Trial Outcomes & Findings for Ixazomib With Cyclophosphamide and Dexamethasone in Patients With Previously Untreated Symptomatic Multiple Myeloma or Light Chain Amyloidosis (NCT NCT01864018)

NCT ID: NCT01864018

Last Updated: 2025-07-24

Results Overview

Will be defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least 1/3 of patients, as assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

87 participants

Primary outcome timeframe

At 28 days

Results posted on

2025-07-24

Participant Flow

The phase I participants are grouped with the phase II, cohort A participants because they were grouped in the published manuscript

Participant milestones

Participant milestones
Measure
Phase I/II, Cohort A
Patients with Multiple Myeloma\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Overall Study
STARTED
51
36
Overall Study
Accrued During Phase I
10
0
Overall Study
Accrued During Phase II
41
36
Overall Study
COMPLETED
48
35
Overall Study
NOT COMPLETED
3
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Phase I/II, Cohort A
Patients with Multiple Myeloma\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Overall Study
Ineligible
3
1

Baseline Characteristics

Ixazomib With Cyclophosphamide and Dexamethasone in Patients With Previously Untreated Symptomatic Multiple Myeloma or Light Chain Amyloidosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phase I/II, Cohort A
n=48 Participants
Patients with multiple myeloma\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
n=35 Participants
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Total
n=83 Participants
Total of all reporting groups
Age, Continuous
64.5 years
n=5 Participants
67 years
n=7 Participants
65 years
n=5 Participants
Sex: Female, Male
Female
23 Participants
n=5 Participants
11 Participants
n=7 Participants
34 Participants
n=5 Participants
Sex: Female, Male
Male
25 Participants
n=5 Participants
24 Participants
n=7 Participants
49 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
White
46 Participants
n=5 Participants
35 Participants
n=7 Participants
81 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Region of Enrollment
United States
48 participants
n=5 Participants
35 participants
n=7 Participants
83 participants
n=5 Participants
ECOG Performance Status
0
25 Participants
n=5 Participants
16 Participants
n=7 Participants
41 Participants
n=5 Participants
ECOG Performance Status
1
19 Participants
n=5 Participants
17 Participants
n=7 Participants
36 Participants
n=5 Participants
ECOG Performance Status
2
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants

PRIMARY outcome

Timeframe: At 28 days

Population: The 10 patients accrued to the phase I portion of the study were analyzed to determine the maximum tolerated dose of ixazomib with cyclophosphamide and dexamethasone

Will be defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least 1/3 of patients, as assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=10 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Maximum Tolerated (MTD) Dose of Cyclophosphamide With Ixazomib and Dexamethasone (Phase I)
MTD of ixazomib
4 mg weekly
Maximum Tolerated (MTD) Dose of Cyclophosphamide With Ixazomib and Dexamethasone (Phase I)
MTD of dexamethasone
40 mg weekly

PRIMARY outcome

Timeframe: Up to 48 weeks

Population: Includes only eligible patients in phase II, cohort A

The percentage of successes will be estimated by the number of successes divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for the true success proportion will be calculated.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=48 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Percentage of Patients With Complete Response or Very Good Partial Response (Phase II, Cohort A)
35 percentage of participants
Interval 22.0 to 50.0

PRIMARY outcome

Timeframe: Up to 48 weeks

Population: Includes only patients with biopsy proven light chain amyloidosis with organ involvement\>\> requiring therapy at baseline

The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for the true success proportion will be calculated.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=35 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Rate of Complete Response, Very Good Partial Response, or Partial Response (Phase II, Cohort B)
63 percentage of participants
Interval 45.0 to 79.0

PRIMARY outcome

Timeframe: At 28 days

Population: The 10 patients accrued to the phase I portion of the study were analyzed to determine the maximum tolerated dose of ixazomib with cyclophosphamide and dexamethasone

Will be defined as the dose level below the lowest dose that induces dose-limiting toxicity in at least 1/3 of patients, as assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=10 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Maximum Tolerated (MTD) Dose of Cyclophosphamide (Phase I)
400 mg/m² weekly

SECONDARY outcome

Timeframe: Up to 5 years

The maximum grade for each type of adverse event will be recorded for each patient, and frequency tables will be reviewed to determine patterns. Additionally, the relationship of the adverse event(s) to the study treatment will be taken into consideration. Adverse events will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. A grade 3 event is one that is severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=48 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
n=35 Participants
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Number of Patients Experiencing a Grade 3 or Greater Adverse Event at Least Possibly Related to Treatment as Assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
36 Participants
16 Participants

SECONDARY outcome

Timeframe: Time from registration to the earliest date of documentation of disease progression or death due to any cause, assessed up to 5 years

The distribution of PFS will be estimated using the method of Kaplan Meier.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=48 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
n=35 Participants
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Progression-free Survival (PFS)
NA months
Interval 31.3 to
Median and upper 95% CI PFS was not reached due to the low number of progressions (11)
NA months
Interval 39.6 to
Median and upper 95% CI PFS was not reached due to the low number of progressions (5)

SECONDARY outcome

Timeframe: Time from registration to death due to any cause, assessed up to 5 years

The distribution of survival time will be estimated using the method of Kaplan-Meier.

