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Iododoxorubicin in Treating Patients With Primary Systemic Amyloidosis

This study has been terminated.
(Administratively complete.)
Information provided by (Responsible Party):
National Cancer Institute (NCI) Identifier:
First received: February 14, 2002
Last updated: January 15, 2013
Last verified: January 2013

February 14, 2002
January 15, 2013
December 2001
January 2003   (final data collection date for primary outcome measure)
MTD of IDOX defined as the highest safely-tolerated dose where =< 1 patient experiences DLT with the next higher dose having at least 2 patients who experience DLT [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
The number and severity of toxicity incidents will indicate the level of tolerance of IDOX in the treatment of primary amyloidosis. Non-hematologic toxicities will be evaluated via the ordinal CTC standard toxicity grading. Hematologic toxicity measures of thrombocytopenia, neutropenia and leukopenia will be assessed using continuous variables as the outcome measures (primarily nadir and percent change from baseline values) as well as categorization via CTC standard toxicity grading.
Not Provided
Complete list of historical versions of study NCT00030381 on Archive Site
Laboratory correlates [ Time Frame: Up to 3 months post treatment ] [ Designated as safety issue: No ]
Descriptive statistics and simple scatterplots will form the basis of presentation of these data. Correlations between these laboratory values and other outcome measures will be carried out by standard parametric and non-parametric correlation procedures (Pearson's and Spearman's coefficients). Prerequisite normality testing of these data will be carried out via standard Shapiro and Wilk (25) testing.
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Iododoxorubicin in Treating Patients With Primary Systemic Amyloidosis
Phase I Trial of 4'-IODO-4'-Deoxydoxorubicin in Primary Amyloidosis (AL)
Iododoxorubicin may dissolve protein deposits and be an effective treatment for primary systemic amyloidosis. Phase I trial to determine the effectiveness of iododoxorubicin in treating patients who have primary systemic amyloidosis


I. Determine the maximum tolerated dose of iododoxorubicin in patients with primary systemic amyloidosis.


I. Determine the safety, especially cardiac safety, of this drug in these patients.

II. Determine the survival rate of patients treated with this drug. III. Determine, preliminarily, the clinical efficacy of this drug in these patients.

IV. Determine the pharmacokinetics of this drug in these patients.

OUTLINE: This is a dose-escalation study.

Patients receive iododoxorubicin IV over 15 minutes on days 1, 8, 15, and 22. Treatment repeats every 12 weeks for a total of 4 courses or a cumulative dose of 400 mg/m^2 in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of iododoxorubicin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at 3 months.

Phase 1
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Primary Systemic Amyloidosis
  • Drug: 4'-iodo-4'-deoxydoxorubicin
    Given IV
    Other Names:
    • IDOX
    • iododoxorubicin
  • Other: pharmacological study
    Correlative studies
    Other Name: pharmacological studies
Experimental: Treatment (iododoxorubicin)
Patients receive iododoxorubicin IV over 15 minutes on days 1, 8, 15, and 22. Treatment repeats every 12 weeks for a total of 4 courses or a cumulative dose of 400 mg/m^2 in the absence of disease progression or unacceptable toxicity.
  • Drug: 4'-iodo-4'-deoxydoxorubicin
  • Other: pharmacological study
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
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January 2003   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Histochemically confirmed amyloidosis by polarizing microscopy of greenbirefringent material in Congo red-stained tissue specimens
  • At least one of the following:

    • Demonstrable M-protein in serum or urine
    • Clonal population of plasma cells in bone marrow
    • Immunohistochemical stain with anti-light chain antisera of amyloid fibrils
  • Symptomatic organ involvement, including liver involvement, mild cardiac involvement, renal involvement, grade 1 or 2 peripheral neuropathy, or soft tissue involvement (including tongue)

    • No purpura or carpal tunnel syndrome as sole manifestation of disease
  • No clinically overt multiple myeloma defined as monoclonal bone marrow platelet concentration greater than 20% and at least one of the following:

    • Bone lesions
    • Anemia
    • Hypercalcemia
  • Performance status - ECOG 0-3 (3 allowed only if related to muscular infiltration by amyloid or peripheral neuropathy)
  • Platelet count at least 100,000/mm^3
  • Absolute neutrophil count at least 1,500/mm^3
  • Total bilirubin no greater than 2.0 mg/dL
  • Direct bilirubin no greater than 1.0 mg/dL
  • Alkaline phosphatase no greater than 4 times upper limit of normal (ULN)
  • AST or ALT no greater than 3 times ULN
  • Creatinine clearance at least 40 mL/min
  • Ejection fraction at least 50% by echocardiogram
  • No New York Heart Association class III or IV heart disease
  • No enzyme-documented myocardial infarction within the past 3 years
  • No chronic atrial fibrillation
  • No grade 2 or 3 atrioventricular block (Mobitz type I allowed)
  • No sustained (greater than 30 seconds) ventricular tachycardia, more than 1 episode of non-sustained ventricular tachycardia (3 consecutive ventricular beats), or frequent (more than 20 in 24 hours) ventricular pairs by 24-hour ambulatory electrocardiographic monitoring
  • No intraventricular septum greater than 16 mm by echocardiogram
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No uncontrolled infection
  • No other active malignancy except nonmelanoma skin cancer or cervical cancer
  • No psychiatric illness or social situation that would preclude study
  • No severe diarrhea (greater than grade 3) that is not controllable with medication or that requires total parenteral nutrition
  • More than 4 weeks since prior interferon alfa
  • No concurrent immunotherapy
  • More than 4 weeks since prior melphalan or other alkylating agents
  • No prior anthracycline exposure greater than 120 mg/m^2
  • Recovered from prior chemotherapy
  • No other concurrent chemotherapy
  • More than 4 weeks since prior high-dose dexamethasone
  • No concurrent radiotherapy
  • No concurrent investigational ancillary therapy
18 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
United States
NCI-2012-02443, MC0113, U01CA069912, CDR0000069160
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National Cancer Institute (NCI)
National Cancer Institute (NCI)
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Principal Investigator: Angela Dispenzieri Mayo Clinic
National Cancer Institute (NCI)
January 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP