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Panobinostat (LBH589): Multiple Myeloma - Autologous Hematopoietic Cell Transplantation (HCT)

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ClinicalTrials.gov Identifier: NCT02722941
Recruitment Status : Recruiting
First Posted : March 30, 2016
Last Update Posted : March 4, 2019
Sponsor:
Collaborator:
Novartis Pharmaceuticals
Information provided by (Responsible Party):
H. Lee Moffitt Cancer Center and Research Institute

Brief Summary:
The purpose of this study is to learn more about ways to prevent or delay relapse of multiple myeloma (MM). This study will determine the best dosing schedule of LBH589 maintenance therapy as well as the safety (side effects) and tolerability of LBH589 maintenance therapy after autologous hematopoietic cell transplant (HCT).

Condition or disease Intervention/treatment Phase
Multiple Myeloma Drug: Panobinostat Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Evaluation of Panobinostat (LBH589) as Maintenance Therapy in Multiple Myeloma Following Autologous Hematopoietic Cell Transplantation
Actual Study Start Date : June 10, 2016
Estimated Primary Completion Date : June 2020
Estimated Study Completion Date : June 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Multiple Myeloma

Arm Intervention/treatment
Active Comparator: Cohort A: Maintenance Therapy
Panobinostat (LBH589): 20 mg by mouth three (3) times per week, every other week, of a 28-day schedule.
Drug: Panobinostat
Maintenance therapy dosing as outlined in Cohorts A and B.
Other Name: LBH589

Active Comparator: Cohort B: Maintenance Therapy
Panobinostat (LBH589): 10 mg by mouth daily for seven (7) days, every other week, of a 28-day schedule.
Drug: Panobinostat
Maintenance therapy dosing as outlined in Cohorts A and B.
Other Name: LBH589




Primary Outcome Measures :
  1. Relative Dose Intensity (RDI) per Cohort [ Time Frame: Up to 2 years ]
    Investigators will calculate RDI for each cohort. Relative dose intensity (RDI) represents the ratio of the amount of a drug actually delivered [actual dose intensity (DI)] to the amount planned (planned DI). The purpose of calculating RDI is to evaluate whether the planned DI of a chemotherapy treatment was actually achieved which may suggest the feasibility of planned treatment regimen. There are multitude of reports demonstrating a correlation between RDI and survival in cancer treatment. RDI = (total dose received by the patient = mg)/(planned full dose of drug = mg).


Secondary Outcome Measures :
  1. Complete Response Rate [ Time Frame: Up to 5 years ]
    Complete Response (CR) rate to panobinostat maintenance therapy after autologous HCT. CR: Negative immunofixation of serum and urine, disappearance of any soft tissue plasmacytomas, and < 5% plasma cells in bone marrow.

  2. Progression Free Survival (PFS) [ Time Frame: 2 years ]

    Progressive Disease (PD) according to Uniform Response Reporting Criteria for Multiple Myeloma by the International Myeloma Working Group (IMWG). Increase of 25% from lowest response value in any of the following:

    • Serum M- component (absolute increase must be ≥ 0.5 g/dL)
    • Urine M-component (absolute increase must be ≥ 200 mg/24 h)
    • Only in patients without measurable serum and urine M protein levels and without measurable disease by free light chain (FLC) levels, bone marrow plasma cell percentage (absolute percentage must be ≥ 10% )
    • Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas
    • Development of hypercalcemia (corrected serum calcium > 11.5 mg/dL) that can be attributed solely to the plasma cell proliferative disorder

  3. Overall Survival (OS) [ Time Frame: 2 years ]
    OS: The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Adult patients, age ≥ 18 years old
  • Ability to provide written informed consent obtained prior to participation in the study and any related procedures being performed
  • Histologically confirmed diagnosis of multiple myeloma
  • Meeting the Criteria for Symptomatic Multiple Myeloma (CRAB criteria) before the initiation of systemic chemotherapy
  • Received high-dose melphalan (≥ 140 mg/m^2) followed by autologous HCT based on the institutional guidelines and within +45 and +180 after autologous HCT at the time of panobinostat maintenance initiation
  • Must have achieved at least partial response (PR) prior to autologous HCT and must not have progressive disease (PD) prior to the initiation of maintenance therapy
  • Must meet the following laboratory criteria (prior to the initiation of panobinostat maintenance): Absolute neutrophil count (ANC) ≥ 1 x 10^9/L; Hemoglobin ≥ 8 g/dl; Platelets ≥ 50 x 10^9/L (without transfusion support); Creatinine clearance ≥ 40 ml/min or serum creatinine ≤ 2.5 x upper limit of normal (ULN); aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN; Serum bilirubin ≤ 1.5 x ULN; Albumin > 3.0 g/dl; Clinically euthyroid. Note: Participants are permitted to receive thyroid hormone supplements to treat underlying hypothyroidism.
  • Baseline (pre-HCT) multigated acquisition (MUGA) or echocardiogram (ECHO) must demonstrate left ventricular ejection fraction (LVEF) ≥ the limit of normal (LLN) of the institutional normal
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2 or Karnofsky performance status ≥ 70%
  • Prior histone deacetylase (HDAC), deacetylase (DAC), HSP90 inhibitors or valproic acid for the treatment of cancer is allowed

