Trial Outcomes & Findings for Study Combining Bortezomib With High Dose Melphalan to Treat Multiple Myeloma (NCT NCT00784823)

NCT ID: NCT00784823

Last Updated: 2022-08-11

Results Overview

The Maximum Tolerated Dose of Bortezomib (MTD) Will be Defined as the Dose Level Prior to That Resulting in Two Out of Six Patients Experiencing a DLT

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

32 participants

Primary outcome timeframe

During dosing of Bortezomib on Day -4 to Day -1 of ASCT

Results posted on

2022-08-11

Participant Flow

Participant milestones

Participant milestones
Measure
Phase I Cohort - Bortezomib Dose 1 mg/m2
Bortezomib at 1 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase I Cohort - Bortezomib 1.3 mg/m2
Bortezomib at 1.3 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase I Cohort - Bortezomib 1.6 mg/m2
Bortezomib at 1.6 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase II Cohort
Bortezomib at 1.6 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Overall Study
STARTED
6
3
3
20
Overall Study
COMPLETED
6
3
3
20
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phase I Cohort - Bortezomib Dose 1 mg/m2
n=6 Participants
Bortezomib at 1 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase I Cohort - Bortezomib 1.3 mg/m2
n=3 Participants
Bortezomib at 1.3 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase I Cohort - Bortezomib 1.6 mg/m2
n=3 Participants
Bortezomib at 1.6 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase II Cohort
n=20 Participants
Bortezomib 1.6 mg/m2 on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Total
n=32 Participants
Total of all reporting groups
Age, Continuous
57 years
n=6 Participants
63 years
n=3 Participants
58 years
n=3 Participants
57 years
n=20 Participants
57 years
n=32 Participants
Sex: Female, Male
Female
5 Participants
n=6 Participants
2 Participants
n=3 Participants
1 Participants
n=3 Participants
9 Participants
n=20 Participants
17 Participants
n=32 Participants
Sex: Female, Male
Male
1 Participants
n=6 Participants
1 Participants
n=3 Participants
2 Participants
n=3 Participants
11 Participants
n=20 Participants
15 Participants
n=32 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
6 participants
n=6 Participants
3 participants
n=3 Participants
3 participants
n=3 Participants
20 participants
n=20 Participants
32 participants
n=32 Participants

PRIMARY outcome

Timeframe: During dosing of Bortezomib on Day -4 to Day -1 of ASCT

The Maximum Tolerated Dose of Bortezomib (MTD) Will be Defined as the Dose Level Prior to That Resulting in Two Out of Six Patients Experiencing a DLT

Outcome measures

Outcome measures
Measure
Combined Dose Intense Melphalan With Bortezomib (MTD)
n=32 Participants
The purpose of this study is to determine the tolerance and potential efficacy of combining dose intense melphalan with escalating doses of bortezomib in patients with multiple myeloma undergoing autologous stem cell transplantation. Combined dose intense Melphalan with maximum tolerated dose of bortezomib (MTD) Bortezomib: - Bortezomib is administered by rapid I.V. push (over 3-5 seconds) via a central or peripheral vein into a flowing saline line * Bortezomib will be administered any time on day -4 and 24 hrs after the start of the melphalan infusion on day -1 * Dosing will be based on actual body weight Patient weight must be measured within seven days of the start of the treatment regimen Melphalan: - Melphalan is administered by rapid intravenous infusion via a central or peripheral vein over one hour * Melphalan will be dissolved with 10 ml of diluent to a concentration of 5 mg/mL which is then immediately diluted in 0.9% normal saline to a concentration NOT exceeding 0.45 mg/mL prior to administration * The final dilution of melphalan is physically and chemically stable for 60 minutes and therefore will be administered within that time period * Melphalan will be given as a single dose (not split over 2 or more days) * Dosing will be based body surface area calculated using actual body weight
The Maximum Tolerated Dose of Bortezomib (MTD)
1.6 mg/m2 of bortezomib

Adverse Events

Phase I Cohort

Serious events: 6 serious events
Other events: 12 other events
Deaths: 0 deaths

Phase II Cohort

Serious events: 6 serious events
Other events: 20 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Phase I Cohort
n=12 participants at risk
Bortezomib was dose escalated at 1, 1.3, and 1.6 mg/m2 (3 × 3 design) on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase II Cohort
n=20 participants at risk
Bortezomib 1.6 mg/m2 (3 × 3 design) on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
General disorders
Death
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Nervous system disorders
Seizure
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Diarrhea
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Respiratory, thoracic and mediastinal disorders
ICU Admission For Respiratory Distress
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Blood and lymphatic system disorders
Engraftment Syndrome
16.7%
2/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Immune system disorders
Guillain-Barre Syndrome
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Blood and lymphatic system disorders
Neutropenic Fever
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Respiratory, thoracic and mediastinal disorders
Pulmonary Embolus
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.

Other adverse events

Other adverse events
Measure
Phase I Cohort
n=12 participants at risk
Bortezomib was dose escalated at 1, 1.3, and 1.6 mg/m2 (3 × 3 design) on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Phase II Cohort
n=20 participants at risk
Bortezomib 1.6 mg/m2 (3 × 3 design) on days -4 and -1 before transplantation with melphalan 200 mg/m2 given on day -2.
Respiratory, thoracic and mediastinal disorders
Shorness of Breath
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
20.0%
4/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Respiratory, thoracic and mediastinal disorders
Cough
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Skin and subcutaneous tissue disorders
Rash
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Musculoskeletal and connective tissue disorders
Humerus Fracture
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
C. diff
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Gram-positive bacteremia
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
15.0%
3/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Gram-negative bacteremia
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Polymicrobial sepsis
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Herpes Zoster
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Candida Bacteremia
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Renal and urinary disorders
Tumor Lysis Syndrome
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Aspiration Pneumonia
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Fever
25.0%
3/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Infections and infestations
Neutropenic Fever
25.0%
3/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
25.0%
5/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Cardiac disorders
Hypotension
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Cardiac disorders
Hypertension
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Nausea
41.7%
5/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
30.0%
6/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Diarrhea
33.3%
4/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Vomiting
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Anorexia
33.3%
4/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
15.0%
3/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Mucositis
33.3%
4/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
20.0%
4/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Esophagitis
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Dysphagia
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Pancreatitis
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Gastrointestinal disorders
Pancreatic Enzyme Elevations
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Nervous system disorders
Neuropathy
25.0%
3/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Nervous system disorders
Seizures
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Nervous system disorders
Fatigue
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Nervous system disorders
Syncope
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Nervous system disorders
Altered Mental Status
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
5.0%
1/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Renal and urinary disorders
Renal Impairment
0.00%
0/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
10.0%
2/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
Renal and urinary disorders
Hypokalemia
8.3%
1/12
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.
0.00%
0/20
The limited number of patients limited our ability to analyze groups separately for adverse event reporting. As a result, adverse events were collected irrespective of dose and therefore cannot be separated further.

Additional Information

Joshua Zenreich

Hackensack Meridian Health

Phone: 551-996-4248

Results disclosure agreements

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