Trial of Immunomodulatory Therapy in High Risk Solitary Bone Plasmacytoma

NCT ID: NCT02544308

Last Updated: 2022-12-23

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-10

Study Completion Date

2026-12-31

Brief Summary

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The purpose of the trial is to establish whether adjuvant therapy with lenalidomide + dexamethasone after radiotherapy can improve progression free survival in patients with high risk solitary bone plasmacytoma compared with RT only.

Detailed Description

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Solitary bone plasmacytoma (SBP) is a localised proliferation of malignant plasma cells (PCs) in the skeleton. The annual UK incidence is 0.4/100,000 (lower than multiple myeloma (MM)) with a peak age incidence at 68 years and there are estimated to be about 260 new cases per year in the United Kingdom (UK). The majority of patients with SBP ultimately progress to myeloma and this is likely due to occult disease not detected by conventional staging methods. Standard care for these patients is involved field radiotherapy (IFRT), but despite radical doses, two-thirds develop multiple myeloma at a median of 2 years, more so if there are high risk features.

The IDRIS Trial is a phase III study where the investigators hope to demonstrate that adjuvant lenalidomide + dexamethasone following IFRT prevents the development of multiple myeloma in patients with high risk solitary bone plasmacytoma. Whilst a proportion of solitary bone plasmacytoma is cured with IFRT, it is clear that the majority will progress to multiple myeloma. The investigators are seeking to prevent this outcome by using adjuvant therapy in this study.

Conditions

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Plasmacytoma

Keywords

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Solitary, Bone

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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No further treatment

No further treatment

Group Type ACTIVE_COMPARATOR

No further treatment

Intervention Type OTHER

Comparator Arm

Lenalidomide + Dexamethasone

Lenalidomide 25mg orally daily on days 1-21 Dexamethasone 20mg orally on days 1, 8, 15 \& 22 Up to 9 cycles

Group Type EXPERIMENTAL

Lenalidomide

Intervention Type DRUG

Experimental Arm

Dexamethasone

Intervention Type DRUG

Experimental Arm

Interventions

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Lenalidomide

Experimental Arm

Intervention Type DRUG

Dexamethasone

Experimental Arm

Intervention Type DRUG

No further treatment

Comparator Arm

Intervention Type OTHER

Other Intervention Names

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Revlimid

Eligibility Criteria

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Inclusion Criteria

* Patients with newly-diagnosed SBP
* SBP treated with local radiotherapy with curative intent (see appendix 2).
* Radiotherapy completed within 28 days of registration
* Age ≥18 years
* ECOG performance status 0-2
* Written informed consent
* Willing to comply with the requirements of the Celgene pregnancy prevention programme

Exclusion Criteria

* Multifocal plasmacytoma, solitary extramedullary plasmacytoma or myeloma
* ≥10% bone marrow plasma cells
* Clinical suspicion of failure to respond to radiotherapy
* Receiving or intention to treat with systemic corticosteroid therapy (e.g. dexamethasone or prednisolone) unless otherwise agreed by the TMG
* Severe hepatic impairment (bilirubin \>2xULN or AST/ALT \>2xULN)
* Creatinine clearance \< 30 mL/min
* Pregnant or lactating women
* Non-haematological malignancy within the past 3 years (exceptions apply - see section 6.2.2)
* Patients at a high risk of venous thromboembolism due to:
* Treatment with erythropoietic stimulating agents (e.g. erythropoietin, epoetin alpha, epoetin beta, darbepoetin alfa, methoxy polyethylene glycol-epoetin beta)
* Other risk factors not listed above and unable to receive thromboprophylaxis
* Patients with untreated osteoporosis
* Patients with uncontrolled diabetes
* Patients with a known history of glaucoma
* Any other medical or psychiatric condition likely to interfere with study participation
* Receiving treatment with an experimental drug or experimental medical device. Concurrent participation in non-treatment studies is allowed, if it will not interfere with participation in this study. Any experimental drug treatments must be stopped at least 4 weeks before planned start of lenalidomide and dexamethasone.
* Evidence of current or past hepatitis B infection. Patient should test negative for both surface antigen (HBsAg) and hepatitis B core antibody (HBcAb)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cancer Research UK

OTHER

Sponsor Role collaborator

Celgene

INDUSTRY

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Roger Owen

Role: PRINCIPAL_INVESTIGATOR

St James's University Hospital

Locations

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Royal United Hospital

Bath, , United Kingdom

Site Status

Blackpool Victoria Hospital

Blackpool, , United Kingdom

Site Status

University Hospital Wales

Cardiff, , United Kingdom

Site Status

Velindre Cancer Centre

Cardiff, , United Kingdom

Site Status

Beatson West of Scotland Cancer Centre

Glasgow, , United Kingdom

Site Status

St James University Hospital

Leeds, , United Kingdom

Site Status

University College London Hospital

London, , United Kingdom

Site Status

The Christie Hospital

Manchester, , United Kingdom

Site Status

Freeman Hospital

Newcastle, , United Kingdom

Site Status

Mount Vernon Cancer Centre

Northwood, , United Kingdom

Site Status

Royal Preston Hospital

Preston, , United Kingdom

Site Status

Salisbury District Hospital

Salisbury, , United Kingdom

Site Status

Southampton General Hospital

Southampton, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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UCL/13/0291

Identifier Type: -

Identifier Source: org_study_id