Safety Study of Lenalidomide Maintenance Therapy Post Allogeneic HCT for High-risk Multiple Myeloma (07-REV)
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This is a multi-institution, non-randomized, open label, Phase IIa prospective trial to evaluate the safety and tolerability of maintenance lenalidomide after allogeneic hematopoietic stem cell transplantation (HCT).
Lenalidomide maintenance therapy will start between day 60 and 90 after allogeneic HCT at a starting dose of 10mg PO once daily. Dose escalation and de-escalation will be performed depending on tolerability of lenalidomide. Dose range is 5mg every other day to 5 - 25 mg given daily on days 1-21 of a 28-day cycle for 12 cycles maximum or maximum of 12 months from first dose of study drug.
Patients will be followed until 28 days from completing the 12th planned cycle of lenalidomide maintenance or 12 months from first dose of study drug, which ever comes first, (14 to 15 months after receiving the allograft) or discontinuation of study drug.
Condition | Intervention | Phase |
---|---|---|
Multiple Myeloma |
Drug: lenalidomide |
Phase 2 |
Study Type: | Interventional |
Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
Official Title: | Evaluation of Lenalidomide as Maintenance Therapy Post Allogeneic Hematopoietic Cell Transplantation for High-risk Multiple Myeloma |
- To determine tolerability and safety profile of a maximum of 12 cycles or 12 months from first dose (which ever comes first) of lenalidomide maintenance therapy post allogeneic hematopoietic cell transplantation for high risk multiple myeloma. [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- To estimate the incidences of ≥ grade 3 adverse events, graft failure, infections, treatment-related mortality (TRM) and incidence and severity of acute and chronic GVHD after initiation of lenalidomide. [ Time Frame: 13 months ] [ Designated as safety issue: Yes ]
- To measure the overall response and best response rates to lenalidomide maintenance therapy following allogeneic HCT. [ Time Frame: 13 Months ] [ Designated as safety issue: Yes ]
- To determine time to disease progression and overall survival after lenalidomide. [ Time Frame: 13 months ] [ Designated as safety issue: Yes ]
Estimated Enrollment: | 30 |
Study Start Date: | February 2009 |
Estimated Primary Completion Date: | February 2013 (Final data collection date for primary outcome measure) |
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Drug: lenalidomide
Lenalidomide maintenance therapy will start within 60 to 90 days after allogeneic HCT at a starting dose of 10mg PO once daily.
Dose escalation and de-escalation are performed depending on tolerability of lenalidomide.
The dose range is 5mg every other day and 5 to 25 mg daily from days 1-21 followed by 7 days of rest for 12 cycles (each cycle 28 days).
Ages Eligible for Study: | 18 Years to 70 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- One prior allograft from an 8/8 or 7/8 allele matched related or unrelated donor, received 60 to 90 days prior to initiation of lenalidomide
- Meet the diagnostic criteria of symptomatic myeloma at anytime prior to allogeneic HCT
- Have high-risk multiple myeloma
- Received ≤ three (3) prior lines of therapy. Prior therapies may include: combination chemotherapy, monotherapy, lenalidomide and autologous HCT. Localized radiation therapy does not count as a single line of therapy. Previous progression on lenalidomide does not exclude participation in the study.
- Received a reduced intensity conditioning regimen
- Received or are receiving a GVHD prophylaxis regimen of a calcineurin inhibitor in combination with either methotrexate, mycophenolate mofetil (MMF) or sirolimus
- Karnofsky performance score ≥ 80 or ECOG ≤ 2
- There must be at least 50% donor chimerism and no evidence of falling donor chimerism within 1 month of enrollment
- Laboratory test results within range, within 14 days prior to initiation of lenalidomide
- All study participants must be registered into the mandatory RevAssist® program, and be willing and able to comply with the requirements of RevAssist®.
Exclusion Criteria:
- Disease progression at time of study entry
- Patients with any grade III-IV GVHD at the time of study entry
- Patients requiring additional immunosuppressive therapy to control acute GVHD other than corticosteroids and immunosuppressive agents used for prophylaxis.
- Concomitant use of other investigational agents
- Patients who have received donor lymphocyte infusions
- Active CNS malignancy
- Uncontrolled bacterial, viral, or fungal infections
- Prior malignancies except resected basal cell carcinoma or treated cervical carcinoma in situ < 5 years from study entry.
- Known hypersensitivity or desquamating rash to either thalidomide or lenalidomide.
- Known positive for HIV or active infectious hepatitis.
- Women who are pregnant or breastfeeding.
- New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities.
United States, California | |
City of Hope National Medical Center | |
Duarte, California, United States, 91010 | |
United States, Florida | |
H. Lee Moffitt Cancer Center & Research Institute | |
Tampa, Florida, United States, 33612 | |
United States, Minnesota | |
University of Minnesota Medical Center | |
Minneapolis, Minnesota, United States, 55455 | |
United States, New Jersey | |
Hackensack University Medical Center | |
Hackensack, New Jersey, United States, 07601 | |
United States, Pennsylvania | |
University of Pennsylvania Hospital Center | |
Philadelphia, Pennsylvania, United States, 19104 | |
United States, Texas | |
The University of Texas, M.D. Anderson Cancer Center | |
Houston, Texas, United States, 77030 | |
United States, Washington | |
Fred Hutchinson Cancer Research Center | |
Seattle, Washington, United States, 98195 | |
United States, Wisconsin | |
Medical College of Wisconsin | |
Milwaukee, Wisconsin, United States, 53226 |
Principal Investigator: | Melissa Alsina, MD | H. Lee Moffitt Cancer Center |
Study Chair: | Marcelo Pasquini, MD | CIBMTR/ Medical College of Wisconsin |
No publications provided
Responsible Party: | Center for International Blood and Marrow Transplant Research |
ClinicalTrials.gov Identifier: | NCT00847639 History of Changes |
Other Study ID Numbers: | 07-REV |
Study First Received: | February 17, 2009 |
Last Updated: | July 25, 2012 |
Health Authority: | United States: Institutional Review Board |
Keywords provided by Center for International Blood and Marrow Transplant Research:
Multiple Myeloma lenalidomide Revlimid Allogeneic Hematopoietic Cell Transplantation |
Additional relevant MeSH terms:
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 Lenalidomide |
Thalidomide Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Leprostatic Agents Anti-Bacterial Agents Anti-Infective Agents Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors |
ClinicalTrials.gov processed this record on September 26, 2012