Outcome measures

Outcome measures
Measure
Treatment (Ixazomib Citrate, Cyclophosphamide, Dexamethasone)
n=48 Participants
INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Phase II, Cohort B
n=35 Participants
Patients with biopsy proven light chain amyloidosis with organ involvement\> requiring therapy\> \> INDUCTION THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15 and cyclophosphamide PO and dexamethasone PO on days 1, 8, 15, and 22. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> MAINTENANCE THERAPY: Patients receive ixazomib citrate PO on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.\> \>\> \> \>\> Cyclophosphamide: Given PO\> \>\> \> \>\> Dexamethasone: Given PO\> \>\> \> \>\> Ixazomib Citrate: Given PO\> \>\> \> \>\> Laboratory Biomarker Analysis: Correlative studies\> \>\> \> \>\> Pharmacological Study: Correlative studies\> \>\> \> \>\> Quality-of-Life Assessment: Ancillary studies\> \>\> \> \>\> Questionnaire Administration: Ancillary studies
Survival Time
NA months
Median and 95% CI PFS was not reached due to the low number of deaths (2)
NA months
Median and 95% CI PFS was not reached due to the low number of deaths (7)

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-dose, 1 and 4 hours on day 1, pre-dose on days 8, 15, and 22, and day 1 of course 2

Will be estimated using noncompartmental analysis methods. The plasma PK parameters calculated for individual plasma ixazomib concentration-time data will include, but are not limited to: peak concentration, time to first maximum plasma concentration, and area under the curve. PK parameters will be summarized using descriptive statistics.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 5 years

Patients will be evaluated by overall score at each time point and changes over time will be calculated. These measures will be correlated with outcome using Fisher's exact test and Kaplan-Meier methods where appropriate.

