Trial Outcomes & Findings for S0417 Bortezomib, Thalidomide, and Dexamethasone in Treating Patients With Relapsed or Refractory Multiple Myeloma (NCT NCT00124579)

NCT ID: NCT00124579

Last Updated: 2018-08-09

Results Overview

Responses are defined as follows: Complete Remission: Absence of bone marrow or blood findings of multiple myeloma. This includes disappearance of all evidence of serum and urine M-proteins on immunofixation electrophoresis studies. Normalization of serum concentrations of normal immunoglobulins is not required for CR. There must also be no evidence of increasing anemia. Bone marrow cellularity must be ≥ 20% with plasma cells ≤ 5%. Remission: A ≥ 75% reduction in the serum M-protein, and if a urine M-protein (Bence-Jones protein) is present, either a ≥ 90% reduction in this protein, or a urine M-protein \< 0.2gm/day. Bone marrow plasma cells must be ≤ 5%. Partial Remission: A ≥ 50% reduction in the serum M-protein, and if present, a ≥ 50% reduction in the urine M-protein (Bence-Jones protein). Bone marrow plasma cells must not be increased from baseline level.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

7 participants

Primary outcome timeframe

1 year

Results posted on

2018-08-09

Participant Flow

Participant milestones

Participant milestones
Measure
Bortezomib With Thalidomide and Dexamethasone Induction
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
Induction
STARTED
7
Induction
COMPLETED
2
Induction
NOT COMPLETED
5
Maintenance
STARTED
2
Maintenance
COMPLETED
0
Maintenance
NOT COMPLETED
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

S0417 Bortezomib, Thalidomide, and Dexamethasone in Treating Patients With Relapsed or Refractory Multiple Myeloma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Bortezomib With Thalidomide and Dexamethasone
n=7 Participants
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
Age, Continuous
63.7 years
n=5 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
Sex: Female, Male
Male
3 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 1 year

Population: Ninety patients is sufficient to distinguish between the null hypothesis that the response rate is 45% versus the alternative of a response rate of 60% with 89% power, using a one-sided test based on the binomial distribution with a significance level of 5%.

Responses are defined as follows: Complete Remission: Absence of bone marrow or blood findings of multiple myeloma. This includes disappearance of all evidence of serum and urine M-proteins on immunofixation electrophoresis studies. Normalization of serum concentrations of normal immunoglobulins is not required for CR. There must also be no evidence of increasing anemia. Bone marrow cellularity must be ≥ 20% with plasma cells ≤ 5%. Remission: A ≥ 75% reduction in the serum M-protein, and if a urine M-protein (Bence-Jones protein) is present, either a ≥ 90% reduction in this protein, or a urine M-protein \< 0.2gm/day. Bone marrow plasma cells must be ≤ 5%. Partial Remission: A ≥ 50% reduction in the serum M-protein, and if present, a ≥ 50% reduction in the urine M-protein (Bence-Jones protein). Bone marrow plasma cells must not be increased from baseline level.

Outcome measures

Outcome measures
Measure
Bortezomib + Thal/Dex
n=7 Participants
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
Overall Response Rate Complete Remission (CR), Remission (R), and Partial Remission (PR).
14 percentage of participants

SECONDARY outcome

Timeframe: From date of protocol therapy start to date of protocol therapy end, i.e., up to about 3.5 years

Population: All participants receiving at least one dose of induction therapy

To evaluate the qualitative and quantitative toxicities associated with this regimen.

Outcome measures

Outcome measures
Measure
Bortezomib + Thal/Dex
n=7 Participants
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
Toxicity Evaluation
Muscle weakness, not d/t neuropathy - Extrem-lower
1 Participants
Toxicity Evaluation
Muscle weakness, not d/t neuropathy - body/general
1 Participants
Toxicity Evaluation
Albumin, serum-low (hypoalbuminemia)
1 Participants
Toxicity Evaluation
Allergy/Immunology-Other
1 Participants
Toxicity Evaluation
Bilirubin (hyperbilirubinemia)
1 Participants
Toxicity Evaluation
Edema: limb
1 Participants
Toxicity Evaluation
Extremity-lower (gait/walking)
1 Participants
Toxicity Evaluation
Fatigue (asthenia, lethargy, malaise)
1 Participants
Toxicity Evaluation
Hemoglobin
1 Participants
Toxicity Evaluation
Inf (clin/microbio) w/Gr 3-4 neuts - Lung
1 Participants
Toxicity Evaluation
Leukocytes (total WBC)
1 Participants
Toxicity Evaluation
Lymphopenia
1 Participants
Toxicity Evaluation
Neuropathy: motor
1 Participants
Toxicity Evaluation
Neuropathy: sensory
1 Participants
Toxicity Evaluation
Neutrophils/granulocytes (ANC/AGC)
2 Participants
Toxicity Evaluation
Platelets
1 Participants

