Trial Outcomes & Findings for Study of Bendamustine and IXAZOMIB (MLN9708) Plus Dexamethasone in Relapsed/Refractory Multiple Myeloma (NCT NCT02477215)

NCT ID: NCT02477215

Last Updated: 2020-10-22

Results Overview

Maximum tolerated dose of bendamustine in combination with fixed doses of ixazomib (MLN9708) and dexamethasone will be determined from the incidence of dose limiting toxicities at each dosage.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

38 participants

Primary outcome timeframe

Six months for each dosing cohort

Results posted on

2020-10-22

Participant Flow

Participant milestones

Participant milestones
Measure
Bendamustine (70 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 70 mg/m\^2 days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Dose Escalation Phase
STARTED
4
8
6
Dose Escalation Phase
COMPLETED
3
6
6
Dose Escalation Phase
NOT COMPLETED
1
2
0
Fixed Dose Phase
STARTED
0
20
0
Fixed Dose Phase
COMPLETED
0
13
0
Fixed Dose Phase
NOT COMPLETED
0
7
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Bendamustine (70 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 70 mg/m\^2 days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Dose Escalation Phase
Physician Decision
1
2
0
Fixed Dose Phase
Physician Decision
0
7
0

Baseline Characteristics

Study of Bendamustine and IXAZOMIB (MLN9708) Plus Dexamethasone in Relapsed/Refractory Multiple Myeloma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Dose Escalation Phase: Bendamustine (70 mg/m^2), MLN9708, Dex.
n=4 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 70 mg/m\^2 days 1 and 2
Dose Escalation Phase: Bendamustine (80 mg/m^2), MLN9708, Dex.
n=8 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 80 mg/m\^2 days 1 and 2
Dose Escalation Phase: Bendamustine (90 mg/m^2), MLN9708, Dex.
n=6 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 90 mg/m\^2 days 1 and 2
Fixed Dose Phase
n=20 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 80 mg/m\^2 days 1 and 2
Total
n=38 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
n=5 Participants
2 Participants
n=7 Participants
1 Participants
n=5 Participants
10 Participants
n=4 Participants
14 Participants
n=21 Participants
Age, Categorical
>=65 years
3 Participants
n=5 Participants
6 Participants
n=7 Participants
5 Participants
n=5 Participants
10 Participants
n=4 Participants
24 Participants
n=21 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
15 Participants
n=21 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
6 Participants
n=7 Participants
2 Participants
n=5 Participants
13 Participants
n=4 Participants
23 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
1 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants
n=5 Participants
8 Participants
n=7 Participants
6 Participants
n=5 Participants
19 Participants
n=4 Participants
37 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 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
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
7 Participants
n=4 Participants
8 Participants
n=21 Participants
Race (NIH/OMB)
White
4 Participants
n=5 Participants
7 Participants
n=7 Participants
5 Participants
n=5 Participants
13 Participants
n=4 Participants
29 Participants
n=21 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Region of Enrollment
United States
4 participants
n=5 Participants
8 participants
n=7 Participants
6 participants
n=5 Participants
20 participants
n=4 Participants
38 participants
n=21 Participants

PRIMARY outcome

Timeframe: Six months for each dosing cohort

Population: All participants received at least ne dose of Bendamustine at either 70 mg/m\^2, 80 mg\^2 or 90 mg/m\^2.

Maximum tolerated dose of bendamustine in combination with fixed doses of ixazomib (MLN9708) and dexamethasone will be determined from the incidence of dose limiting toxicities at each dosage.

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=15 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Maximum Tolerated Dose of Bendamustine
80 mg/m^2

PRIMARY outcome

Timeframe: 18 months

Population: Subjects receiving the fixed dose of 80 mg/m\^2 Bendamustine were included in this analysis. Results from five of the subjects in the Dose Escalation Phase of this study who also received 80 mg/m\^2 Bendamustine were included in the analysis. One of the Dose Expansion Phase subjects did not complete sufficient dosing cycles for inclusion.

Objective response rate was defined as the number of subjects achieving a complete response (CR) or partial response (PR) after at least four cycles of ixazomib (MLN9708) and bendamustine plus dexamethasone.

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=18 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Objective Response Rate
11 participants

SECONDARY outcome

Timeframe: 36 months

Population: Subjects receiving the fixed dose of 80 mg/m\^2 Bendamustine were included in this analysis. Results from five of the subjects in the Dose Escalation Phase of this study who also received 80 mg/m\^2 Bendamustine were included in the analysis. One of the Dose Expansion Phase subjects did not complete sufficient dosing cycles for inclusion.

Overall survival was determined as the average number of months subjects survived following enrollment.

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=18 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Overall Survival (OS)
23.2 MONTHS
Interval 16.3 to 30.07

SECONDARY outcome

Timeframe: 18 months

Population: For this analysis, all 20 participants who received the fixed dose of 80 mg/m\^2 Bendamustine and all 8 participants who received Bendamustine (80 mg/m\^2) in the Dose Escalation phase, were combined.

This measure is the number of months participants remain free from evidence of disease.