Outcome measures

Outcome data not reported

Adverse Events

Phase I/II, Cohort A

Serious events: 16 serious events
Other events: 48 other events
Deaths: 2 deaths

Phase II, Cohort B

Serious events: 15 serious events
Other events: 35 other events
Deaths: 7 deaths

Serious adverse events

Serious adverse events
Measure
Phase I/II, Cohort A
n=48 participants at risk
Questionnaire Administration: Ancillary studies
Phase II, Cohort B
n=35 participants at risk
Questionnaire Administration: Ancillary studies
Blood and lymphatic system disorders
Anemia
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Cardiac disorders
Atrial fibrillation
2.1%
1/48 • Number of events 1 • 5 years
8.6%
3/35 • Number of events 3 • 5 years
Cardiac disorders
Cardiac arrest
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Cardiac disorders
Chest pain - cardiac
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Cardiac disorders
Heart failure
0.00%
0/48 • 5 years
8.6%
3/35 • Number of events 3 • 5 years
Cardiac disorders
Pericardial effusion
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Cardiac disorders
Pericarditis
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Cardiac disorders
Ventricular tachycardia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Gastrointestinal disorders
Diarrhea
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Gastrointestinal disorders
Gastric hemorrhage
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Gastrointestinal disorders
Pancreatitis
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
General disorders
Death NOS
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
General disorders
Fatigue
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Hepatobiliary disorders
Cholecystitis
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Immune system disorders
Allergic reaction
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Infections and infestations
Infections and infestations - Oth spec
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Infections and infestations
Lung infection
0.00%
0/48 • 5 years
8.6%
3/35 • Number of events 3 • 5 years
Infections and infestations
Skin infection
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Infections and infestations
Upper respiratory infection
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Infections and infestations
Urinary tract infection
2.1%
1/48 • Number of events 1 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Injury, poisoning and procedural complications
Vascular access complication
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Investigations
Alanine aminotransferase increased
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Investigations
Alkaline phosphatase increased
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Investigations
Aspartate aminotransferase increased
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Investigations
Blood bilirubin increased
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Investigations
Lymphocyte count decreased
10.4%
5/48 • Number of events 5 • 5 years
0.00%
0/35 • 5 years
Investigations
Neutrophil count decreased
4.2%
2/48 • Number of events 2 • 5 years
0.00%
0/35 • 5 years
Investigations
Platelet count decreased
2.1%
1/48 • Number of events 2 • 5 years
5.7%
2/35 • Number of events 2 • 5 years
Investigations
Weight gain
2.1%
1/48 • Number of events 12 • 5 years
0.00%
0/35 • 5 years
Investigations
White blood cell decreased
4.2%
2/48 • Number of events 2 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Metabolism and nutrition disorders
Hyperglycemia
4.2%
2/48 • Number of events 3 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Metabolism and nutrition disorders
Hypokalemia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Metabolism and nutrition disorders
Hyponatremia
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Musculoskeletal and connective tissue disorders
Back pain
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Musculoskeletal and connective tissue disorders
Chest wall pain
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Musculoskeletal and connective tissue disorders
Neck pain
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, mal, uncpec - Oth spec
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Nervous system disorders
Leukoencephalopathy
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Nervous system disorders
Peripheral sensory neuropathy
2.1%
1/48 • Number of events 1 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Nervous system disorders
Stroke
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Nervous system disorders
Syncope
0.00%
0/48 • 5 years
5.7%
2/35 • Number of events 2 • 5 years
Renal and urinary disorders
Acute kidney injury
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Renal and urinary disorders
Chronic kidney disease
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Respiratory, thoracic and mediastinal disorders
Bronchial obstruction
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
0.00%
0/48 • 5 years
5.7%
2/35 • Number of events 3 • 5 years
Respiratory, thoracic and mediastinal disorders
Hypoxia
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Respiratory, thoracic and mediastinal disorders
Pleuritic pain
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Respiratory, thoracic and mediastinal disorders
Pneumonitis
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Respiratory, thoracic and mediastinal disorders
Resp, thoracic, mediastinal - Oth spec
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Respiratory, thoracic and mediastinal disorders
Respiratory failure
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Skin and subcutaneous tissue disorders
Rash maculo-papular
4.2%
2/48 • Number of events 2 • 5 years
0.00%
0/35 • 5 years
Vascular disorders
Hypotension
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years