SECONDARY outcome

Timeframe: about 12-18 months

Population: With ninety patients, we will have 82% power to rule out a null hypothesis of a 12-month median survival versus an alternative hypothesis of an 18-month median survival at a significance level of 5%.

From date of initial registration to date of progression/relapse of disease (\> 25% increase from baseline in myeloma protein production or other signs of disease progression such as hypercalcemia, etc.) or death from any cause, whichever came first, up to 5 years

Outcome measures

Outcome measures
Measure
Bortezomib + Thal/Dex
n=7 Participants
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
Progression-Free Survival
8 Months
Interval 4.0 to 12.0

Adverse Events

Bortezomib + Thal/Dex

Serious events: 1 serious events
Other events: 7 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Bortezomib + Thal/Dex
n=7 participants at risk
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
General disorders
Edema: limb
14.3%
1/7
Investigations
Bilirubin (hyperbilirubinemia)
14.3%
1/7
Investigations
Platelets
14.3%
1/7
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Death - Disease progression NOS
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Dyspnea (shortness of breath)
14.3%
1/7

Other adverse events

Other adverse events
Measure
Bortezomib + Thal/Dex
n=7 participants at risk
Induction (per 21-day cycle): Bortezomib - 1.0 mg/m2 (Days 1, 4, 8, and 11). Dexamethasone - 20 mg/d PO (Days 1, 2, 4, 5, 8, 9, 11, and 12). Thalidomide 100 mg (Days 1-21). Maintenance (per 28-day cycle): thalidomide 100mg (Days 1-28). Dexamethasone 40 mg Days 1-4.
Blood and lymphatic system disorders
Hemoglobin
85.7%
6/7
Cardiac disorders
SVT and nodal arrhythmia - Atrial fibrillation
14.3%
1/7
Cardiac disorders
SVT and nodal arrhythmia - Sinus bradycardia
14.3%
1/7
Endocrine disorders
Cushingoid appearance
14.3%
1/7
Eye disorders
Night blindness (nyctalopia)
14.3%
1/7
Eye disorders
Vision-blurred vision
14.3%
1/7
Eye disorders
Watery eye (epiphora, tearing)
14.3%
1/7
Gastrointestinal disorders
Constipation
100.0%
7/7
Gastrointestinal disorders
Diarrhea
14.3%
1/7
Gastrointestinal disorders
Distention/bloating, abdominal
14.3%
1/7
Gastrointestinal disorders
Flatulence
14.3%
1/7
Gastrointestinal disorders
Heartburn/dyspepsia
14.3%
1/7
Gastrointestinal disorders
Nausea
42.9%
3/7
Gastrointestinal disorders
Pain - Abdomen NOS
28.6%
2/7
Gastrointestinal disorders
Vomiting
28.6%
2/7
General disorders
Edema: head and neck
14.3%
1/7
General disorders
Edema: limb
42.9%
3/7
General disorders
Extremity-lower (gait/walking)
28.6%
2/7
General disorders
Fatigue (asthenia, lethargy, malaise)
100.0%
7/7
General disorders
Fever in absence of neutropenia, ANC lt1.0x10e9/L
28.6%
2/7
General disorders
Pain-Other
28.6%
2/7
General disorders
Rigors/chills
14.3%
1/7
Immune system disorders
Allergy/Immunology-Other
14.3%
1/7
Infections and infestations
Inf (clin/microbio) w/Gr 3-4 neuts - Bladder
14.3%
1/7
Infections and infestations
Inf (clin/microbio) w/Gr 3-4 neuts - Lung
14.3%
1/7
Infections and infestations
Inf w/normal ANC or Gr 1-2 neutrophils - Skin
14.3%
1/7
Infections and infestations
Inf w/normal ANC or Gr 1-2 neutrophils - Soft tiss
14.3%
1/7
Infections and infestations
Inf w/normal ANC or Gr 1-2 neutrophils - Up airway
14.3%
1/7
Infections and infestations
Infection with unknown ANC - Upper airway NOS
14.3%
1/7
Infections and infestations
Infection-Other
14.3%
1/7
Investigations
ALT, SGPT (serum glutamic pyruvic transaminase)
28.6%
2/7
