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Safety and Efficacy Study of a Triplet Combination of MLN9708, Lenalidomide and Dexamethasone in the Initial Management of Multiple Myeloma (IFM2013-06) (IFM2013-06)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01936532
Recruitment Status : Active, not recruiting
First Posted : September 6, 2013
Last Update Posted : February 20, 2020
Information provided by (Responsible Party):
Nantes University Hospital

Brief Summary:

This is a phase II, multicenter, open-label study to evaluate the safety and efficacy of MLN9708 in combination with Lenalidomide and Dexamethasone in patients with newly diagnosed multiple myeloma. The patient population will consist of adult men and women younger than 66 years, who have a confirmed diagnosis of MM who meet eligibility criteria.

Following the screening period, patients will be enrolled and treated then, they will receive induction therapy (3 cycles), a systematic Peripheral Blood Stem Cell harvest. After Peripheral Blood Stem Cell Transplantation, patient will enter in the consolidation phase (early and late one) 2 months after transplantation. Finally, patients follow a Maintenance therapy (start 1 month after the last cycle of consolidation) during 12 months.

Condition or disease Intervention/treatment Phase
Newly Diagnosed Multiple Myeloma Drug: MLN9708 Drug: Lenalidomide Drug: Dexamethasone Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 42 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase II Trial Studying the Efficacy of a Triplet Combination of MLN9708, Lenalidomide and Dexamethasone as Induction Prior to, and as Consolidation After High-dose Therapy With Peripheral Stem Cell Transplantation Followed by MLN9708 Maintenance in the Initial Management of Multiple Myeloma in Patients Younger Than 66 Years
Actual Study Start Date : November 12, 2014
Actual Primary Completion Date : March 2019
Estimated Study Completion Date : July 2020

Arm Intervention/treatment
Experimental: assessment of treatment lenalidomide, dexamethasone,MLN9708 Drug: MLN9708

Induction therapy Patients will receive 3 cycles of induction therapy with MLN9708 (4 mg) on Days 1, 8 and 15, plus Lenalidomide (25 mg) on Days 1 through 21 and Dexamethasone (40 mg) on Days 1, 8, 15 and 22 of a 28-day cycle.

Consolidation therapy

  • Early consolidation (consolidation part 1) will comprise 2 cycles of MRD identical to induction therapy.
  • Late consolidation (consolidation part 2) will consist in 6 additional cycles of MLN9708 (4 mg on Days 1, 8 and 15) plus lenalidomide (25 mg on Days 1 through 21) of a 28-day cycle.

Maintenance therapy MLN9708 monotherapy (4 mg/day), will be given on days 1, 8 and 15 of a 28 day cycle, during 12 months.

Drug: Lenalidomide
Drug: Dexamethasone

Primary Outcome Measures :
  1. To evaluate the stringent Complete Response (sCR) rate of the combination of MLN9708, Lenalidomide and Dexamethasone in newly diagnosed multiple myeloma (MM) patients after extended consolidation therapy [ Time Frame: sixteen months ]

Secondary Outcome Measures :
  1. To evaluate the overall response rate after induction therapy [ Time Frame: after 63 days ]
  2. To evaluate the safety Evaluate the safety [ Time Frame: after 63 days ]

    Descriptive statistics of treatment duration cumulative dose, dose intensity and relative dose intensity will be presented.

    Treatment emergent adverse events will be summarized by period (induction, consolidation and maintenance) and overall.

    Overall adverse events will be summarized by system organ class and preferred term and by severity (worst toxicity grade owing to the NCI CTCAE v4.0).

  3. To evaluate the quality of stem cell harvest [ Time Frame: after 84 days ]

    according to institutional practice, participants must collect a minimum CD34 count of > 5x106 cells/kg. In case of insufficient collection, collection of a minimum CD34 count of > 2x106 cells/kg will be allowed.

    Thus the number of cells collected will be evaluated

  4. To evaluate the overall response rate after high-dose therapy (prior to consolidation) [ Time Frame: after 84 days ]
  5. To evaluate the overall response rate after consolidation therapy [ Time Frame: after 270 days ]
  6. To evaluate the feasibility of maintenance with MLN9708 [ Time Frame: after 270 days ]
    number of dose

  7. To evaluate duration of response, progression-free and overall survival [ Time Frame: five years and a half ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 66 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria

  1. Male or female patients ≥ 18 years and ≤ 65 years at the time
  2. Voluntary written consent must be given before performance of any study related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.
  3. Patients diagnosed with multiple myeloma
  4. Subjects must have symptomatic myeloma with CRAB criteria.
  5. Subjects must have measurable disease requiring systemic therapy defined by serum M-component ≥ 5g/l, urine M-component ≥ 200 mg/24h or serum FLC ≥ 100 mg/l.
  6. Subjects must not have been treated previously with any systemic therapy for multiple myeloma. 7.Subjects must be eligible for high dose therapy.

