Thalidomide Versus Bortezomib in Melphalan Refractory Myeloma

This study has been completed.
Information provided by:
Nordic Myeloma Study Group Identifier:
First received: January 15, 2008
Last updated: February 8, 2011
Last verified: February 2011
The purpose of the study is to compare thalidomide + dexamethasone with bortezomib + dexamethasone in patients with multiple myeloma refractory to melphalan therapy. The main goal is to find out which of these two 2:nd line regimens that offers the patients the best chance for a response with as long duration and as good quality of life as possible.

Condition Intervention Phase
Multiple Myeloma
Drug: Bortezomib
Drug: Thalidomide
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Thalidomide Versus Bortezomib in Melphalan Refractory Myeloma

Resource links provided by NLM:

Further study details as provided by Nordic Myeloma Study Group:

Primary Outcome Measures:
  • Progression free survival [ Time Frame: Not specified ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response rate [ Time Frame: Not specified ] [ Designated as safety issue: No ]
  • Response duration [ Time Frame: Not specified ] [ Designated as safety issue: No ]
  • Time to start of other treatment [ Time Frame: Not specified ] [ Designated as safety issue: No ]
  • Toxicity [ Time Frame: Not specified ] [ Designated as safety issue: Yes ]
  • Quality of life [ Time Frame: Not specified ] [ Designated as safety issue: No ]
  • Response rate after cross-over [ Time Frame: Not specified ] [ Designated as safety issue: No ]
  • Response duration after cross-over [ Time Frame: Not specified ] [ Designated as safety issue: No ]

Estimated Enrollment: 300
Study Start Date: October 2007
Study Completion Date: December 2010
Primary Completion Date: September 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
Bortezomib - dexamethasone
Drug: Bortezomib

Bortezomib 1,3 mg/m2 intravenously on days 1, 4, 8 och 11 of every 3 weeks cycle until maximal response, toxicity or maximum 8 cycles

Dexamethasone 20 mg days 1-2, 4-5, 8-9 and 11-12 during the first 2 cycles, thereafter individualized dose depending on response and toxicity

Experimental: 2
Thalidomide - dexamethasone
Drug: Thalidomide

Thalidomide 50 mg/day with dose escalation every 3 weeks until response or toxicity, maximal dose 200 mg/day

Dexamethasone 40 mg/day day 1-4 every 3 weeks for at least 2 courses, thereafter individualized dose depending on response and toxicity

Detailed Description:

The study is an open randomized multicentre study in which patients with multiple myeloma refractory to melphalan therapy are randomized between bortezomib and thalidomide therapy, in both arms with the addition of dexamethasone. In case of failure to the initially given treatment the patient will be crossed over to the alternative treatment.

The number of patients needed is calculated to 300, based upon the hypothesis of a 50% difference in progression free survival, a significance level of 95% and a power of 80%. With 12 patients being recruited each month during 25 months and a 4 months follow-up after the last included patient, the total study time will be 29 months.

The dose regimens for bortezomib and thalidomide follow general clinical praxis as regards recommendations for optimal dosing in the Nordic countries.

Evaluation of response and toxicity is performed every 3 weeks for at least 12 weeks, thereafter every 6 weeks. Evaluation of efficacy is done according to The International Myeloma Working Group Uniform Response Criteria. Evaluation of toxicity is done by CTCAE grading. Evaluation of quality of life is done by the EORTC QLQ30 questionnaires with the addition of the myeloma specific MY-24 module which are mailed to the patients at predetermined intervals during the study.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Treatment demanding multiple myeloma
  • Refractoriness to melphalan
  • Acceptance of rules for prevention of pregnancy

Exclusion Criteria:

  • Previous treatment with bortezomib, thalidomide, or lenalidomide
  • Sensory neuropathy grade III or neuropathic pain grade II
  • Severe concomitant disorder, e.g. other malignancy or severe heart disease
  • Transformation to plasma cell leukemia or aggressive lymphoma
  • Frequent visits for bortezomib injections not feasible
  • Anticipated non-adherence to study protocol
  • Pregnancy
  • Anticipated non-adherence to rules for prevention of pregnancy
  • Severe thrombocytopenia (Thrombocyte count less than 25000/microliter)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00602511

Ålborg university Hospital
Aalborg, Denmark, 9000
Herlev University Hospital
Herlev, Denmark, 2730
Koebenhavn, Denmark, 2100
Odense University Hospital
Odense, Denmark, 5000
Århus University Hospital
Århus, Denmark, 8000
Ullevål Sykehus
Oslo, Norway, 0407
Oslo, Norway
Stavanger Universitetssykehus
Stavanger, Norway, 4068
Trondheim University Hospital
Trondheim, Norway, N-7006
Falun Hospital
Falun, Sweden, 79182
Gävle Hospital
Gävle, Sweden, 80187
Sahlgrenska University Hospital
Göteborg, Sweden, 41345
Helsingborg Hospital
Helsingborg, Sweden, 25187
Lidköping Hospital
Lidköping, Sweden, 53185
Lund University Hospital
Lund, Sweden, 22185
Malmö University Hospital
Malmö, Sweden, 20502
Mölndal hospital
Mölndal, Sweden, 43180
Skövde Hospital
Skövde, Sweden, 54185
St Göran Hospital
Stockholm, Sweden, 11281
Sundsvall Hospital
Sundsvall, Sweden, 85186
Uddevalla Hospital
Uddevalla, Sweden, 45180
Norrland University Hospital
Umeå, Sweden, 90185
Uppsala University Hospital
Uppsala, Sweden, 75185
Västerås Hospital
Västerås, Sweden, 72189
Växjö Hospital
Växjö, Sweden, 35185
Örebro University Hospital
Örebro, Sweden, 70185
Örnsköldsvik Hospital
Örnsköldsvik, Sweden, 89189
Sponsors and Collaborators
Nordic Myeloma Study Group
Principal Investigator: Martin Hjorth, MD, PhD Department of Medicine, Lidköping Hospital, S-53185 Lidköping, Sweden
  More Information

Responsible Party: Martin Hjorth, Department of Medicine, Lidköping Hospital, S-53185 Lidköping, Sweden Identifier: NCT00602511     History of Changes
Other Study ID Numbers: NMSG 17/07  EudraCT no. 2007-001292-11 
Study First Received: January 15, 2008
Last Updated: February 8, 2011
Health Authority: Sweden: Medical Products Agency

Keywords provided by Nordic Myeloma Study Group:
Melfalan refractory multiple myeloma
Multiple myeloma
Randomized clinical trial

Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Blood Protein Disorders
Cardiovascular Diseases
Hematologic Diseases
Hemorrhagic Disorders
Hemostatic Disorders
Immune System Diseases
Immunoproliferative Disorders
Lymphoproliferative Disorders
Neoplasms by Histologic Type
Vascular Diseases
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Anti-Bacterial Agents
Anti-Infective Agents
Anti-Inflammatory Agents
Antineoplastic Agents
Antineoplastic Agents, Hormonal
Autonomic Agents
Gastrointestinal Agents
Growth Inhibitors
Growth Substances processed this record on May 26, 2016