Multiple Myeloma
Conditions
Keywords
Newly Diagnosed Multiple myeloma, Daratumumab, Lenalidomide, Ixazomib, Dexamethasone
Brief summary
The main objective of this study is to evaluate the minimal residual disease-negativity rate after administration of the combination of Lenalidomide, Ixazomib, Dexamethasone and Daratumumab as induction and consolidation therapy in an intensive program in newly diagnosed standard risk multiple myeloma patients. For the induction therapy, each patient received 6 cycles of Lenalidomide, Ixazomib, Dexamethasone and Daratumumab, then peripheral blood stem cell harvest, intensification with autologous stem cell transplantation, consolidation therapy and maintenance.
Detailed description
This is a phase II, multicenter, non-randomized, open-label study to evaluate the safety and efficacy of Lenalidomide, Ixazomib, Dexamethasone, and Daratumumab in patients with newly diagnosed multiple myeloma. The patient population will consist of adult men and women ≤ 65 years, who have a confirmed diagnosis of standard risk multiple myeloma, who meet eligibility criteria. Treatment periods will be defined as 21-day cycles for induction, and 28-day cycles for consolidation, and maintenance. Patients will be seen at regular treatment cycle intervals while they are participating in the study. Patients will be assessed for disease response and progression according to the International Myeloma Working Group criteria at each cycle during induction and consolidation and every other cycle during maintenance. Eastern Cooperative Oncology Group performance status, adverse events, laboratory values, and vital sign measurements will be collected and assessed to evaluate the safety of therapy throughout the study. Toxicity will be evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events. Patients will attend an End of Treatment visit after receiving their last dose of study drug and will continue to be followed for other follow-up assessments specified in the Schedule of events. All patients will be followed for survival after progression.
Interventions
DRUGIxazomib
21-day cycles induction and 28-day cycles consolidation
DRUGLenalidomide
21-day cycles induction and 28-day cycles consolidation and 28-day cycles maintenance therapy
DRUGDexamethasone
21-day cycles induction and 28-day cycles consolidation
DRUGDaratumumab
21-day cycles induction and 28-day cycles consolidation
Sponsors
University Hospital, Toulouse
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* De novo symptomatic myeloma on the International Myeloma Working Group Diagnostic Criteria for the Diagnosis of Multiple Myeloma * Measurable disease requiring systemic therapy defined by serum M-component ≥ 10g/l or urine M-component ≥ 200 mg/24h or involved free light level ≥ 100 mg/l * Eastern Cooperative Oncology Group performance status 0, 1 or 2 * Eligible to high dose therapy
Exclusion criteria
* Previously treated with any systemic therapy for multiple myeloma * Clinical signs of central nervous system involvement * Renal insufficiency defined as estimated Glomerular Filtration Rate lower or equal to 40 ml/min/1.73 m2 * Hepatic impairment defined as aspartate transminase or alanine transaminase greater or equal to 3 x upper limit of normal, or Total bilirubin greater or equal to 3 x upper limit of normal * Platelet count \< 75,000 per µL * Absolute neutrophil count ≤ 1,000 cells/mm3 * Evidence of current uncontrolled cardiovascular conditions * Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening * Infection requiring systemic antibiotic therapy or other serious infection within 14 days before first dose of study drug * Grade 3 or higher peripheral neuropathy, or grade 2 with pain, on clinical examination during the screening period * Known or suspected chronic obstructive pulmonary disease with a Forced Expiratory Volume in 1 second \< 50% of predicted normal * Systemic treatment with strong CYP3A inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of St. John's wort within 14 days before initiation of the study drug
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| minimal residual disease-negativity rate | 22 months | after completion of the consolidation therapy and before maintenance |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adverse events | up to 54 Months | Number of participants with treatment-related adverse events as assessed by CTCAE v5.0 |
| Response rates | 3 months, 5 months, 7 months, 13 months, 25 months | Response rates according to the IMWG criteria after induction, high dose Melphalan, consolidation and maintenance therapy |
| Progression free survival | 54 months | — |
| Overall survival | 54 months | — |
Countries
France
Contacts
Primary ContactLaura BOGDANOVITCH, CRA
Outcome results
None listed