Investigations
AST, SGOT
14.3%
1/7
Investigations
Alkaline phosphatase
28.6%
2/7
Investigations
Bilirubin (hyperbilirubinemia)
28.6%
2/7
Investigations
Creatinine
28.6%
2/7
Investigations
Leukocytes (total WBC)
57.1%
4/7
Investigations
Lymphopenia
14.3%
1/7
Investigations
Neutrophils/granulocytes (ANC/AGC)
42.9%
3/7
Investigations
Platelets
57.1%
4/7
Investigations
Weight gain
14.3%
1/7
Investigations
Weight loss
14.3%
1/7
Metabolism and nutrition disorders
Albumin, serum-low (hypoalbuminemia)
57.1%
4/7
Metabolism and nutrition disorders
Anorexia
14.3%
1/7
Metabolism and nutrition disorders
Calcium, serum-high (hypercalcemia)
14.3%
1/7
Metabolism and nutrition disorders
Calcium, serum-low (hypocalcemia)
57.1%
4/7
Metabolism and nutrition disorders
Dehydration
14.3%
1/7
Metabolism and nutrition disorders
Glucose, serum-high (hyperglycemia)
71.4%
5/7
Metabolism and nutrition disorders
Glucose, serum-low (hypoglycemia)
14.3%
1/7
Metabolism and nutrition disorders
Magnesium, serum-low (hypomagnesemia)
14.3%
1/7
Metabolism and nutrition disorders
Potassium, serum-low (hypokalemia)
28.6%
2/7
Metabolism and nutrition disorders
Sodium, serum-low (hyponatremia)
14.3%
1/7
Musculoskeletal and connective tissue disorders
Muscle weakness, not d/t neuropathy - Extrem-lower
28.6%
2/7
Musculoskeletal and connective tissue disorders
Muscle weakness, not d/t neuropathy - body/general
14.3%
1/7
Musculoskeletal and connective tissue disorders
Pain - Back
28.6%
2/7
Musculoskeletal and connective tissue disorders
Pain - Bone
14.3%
1/7
Musculoskeletal and connective tissue disorders
Pain - Extremity-limb
28.6%
2/7
Musculoskeletal and connective tissue disorders
Pain - Joint
28.6%
2/7
Musculoskeletal and connective tissue disorders
Pain - Neck
14.3%
1/7
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Pain - Tumor pain
14.3%
1/7
Nervous system disorders
Dizziness
14.3%
1/7
Nervous system disorders
Neurology-Other
14.3%
1/7
Nervous system disorders
Neuropathy: motor
14.3%
1/7
Nervous system disorders
Neuropathy: sensory
85.7%
6/7
Nervous system disorders
Pain - Head/headache
14.3%
1/7
Nervous system disorders
Tremor
28.6%
2/7
Psychiatric disorders
Confusion
14.3%
1/7
Psychiatric disorders
Insomnia
14.3%
1/7
Psychiatric disorders
Mood alteration - depression
14.3%
1/7
Renal and urinary disorders
Glomerular filtration rate
14.3%
1/7
Renal and urinary disorders
Proteinuria
28.6%
2/7
Reproductive system and breast disorders
Sexual/Reproductive Function-Other (Specify)
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Bronchospasm, wheezing
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Cough
42.9%
3/7
Respiratory, thoracic and mediastinal disorders
Dyspnea (shortness of breath)
57.1%
4/7
Respiratory, thoracic and mediastinal disorders
Hemorrhage, Respiratory tract NOS
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Hemorrhage, pulmonary/upper respiratory - Nose
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Pulmonary/Upper Respiratory-Other
14.3%
1/7
Skin and subcutaneous tissue disorders
Dermatology/Skin-Other
14.3%
1/7
Skin and subcutaneous tissue disorders
Dry skin
14.3%
1/7
Skin and subcutaneous tissue disorders
Rash/desquamation
28.6%
2/7
Skin and subcutaneous tissue disorders
Rash: erythema multiforme
14.3%
1/7
Skin and subcutaneous tissue disorders
Skin breakdown/decubitus ulcer
14.3%
1/7
Vascular disorders
Hypotension
14.3%
1/7

Additional Information

Robert Z. Orlowski, MD, PhD

SWOG

Phone: (713) 792-2860

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place