A Safety Study of Carfilzomib, Cyclophosphamide & Dexamethasone Prior to ASCT in Patients With Newly Diagnosed Myeloma

NCT ID: NCT01660750

Last Updated: 2017-10-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2015-12-31

Brief Summary

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This is a dose finding pilot study to evaluate the safety and determine the maximum tolerated dose of the combination of carfilzomib and cyclophosphamide with dexamethasone (Car-Cy-Dex) prior to autologous stem cell transplant (ASCT) in patients with newly diagnosed transplant eligible multiple myeloma.

Detailed Description

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This is a dose finding pilot study to evaluate the safety and determine the maximum tolerated dose of the combination of carfilzomib and cyclophosphamide with dexamethasone (Car-Cy-Dex) prior to autologous stem cell transplant (ASCT) in patients with newly diagnosed transplant eligible multiple myeloma. The study will also explore the efficacy of Car-Cy-Dex including overall response after induction therapy, overall response at 3 and 6 months post ASCT, and time to progression, progression free survival, and time to next therapy if it occurs within 6 months post ASCT.

Conditions

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Multiple Myeloma

Keywords

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newly diagnosed multiple myeloma transplant eligible multiple myeloma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Carfilzomib, Cyclophosphamide, Dexamethasone

All eligible subjects will receive Carfilzomib, Cyclophosphamide, and Dexamethasone.

Group Type EXPERIMENTAL

Carfilzomib

Intervention Type DRUG

IV over 30 minutes on Days 1,2,8,9,15, and 16 every 28 days

Cyclophosphamide

Intervention Type DRUG

PO on days 1, 8, and 15 every 28 days

Dexamethasone

Intervention Type DRUG

40 mg weekly PO or IV on Days 1, 8, 15, and 22, every 28 days.

Interventions

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Carfilzomib

IV over 30 minutes on Days 1,2,8,9,15, and 16 every 28 days

Intervention Type DRUG

Cyclophosphamide

PO on days 1, 8, and 15 every 28 days

Intervention Type DRUG

Dexamethasone

40 mg weekly PO or IV on Days 1, 8, 15, and 22, every 28 days.

Intervention Type DRUG

Other Intervention Names

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PR-171 Kyprolis Cytoxan Decadron

Eligibility Criteria

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Inclusion Criteria

* Cytopathologically or histologically confirmed diagnosis of MM
* Measurable disease, as indicated by one or more of the following:
* Serum M-protein ≥ 1.0 g/dL
* Urine Bence Jones protein ≥ 200 mg/24 hr
* Elevated Free Light Chain as per the International Myeloma Working Group (IMWG) criteria
* Males and females ≥ 18 years of age
* Life expectancy of more than 5 months
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
* Adequate hepatic function, with bilirubin \< 2 times the upper limit of normal (ULN), and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3.5 times ULN
* Serum Creatinine Clearance(CrCl) ≥ 30 mL/min, either measured or calculated using a standard formula (e.g. Cockcroft and Gault)
* Additional Laboratory Requirements
* Absolute neutrophil count (ANC) ≥1.0 x 109/L
* Hemoglobin ≥8 g/dL \[transfusion permitted\]
* Platelet count ≥50.0 x 109/L
* Screening ANC should be independent of granulocyte-and granulocyte/macrophage colony stimulating factor (G-CSF and GM-CSF) support for at least 1 week and of pegylated G-CSF for at least 2 weeks
* Patients may receive RBC or platelet transfusions, if clinically indicated, in accordance with institutional guidelines
* Written informed consent in accordance with federal, local, and institutional guidelines
* Patients must agree to practice contraception
* Male patients must agree not to donate semen or sperm.

Exclusion Criteria

* Patients with non-secretory or hyposecretory MM
* Prior treatment for MM (prior radiation therapy or dexamethasone up to 160 mg for spinal cord compression is allowed. Other limited field radiation involving ≤ 1/3 of the pelvic area is also allowed)
* Plasma cell leukemia
* Pregnant or lactating females
* Major surgery within 21 days prior to first dose
* Congestive heart failure (CHF) (New York Heart Association class III to IV), symptomatic ischemia, conduction abnormalities uncontrolled by conventional intervention or myocardial infarction in the previous six months
* Acute active infection requiring systemic antibiotics, antivirals, or antifungals within 14 days prior to first dose
* Patients receiving active treatment or intervention for any other malignancy or patients who, at the Investigator's discretion, may require active treatment or intervention for any other malignancy within 8 months of starting study treatment.
* Serious psychiatric or medical conditions that could interfere with treatment
* Significant neuropathy (Grade 3, Grade 4, or Grade 2 with pain) at the time of the first dose and/or within 14 days before study treatment
* Contraindication to any of the required concomitant drugs, including antiviral (e.g. Valacyclovir) and proton-pump inhibitor (e.g. lansoprazole). Corticosteroid therapy in a dose equivalent to dexamethasone ≥ 1.5 mg/day or prednisone ≥ 10 mg/day. (Steroid use is allowed if necessary to treat spinal cord compression and/or hypocalcaemia.)
* Patients in whom the required program of oral and IV fluid hydration is contraindicated, e.g. due to pre-existing pulmonary, cardiac, or renal impairment
* Patients with primary systemic amyloidosis.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role collaborator

Criterium, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jatin Shah, MD

Role: PRINCIPAL_INVESTIGATOR

AMyC

Brian GM Durie, MD

Role: PRINCIPAL_INVESTIGATOR

AMyC

Locations

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Samuel Oschin Comprehensive Cancer Center at Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

Comprehensive Cancer Center at Desert Regional Medical Center

Palm Springs, California, United States

Site Status

University of Massachusettes Memorial

Worcester, Massachusetts, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Fred Hutchinson Cancer Research Center

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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CAR-IST-520

Identifier Type: OTHER

Identifier Source: secondary_id

AMyC 11-MM-01

Identifier Type: -

Identifier Source: org_study_id