8.Life expectancy ≥ 3 months.9.ECOG performance status 0, 1 or 2. 10.Patients must meet the following clinical laboratory criteria

  • Adequate hepatic function, with serum ALT and AST ≤ 3 times the upper limit of normal and serum direct bilirubin ≤ 1.5 times the upper limit of normal within 14 days prior to enrolment.
  • Absolute neutrophil count (ANC) ≥ 1.0 × 109/L within 14 days prior to enrollment.
  • Hemoglobin ≥ 8 g/dL (80 g/L) within 14 days prior to enrollment (subjects may be receiving red blood cell [RBC] transfusions in accordance with institutional guidelines with a wash-out period of 7 days).
  • Platelet count ≥ 75 × 109/L (≥ 30 × 109/L if myeloma involvement in the bone marrow is > 50%) within 14 days prior to enrollment. Platelet transfusions to help patients meet eligibility criteria are not allowed within 3 days before study enrollment.
  • Calculated creatinine clearance ≥ 30 mL/minute (MDRD formula should be used for calculating creatinine clearance values:

    11.Female of childbearing potential:must have two negative pregnancy tests : one serum pregnancy test within 10 to 14 days prior to therapy and one urine pregnancy test within 24 hours before starting study drug.

must agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 3 months after the last dose of study drug, or agree to completely abstain from heterosexual intercourse.

12.Male patients, even if surgically sterilized, must agree to not father a child and agree to use a latex condom during therapy and for 3 months after the last dose of study drug, even if they have had a successful vasectomy, if their partner is of childbearing potential.

13.Affiliation number to National Health Care System.

Exclusion Criteria:

  1. Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening period or a positive urine pregnancy test within 24 hours before first dose of study drug.
  2. Evidence of mucosal or internal bleeding and/or platelet refractory.
  3. Prior myeloma systemic therapy.
  4. Major surgery within 14 days before first dose of study drug.
  5. Radiotherapy within 14 days before first dose of study drug. If the involved field is small, 7 days will be considered a sufficient interval between treatment and administration of the MLN9708.
  6. Treatment by corticosteroids if exceed the equivalent of 160 mg of dexamethasone within 14 days before first dose of study drug.
  7. Subjects not eligible for high dose therapy.
  8. Growth factors within 7 days prior to enrolment.
  9. Transfusion within 3 days prior to enrolment.
  10. Uncontrolled hypertension or uncontrolled diabetes within 14 days prior to first dose of study drug.
  11. Infection requiring systemic antibiotic therapy or other serious infection within 14 days before first dose of study drug.
  12. Evidence of current uncontrolled cardiovascular conditions, including uncontrolled hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure, unstable angina, or myocardial infarction within 6 months.
  13. Systemic treatment, within 14 days before first dose of study drug, with strong inhibitors of CYP1A2, strong inhibitors of CYP3A or strong CYP3A inducers, or use of Ginkgo biloba or St. John's wort.
  14. Ongoing or active systemic infection, known human immunodeficiency virus positive, known active hepatitis B virus hepatitis, or known active hepatitis C virus hepatitis.
  15. Co-morbid systemic illnesses or other severe concurrent disease that, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens.
  16. Psychiatric illness/social situation that would limit compliance with study requirements.
  17. Known allergy to any of the study medications, their analogues, or excipients in the various formulations of any agent.
  18. Contraindication to any of the required concomitant drugs or supportive treatments, including hypersensitivity to all anticoagulation and antiplatelet options, antiviral drugs, or intolerance to hydration due to preexisting pulmonary or cardiac impairment.
  19. Inability to swallow oral medication, inability or unwillingness to comply with the drug administration requirements, or GI procedure that could interfere with the oral absorption or tolerance of treatment.
  20. Diagnosed or treated for another malignancy within 2 years before study enrollment or previously diagnosed with another malignancy and have any evidence of residual disease. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
  21. Patient has significant neuropathy within 14 days prior to enrolment.
  22. Subjects with pleural effusions requiring thoracentesis or ascites requiring paracentesis within 14 days prior to enrolment.
  23. Any other clinically significant medical disease or condition that, in the Investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent.
  24. Participation in clinical trials with other investigational agents not included in this trial, within 21days of the start of this trial and throughout the duration of this trial.
  25. Failure to have fully recovered from the reversible effects of prior chemotherapy.
  26. Central nervous system involvement

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01936532

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CHRU - Hôpital du Haut Lévêque
Bordeaux, France, 33604
CHRU Dijon
Dijon, France, 21000
Centre hospitalier départemental Vendée
La Roche Sur Yon, France, 85925
CHRU - Hôpital Claude Huriez
Lille, France, 59037
Nantes University Hospital
Nantes, France, 44093
Hôpital Saint-Antoine
Paris, France, 75 571
Centre Hospitalier Lyon sud
Pierre Benite, France, 69495
Pole IUC Oncopole CHU
Toulouse cedex 9, France, 31059
CHRU - Hôpital Bretonneau
Tours, France, 37044
CHRU - Hôpitaux de Brabois
Vandoeuvre Les Nancy, France, 54511
Sponsors and Collaborators
Nantes University Hospital
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Principal Investigator: Philippe MOREAU Nantes University Hospital
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Responsible Party: Nantes University Hospital Identifier: NCT01936532    
Other Study ID Numbers: RC12_0447
2013-001443-31 ( EudraCT Number )
First Posted: September 6, 2013    Key Record Dates
Last Update Posted: February 20, 2020
Last Verified: February 2020
Keywords provided by Nantes University Hospital:
multiple myeloma
Additional relevant MeSH terms:
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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
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Immunologic Factors
Angiogenesis Inhibitors