Exclusion Criteria:

  • Potential participants who have purely non-secretory multiple myeloma (i.e., the absence of a measurable protein in serum by electrophoresis and immunofixation and the absence of Bence-Jones protein in the urine defined by use of electrophoresis and immunofixation)
  • Prior allogeneic HCT
  • Prior solid organ transplant requiring immunosuppressive therapy
  • Potential participants who will need valproic acid for any medical condition during the study or within 5 days prior to first panobinostat treatment
  • Impaired cardiac function or clinically significant cardiac diseases
  • Diarrhea > Common Terminology Criteria for Adverse Events (CTCAE) grade 2
  • Other concurrent severe and/or uncontrolled medical conditions (e.g., uncontrolled diabetes or active or uncontrolled infection) including abnormal laboratory values, that could cause unacceptable safety risks or compromise compliance with the protocol
  • Using medications that have a relative risk of prolonging the QT interval or inducing torsade de pointes if treatment cannot be discontinued or switched to a different medication prior to starting study drug
  • Have received targeted agents within 2 weeks or within 5 half-lives of the agent and active metabolites (whichever is longer) and who have not recovered from side effects of those therapies.
  • Have received either immunotherapy within < 8 weeks; chemotherapy within < 4 weeks; or radiation therapy to > 30% of marrow-bearing bone within < 2 weeks prior to starting study treatment; or who have not yet recovered from side effects of such therapies
  • Have undergone major surgery ≤ 4 weeks prior to starting study drug or have not recovered from side effects of such therapy
  • Women who are pregnant or breast feeding or women of childbearing potential (WOCBP) not using an effective method of birth control. WOCBP must have a negative serum pregnancy test within 24 hours of receiving the first dose of study medication.
  • Male patients whose sexual partners are WOCBP not using effective birth control
  • A prior malignancy with in the last 5 years (except for basal or squamous cell carcinoma, or in situ cancer of the cervix)
  • Known positivity for human immunodeficiency virus (HIV) or hepatitis C; baseline testing for HIV and hepatitis C is not required
  • Any significant history of non-compliance to medical regimens or unwilling or unable to comply with the instructions given to him/her by the study staff

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 ClinicalTrials.gov identifier (NCT number): NCT02722941


Contacts
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Contact: Taiga Nishihori, M.D. 813-745-8156 taiga.nishihori@moffitt.org

Locations
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United States, Florida
H. Lee Moffitt Cancer Center and Research Institute Recruiting
Tampa, Florida, United States, 33612
Contact: Caitlyn Ward    813-745-1344    caitlyn.ward@moffitt.org   
Contact: Taiga Nishihori    813-745-8156    taiga.nishihori@moffitt.org   
Principal Investigator: Taiga Nishihori, M.D.         
Sub-Investigator: Melissa Alsina, M.D.         
Sub-Investigator: Claudio Anasetti, M.D.         
Sub-Investigator: Ernesto Ayala, M.D.         
Sub-Investigator: Rachid Baz, M.D.         
Sub-Investigator: Brian Betts, M.D.         
Sub-Investigator: Hugo Fernandez, M.D.         
Sub-Investigator: Jingsong Zhang, M.D., Ph.D.         
Sub-Investigator: Mohamed Kharfan-Dabaja, M.D.         
Sub-Investigator: Farhad Khimani, M.D.         
Sub-Investigator: Frederick Locke, M.D.         
Sub-Investigator: Asmita Mishra, M.D.         
Sub-Investigator: Jose Ochoa-Bayona, M.D.         
Sub-Investigator: Lia Perez, M.D.         
Sub-Investigator: Joseph Pidala, M.D., Ph.D.         
Sub-Investigator: Kenneth Shain, M.D., Ph.D.         
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Novartis Pharmaceuticals
Investigators
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Principal Investigator: Taiga Nishihori, M.D. H. Lee Moffitt Cancer Center and Research Institute

Additional Information:
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Responsible Party: H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier: NCT02722941     History of Changes
Other Study ID Numbers: MCC-18430
CLBH589DUS97T ( Other Identifier: Novartis Pharmaceuticals )
First Posted: March 30, 2016    Key Record Dates
Last Update Posted: March 4, 2019
Last Verified: March 2019

Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
autologous hematopoietic cell transplant (HCT)
autologous

Additional relevant MeSH terms:
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Multiple Myeloma
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Neoplasms
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Paraproteinemias
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Lymphoproliferative Disorders
Immunoproliferative Disorders
Immune System Diseases
Panobinostat
Antineoplastic Agents
Histone Deacetylase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action