoma as determined by clinical examination or applicable radiographs (i.e. MRI, CT-Scan); bone marrow plasma cells >10%.
  • Patient has a Karnofsky performance status ≥ 60%
  • Patient has a life-expectancy > 6 months.
  • Patient has the following laboratory values within 14 days before Baseline (day 1 of the Cycle 1):
  • Absolute neutrophil count > 1.5 x 109/L without the use of growth factors
  • Platelet count > 75 x 109/L without transfusion support within 7 days before the test.
  • Calculated or measured creatinine clearance: ≥ 20 mL/minute
  • Total bilirubin < 1.5 x the ULN
  • AST (SGOT) and ALT (SGPT) < 2.5 x ULN
  • Corrected serum calcium ≤ 14 mg/dL (3.5 mmol/L

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or beast feeding females.
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Use of any other concomitant standard/experimental anti-myeloma drug or therapy.
  • Any prior use of CC-5013 or other anti-myeloma therapy.
  • Any of the following laboratory abnormalities:
  • Platelet count < 75 x 109/L.
  • Absolute neutrophil count <1.5 x 109/L.
  • Calculated or measured creatinine clearance <20 mL/minute.
  • Corrected serum calcium >14 mg/dL (3.5 mmol/L).
  • Aspartate transaminase (AST): >2.5 x the upper limit of normal (ULN).
  • Alanine transaminase (AST): > 2.5 x the ULN.
  • Total bilirubin: > 1.5 x the ULN.
  • Known positive for HIV or active infectious hepatitis, type B or C.
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Please refer to this study by its identifier: NCT00396045

Unità Operativa di Ematologia Trapianto di Cellule Staminali, Casa Sollievo della Sofferenza
San Giovanni Rotondo, Foggia, Italy, 71013
Unità Operativa di Ematologia, Spedali Civili
Brescia, Italy, 25100
Reparto di Ematologia, Ospedale Ferrarotto
Catania, Italy, 95124
Unità Operativa Complessa Di Ematologia, Presidio Ospedaliero Dell’Annunziata, Azienda Ospedaliera Di Cosenza
Cosenza, Italy
Clinica Ematologica, Ospedale San Martino -Università di Genova
Genova, Italy, 16132
Cattedra di Ematologia, Dipart. Di Medicina Interna e Scienze Biomediche
Parma, Italy, 43100
Divisione di Ematologia-Policlinico Umberto I-Università La Sapienza
Roma, Italy, 00161
Divisione di Ematologia, Azienda Ospedaliera Senese Ospedale A. Sclavo
Siena, Italy, 53100
Div. Univ. Di Ematologia, Az. Osp. San Giovanni Battista
Torino, Italy, 10126
Sponsors and Collaborators
University of Turin, Italy
  More Information

Publications: Identifier: NCT00396045     History of Changes
Other Study ID Numbers: RV-MM-PI-026
Study First Received: November 2, 2006
Last Updated: November 29, 2006

Keywords provided by University of Turin, Italy:
Multiple Myeloma, Lenalidomide, elderly patients

Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Lymphoproliferative Disorders
Immunoproliferative Disorders
Immune System Diseases
Anti-Inflammatory Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Immunologic Factors
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors processed this record on May 23, 2017