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Trial record 1 of 1 for:    NCT03004287
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2015-12: A Study Exploring the Use of Early and Late Consolidation/Maintenance Therapy

This study is currently recruiting participants.
Verified July 2017 by University of Arkansas
Sponsor:
ClinicalTrials.gov Identifier:
NCT03004287
First Posted: December 28, 2016
Last Update Posted: July 11, 2017
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. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Collaborator:
Janssen, LP
Information provided by (Responsible Party):
University of Arkansas
December 19, 2016
December 28, 2016
July 11, 2017
July 1, 2017
January 2021   (Final data collection date for primary outcome measure)
Measure the progression-free survival in patients with high risk multiple myeloma [ Time Frame: 48 months ]
Same as current
Complete list of historical versions of study NCT03004287 on ClinicalTrials.gov Archive Site
Not Provided
Not Provided
Not Provided
Not Provided
 
2015-12: A Study Exploring the Use of Early and Late Consolidation/Maintenance Therapy
2015-12: A Phase II Study Exploring the Use of Early and Late Consolidation/Maintenance With Anti-CD38 (Protein) Monoclonal Antibody to Improve Progression Free Survival in Patients With Newly Diagnosed Multiple Myeloma
This study will assess whether adding one of the newest multiple myeloma therapies, daratumumab, into the Total Therapy approach helps patients live longer with fewer side effects
Past studies conducted at the Myeloma Institute and at other institutions have shown that many patients with high-risk disease (as determined by gene array studies - studies that look at specific genes using special equipment) tend to have shorter remissions (disappearance of signs and symptoms of myeloma) and do not survive as long as participants with low-risk myeloma. The Total Therapy approach to treatment carried out at the Myeloma Institute where multiple chemotherapy agents are given as induction followed by a stem cell transplant, post-transplant consolidation, and maintenance therapy has proven to be the best available treatment strategy. However, the availability of new treatments that work in different ways offers the possibility of improving the effectiveness of Total Therapy treatment while potentially reducing the number of side effects patients' experience. Daratumumab is a human monoclonal antibody or protein drug. It recognizes a specific protein, CD38, which is found at high levels on multiple myeloma cells. An antibody is something that finds and kills foreign objects in your body, in this case, myeloma cells. The other drugs that will be used in the study treatment regimen include carfilzomib or bortezomib, thalidomide, lenalidomide, dexamethasone, cisplatin, adriamycin, cyclophosphamide, etoposide, lenalidomide and dexamethasone.
Interventional
Phase 2
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Multiple Myeloma
  • Drug: Carfilzomib
    Given by vein: days 1 and 2 of Induction; days 1, 8, 15, and 22 of Consolidation 1; and days 1, 8, 15, and 22 of alternating 3-month blocks during Maintenance.
    Other Name: Kyprolis
  • Drug: Thalidomide
    Given by mouth at bedtime: days 1-4 of Induction
    Other Name: Thalomid
  • Drug: Dexamethasone
    Given by mouth or by vein: days 1-4 of Induction; days -4 - -1 of Transplant(s); and days 1, 8, 15, and 22 of every cycle during Maintenance
    Other Name: Baycadron
  • Drug: Daratumumab
    Given by vein: day -1 of induction; days 1 and 8 of Immunological Consolidations; and day 1 of each Maintenance cycle
    Other Name: Darzalex
  • Drug: Cisplatin
    Given by vein: days 1-4 (continuous infusion) of Induction
    Other Name: Platinol
  • Drug: Adriamycin
    Given by vein: days 1-4 (continuous infusion) of Induction
    Other Name: Doxorubicin
  • Drug: Cyclophosphamide
    Given by vein: days 1-4 (continuous infusion) of Induction
    Other Name: Cytoxan
  • Drug: Etoposide
    Given by vein: days 1-4 (continuous infusion) of Induction
    Other Name: Eposin
  • Drug: Melphalan
    Given by vein: days -4 - -1 of Transplant(s)
  • Procedure: ASCT
    day 0 of Transplant(s)
  • Drug: Lenalidomide
    Given by mouth: days 1-21 of alternating 3-month blocks during Maintenance
    Other Name: Revlimid
  • Drug: Bortezomib
    Given by vein or subcutaneous injection: may be substituted for carfilzomib throughout the study regimen at the discretion of the treating physician
    Other Name: Velcade
Experimental: Study Treatment

Induction Chemotherapy: Carfilzomib, Thalidomide, Dexamethasone, Daratumumab , CisPlatin, Adriamycin, Cyclophosphamide and Etoposide (KTD-Dara-PACE).