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=28 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Progression Free Survival (PFS)
5.2 MONTHS
Interval 1.96 to 8.3

SECONDARY outcome

Timeframe: 18 months

Population: Subjects receiving the fixed dose of 80 mg/m\^2 Bendamustine were included in this analysis. Results from five of the subjects in the Dose Escalation Phase of this study who also received 80 mg/m\^2 Bendamustine were included in the analysis. One of the Dose Expansion Phase subjects did not complete sufficient dosing cycles for inclusion.

Percentage of subject response rates at any point during the eight cycles.

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=18 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Cumulative Response Rates in Patients After Eight Cycles.
28 percentage of participants

SECONDARY outcome

Timeframe: 36 months

Population: Subjects receiving the fixed dose of 80 mg/m\^2 Bendamustine were included in this analysis. Results from five of the subjects in the Dose Escalation Phase of this study who also received 80 mg/m\^2 Bendamustine were included in the analysis. One of the Dose Expansion Phase subjects did not complete sufficient dosing cycles for inclusion.

Median time in months participants maintain CR, PR or stable disease.

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=18 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Duration of Response (DoR)
5.1 MONTHS
Interval 1.0 to 5.2

SECONDARY outcome

Timeframe: Six months

A 3+3 design was employed. At each dose, three patients were initially evaluated. If no dose limiting toxicities were observed, the bendamustine dose was increased; if one dose limiting toxicity is observed, three additional patients were treated at that dose. A dose at which 2 DLTs were observed in 3 or 6 patients were judged to be too toxic and the lower dose was defined as the maximally tolerated dose (MTD).

Outcome measures

Outcome measures
Measure
MLN9708, Bendamustine and Dexamethasone
n=3 Participants
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine:70 mg/m\^2, 80 mg/m\^2, or 90 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708, Dexamethasone
n=6 Participants
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 80 mg/m\^2 days 1 and 2
Bendamustine (90 mg/m^2), MLN9708, Dexamethasone
n=6 Participants
MLN9708 : 4 mg, days 1, 8, 15. Dexamethasone: 40 mg oral weekly. Bendamustine: 90 mg/m\^2 days 1 and 2
Number of Participants Experiencing Dose-Limiting Toxicity (DLT)
0 Participants
1 Participants
2 Participants

Adverse Events

Bendamustine (70 mg/m^2), MLN9708 and Dexamethasone

Serious events: 2 serious events
Other events: 0 other events
Deaths: 2 deaths

Bendamustine (80 mg/m^2), MLN9708 and Dexamethasone

Serious events: 8 serious events
Other events: 0 other events
Deaths: 8 deaths

Bendamustine (90 mg/m^2), MLN9708 and Dexamethasone

Serious events: 0 serious events
Other events: 0 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Bendamustine (70 mg/m^2), MLN9708 and Dexamethasone
n=3 participants at risk
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 70 mg/m\^2 on days 1 and 2
Bendamustine (80 mg/m^2), MLN9708 and Dexamethasone
n=19 participants at risk
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 80 mg/m\^2 on days 1 and 2. This reporting group includes subjects from both the Dose Escalation and Fixed Dose Phases who received Bendamustine at 80 mg/m\^2.
Bendamustine (90 mg/m^2), MLN9708 and Dexamethasone
n=6 participants at risk
MLN9708: 4 mg of MLN9708 delivered on days 1, 8 and 15 of a 28 day cycle. Dexamethasone: 40 mg oral on Days 1, 8, 15 of each 28 day cycle. Bendamustine: 90 mg/m\^2 on days 1 and 2
Gastrointestinal disorders
Fecal incontinence
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Renal and urinary disorders
Urinary incontinence
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Cardiac disorders
Mobitz type 1
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
General disorders
Non-cardiac chest pain
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Infections and infestations
Sepsis
0.00%
0/3 • 3 years
10.5%
2/19 • Number of events 2 • 3 years
0.00%
0/6 • 3 years
Injury, poisoning and procedural complications
Fall
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Respiratory, thoracic and mediastinal disorders
Respiratory failure
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Gastrointestinal disorders
Colitis
0.00%
0/3 • 3 years
10.5%
2/19 • Number of events 2 • 3 years
0.00%
0/6 • 3 years
Respiratory, thoracic and mediastinal disorders
Pneumonitis
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Musculoskeletal and connective tissue disorders
Pain in extremity
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Respiratory, thoracic and mediastinal disorders
Exacerbated COPD
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Infections and infestations
Lung infection
33.3%
1/3 • Number of events 1 • 3 years
0.00%
0/19 • 3 years
0.00%
0/6 • 3 years
Gastrointestinal disorders
Nausea
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Gastrointestinal disorders
Vomiting
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
General disorders
Fever
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Investigations
Creatinine increased
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Renal and urinary disorders
Hematuria
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Gastrointestinal disorders
Diarrhea
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Psychiatric disorders
Suicidal ideation
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Gastrointestinal disorders
Gastric hemorrhage
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Vascular disorders
Thromboembolic event
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
General disorders
Edema limbs
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Progressive disease
0.00%
0/3 • 3 years
5.3%
1/19 • Number of events 1 • 3 years
0.00%
0/6 • 3 years
Blood and lymphatic system disorders
Anemia
33.3%
1/3 • Number of events 1 • 3 years
0.00%
0/19 • 3 years
0.00%
0/6 • 3 years

Other adverse events

Adverse event data not reported

Additional Information

Parameswaran Hari

Medical College of Wisconsin

Phone: 414-805-4600

Results disclosure agreements

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