Other adverse events

Other adverse events
Measure
Phase I/II, Cohort A
n=48 participants at risk
Questionnaire Administration: Ancillary studies
Phase II, Cohort B
n=35 participants at risk
Questionnaire Administration: Ancillary studies
Blood and lymphatic system disorders
Anemia
29.2%
14/48 • Number of events 29 • 5 years
5.7%
2/35 • Number of events 3 • 5 years
Blood and lymphatic system disorders
Febrile neutropenia
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Cardiac disorders
Chest pain - cardiac
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 2 • 5 years
Cardiac disorders
Heart failure
2.1%
1/48 • Number of events 5 • 5 years
0.00%
0/35 • 5 years
Ear and labyrinth disorders
Hearing impaired
2.1%
1/48 • Number of events 4 • 5 years
0.00%
0/35 • 5 years
Eye disorders
Cataract
2.1%
1/48 • Number of events 3 • 5 years
0.00%
0/35 • 5 years
Gastrointestinal disorders
Constipation
75.0%
36/48 • Number of events 179 • 5 years
71.4%
25/35 • Number of events 68 • 5 years
Gastrointestinal disorders
Diarrhea
60.4%
29/48 • Number of events 115 • 5 years
42.9%
15/35 • Number of events 48 • 5 years
Gastrointestinal disorders
Duodenal ulcer
2.1%
1/48 • Number of events 2 • 5 years
0.00%
0/35 • 5 years
Gastrointestinal disorders
Dyspepsia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Gastrointestinal disorders
Gastroesophageal reflux disease
2.1%
1/48 • Number of events 2 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Gastrointestinal disorders
Gastrointestinal disorders - Oth spec
4.2%
2/48 • Number of events 2 • 5 years
0.00%
0/35 • 5 years
Gastrointestinal disorders
Nausea
60.4%
29/48 • Number of events 138 • 5 years
62.9%
22/35 • Number of events 66 • 5 years
Gastrointestinal disorders
Vomiting
25.0%
12/48 • Number of events 17 • 5 years
17.1%
6/35 • Number of events 11 • 5 years
General disorders
Edema limbs
2.1%
1/48 • Number of events 2 • 5 years
17.1%
6/35 • Number of events 10 • 5 years
General disorders
Edema trunk
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
General disorders
Fatigue
97.9%
47/48 • Number of events 546 • 5 years
91.4%
32/35 • Number of events 221 • 5 years
General disorders
Pain
2.1%
1/48 • Number of events 4 • 5 years
0.00%
0/35 • 5 years
Infections and infestations
Infections and infestations - Oth spec
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Infections and infestations
Lung infection
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Infections and infestations
Sepsis
6.2%
3/48 • Number of events 4 • 5 years
0.00%
0/35 • 5 years
Infections and infestations
Upper respiratory infection
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Investigations
Alkaline phosphatase increased
2.1%
1/48 • Number of events 3 • 5 years
2.9%
1/35 • Number of events 5 • 5 years
Investigations
CD4 lymphocytes decreased
10.4%
5/48 • Number of events 5 • 5 years
0.00%
0/35 • 5 years
Investigations
Creatinine increased
20.8%
10/48 • Number of events 25 • 5 years
42.9%
15/35 • Number of events 138 • 5 years
Investigations
Lymphocyte count decreased
87.5%
42/48 • Number of events 296 • 5 years
25.7%
9/35 • Number of events 40 • 5 years
Investigations
Lymphocyte count increased
10.4%
5/48 • Number of events 8 • 5 years
5.7%
2/35 • Number of events 2 • 5 years
Investigations
Neutrophil count decreased
60.4%
29/48 • Number of events 138 • 5 years
5.7%
2/35 • Number of events 3 • 5 years
Investigations
Platelet count decreased
64.6%
31/48 • Number of events 86 • 5 years
31.4%
11/35 • Number of events 25 • 5 years
Investigations
White blood cell decreased
87.5%
42/48 • Number of events 230 • 5 years
17.1%
6/35 • Number of events 8 • 5 years
Metabolism and nutrition disorders
Anorexia
4.2%
2/48 • Number of events 3 • 5 years
0.00%
0/35 • 5 years
Metabolism and nutrition disorders
Hyperglycemia
8.3%
4/48 • Number of events 9 • 5 years
5.7%
2/35 • Number of events 3 • 5 years
Metabolism and nutrition disorders
Hyperuricemia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 3 • 5 years
Metabolism and nutrition disorders
Hypoalbuminemia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Metabolism and nutrition disorders
Hypocalcemia
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Metabolism and nutrition disorders
Hypokalemia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Metabolism and nutrition disorders
Hyponatremia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Musculoskeletal and connective tissue disorders
Arthritis
2.1%
1/48 • Number of events 2 • 5 years
0.00%
0/35 • 5 years
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Musculoskeletal and connective tissue disorders
Musculoskeletal, conn tissue - Oth spec
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Musculoskeletal and connective tissue disorders
Myalgia
4.2%
2/48 • Number of events 7 • 5 years
0.00%
0/35 • 5 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, mal, uncpec - Oth spec
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Nervous system disorders
Dysgeusia
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Nervous system disorders
Headache
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Nervous system disorders
Peripheral motor neuropathy
18.8%
9/48 • Number of events 24 • 5 years
8.6%
3/35 • Number of events 4 • 5 years
Nervous system disorders
Peripheral sensory neuropathy
72.9%
35/48 • Number of events 361 • 5 years
54.3%
19/35 • Number of events 91 • 5 years
Psychiatric disorders
Agitation
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Psychiatric disorders
Anxiety
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Psychiatric disorders
Confusion
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Psychiatric disorders
Insomnia
12.5%
6/48 • Number of events 10 • 5 years
22.9%
8/35 • Number of events 18 • 5 years
Psychiatric disorders
Libido decreased
2.1%
1/48 • Number of events 9 • 5 years
0.00%
0/35 • 5 years
Renal and urinary disorders
Hematuria
2.1%
1/48 • Number of events 1 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Renal and urinary disorders
Urinary frequency
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
2.1%
1/48 • Number of events 1 • 5 years
14.3%
5/35 • Number of events 10 • 5 years
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 7 • 5 years
Respiratory, thoracic and mediastinal disorders
Voice alteration
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 2 • 5 years
Skin and subcutaneous tissue disorders
Pruritus
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Skin and subcutaneous tissue disorders
Rash maculo-papular
39.6%
19/48 • Number of events 34 • 5 years
31.4%
11/35 • Number of events 70 • 5 years
Vascular disorders
Hematoma
2.1%
1/48 • Number of events 1 • 5 years
0.00%
0/35 • 5 years
Vascular disorders
Hypotension
0.00%
0/48 • 5 years
2.9%
1/35 • Number of events 1 • 5 years
Vascular disorders
Thromboembolic event
2.1%
1/48 • Number of events 12 • 5 years
5.7%
2/35 • Number of events 7 • 5 years

Additional Information

Shaji Kumar

Mayo Clinic

Phone: 507-284-2511

Results disclosure agreements

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