Autologous Stem Cell Transplant (ASCT) 1: Melphalan, Dexamethasone, ASCT.

Immunological Consolidation 1: Daratumumab.

Consolidation 1: Daratumumab, Carfilzomib, Dexamethasone (Dara-KD).

ASCT 2 (optional): Melphalan, Dexamethasone, ASCT.

Immunological Consolidation 2: Daratumumab.

Maintenance: Dara-KD alternating with Daratumumab, lenalidomide, and Dexamethasone (Dara-RD) in 3-month blocks.

Bortezomib may be substituted for carfilzomib throughout the regimen at the discretion of the treating physician.

Interventions:
  • Drug: Carfilzomib
  • Drug: Thalidomide
  • Drug: Dexamethasone
  • Drug: Daratumumab
  • Drug: Cisplatin
  • Drug: Adriamycin
  • Drug: Cyclophosphamide
  • Drug: Etoposide
  • Drug: Melphalan
  • Procedure: ASCT
  • Drug: Lenalidomide
  • Drug: Bortezomib
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
50
January 2021
January 2021   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients must have newly diagnosed active Multiple Myeloma (MM) requiring treatment. Patients with a previous history of smoldering myeloma will be eligible if there is evidence of progressive disease requiring chemotherapy.
  • Patients must be either untreated or have not received more than four cycles of systemic MM therapy (e.g. Revlimid Dexamethasone (RD), Bortezomib Revlimid Dexamethasone (VRD). Prior bisphosphonates and localized radiation are allowed.
  • Participants must have high-risk disease, as defined by at least one of the following:
  • Myeloma Prognostic Risk Signature (MyPRS) risk score ≥ 50.4
  • Lactate Dehydrogenase (LDH) ≥ 360 U/L (Rule out hemolysis and infection; contact PI if any doubt.)
  • Diagnosis of primary plasma cell leukemia.
  • Eastern Cooperative Oncology Group (ECOG) ≤ 2, unless solely due to symptoms of MM-related bone disease.
  • Patients must have a platelet count ≥ 50,000/μL, unless lower levels are explained by extensive bone marrow plasmacytosis.
  • Patients must be at least 18 years of age and not older than 75 years of age at the time of registration.
  • Participants must have a baseline serum creatinine level < 3 mg/dL and baseline Alanine Aminotransferase (ALT) < 3x Upper Limit of Normal (ULN).
  • Participants must have an ejection fraction by echocardiogram (ECHO) or Multiple-gated Acquisition Scan (MUGA) scan ≥ 45%
  • Patients must have adequate pulmonary function studies > 50% of predicted on mechanical aspects (Forced Expiratory Volume 1 (FEV1), Forced Vital Capacity (FVC) and diffusion capacity (DLCO) > 50% of predicted. If the patient is unable to complete pulmonary function tests due to MM related pain or other conditions, an exception may be granted if the principal investigator documents that the patient is a candidate for high dose therapy.
  • Patients must have signed an Institutional Review Board (IRB)-approved informed consent indicating their understanding of the proposed treatment and that the protocol has been approved by the Institutional Review Board (IRB).

Exclusion Criteria:

  • No evidence of high-risk disease
  • Poorly controlled hypertension, diabetes mellitus, active or uncontrolled hepatitis, or other serious medical or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol.
  • Patients must not have prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has not received treatment for one year prior to enrollment. Other cancers will only be acceptable if the patient's life expectancy exceeds five years.
  • Pregnant or nursing women may not participate. Women of childbearing potential must have a negative pregnancy documented within one week of registration.
  • Subjects of reproductive potential may not participate unless they have agreed to use an effective contraceptive method.
Sexes Eligible for Study: All
18 Years to 75 Years   (Adult, Senior)
No
Contact: Nathan M Petty 501-526-6990 ext 2435 pettynathanm@uams.edu
Contact: David A Avery 501-526-6990 ext 2431 daavery@uams.edu
United States
 
 
NCT03004287
206241
Yes
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Plan to Share IPD: No
University of Arkansas
University of Arkansas
Janssen, LP
Principal Investigator: Faith E Davies University of Arkansas for Medical Science-Myeloma Institute
University of Arkansas
July 2017

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