Allogeneic Stem Cell Transplantation vs. Conventional Therapy as Salvage Therapy for Relapsed / Progressive Patients With Multiple Myeloma After First-line Therapy

NCT ID: NCT05675319

Last Updated: 2026-01-05

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

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-03

Study Completion Date

2025-03-21

Brief Summary

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Allogeneic stem cell (allo SCT) transplantation for multiple myeloma is a potential curative treatment, but is associated with morbidity and treatment related mortality. Approved drug combinations or another autologous stem cell transplantation (auto-SCT) can be used for relapsed patients resulting in a median progression free survival up to 2-3 years.

In the current trial after first-line treatment relapsed or progressed myeloma patients with an HLA compatible donor will be randomized after 3 cycles of salvage therapy to allogeneic stem cell transplantation or to continuous conventional salvage therapy.

Detailed Description

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The primary objective of the present clinical study aims to demonstrate the superiority of allogeneic stem cell transplantation (allo SCT) compared to conventional therapy for the difference in overall survival (OS) at 5 years in patients with multiple myeloma who have relapsed or progressed after first-line autologous hematopoietic stem cell therapy.

The secondary objectives are to show an improvement of progression free survival and relapse free survival after allo SCT compared to conventional therapy.

In addition, quality of life, toxicities, recurrence rates, non-relapse mortality (NRM), remission rates including minimal residual disease (MRD) and incidence of severe or life-threatening infection between the two arms are compared. Acute and chronic graft-versus-host disease (GvHD) after allo SCT are evaluated.

Conditions

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Multiple Myeloma

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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Arm A (allo SCT)

Allogeneic stem cell transplantation

Group Type EXPERIMENTAL

Allogeneic Stem Cells

Intervention Type DRUG

Allogeneic Stem Cell Transplantation

Arm B (conventional therapy)

Currently approved triple regimens for first relapse:

* carfilzomib/lenalidomide/dexamethasone (KRD) or
* elotuzumab/lenalidomide/dexamethasone (ERD) or
* daratumumab/bortezomib/dexamethasone DVD) or
* daratumumab/lenalidomide/dexamethasone (DRD) or
* ixazomib/lenalidomide/dexamethasone (IRD) or
* pomalidomide/bortezomib/dexamethasone (PVD) or
* carfilzomib/daratumumab/dexamethasone (KDD) or
* daratumumab/pomalidomide/dexamethasone (DPD) or
* isatuximab/carfilzomib/dexamethasone (Isa-KD) or
* selinexor/bortezomib/dexamethasone (SVD)

Alternatively, autologous stem cell transplantation may also be performed, if sufficient stem cells are still cryopreserved.

Group Type ACTIVE_COMPARATOR

carfilzomib/lenalidomide/dexamethasone (KRD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest Summary of Product Characteristics (SmPC) version

elotuzumab/lenalidomide/dexamethasone (ERD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

daratumumab/bortezomib/dexamethasone (DVD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

daratumumab/lenalidomide/dexamethasone (DRD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

ixazomib/lenalidomide/dexamethasone (IRD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

pomalidomide/bortezomib/dexamethasone (PVD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

carfilzomib/daratumumab/dexamethasone (KDD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

Autologous Stem Cells

Intervention Type DRUG

Autologous Stem Cell Transplantation

daratumumab/pomalidomide/dexamethasone (DPD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

isatuximab/carfilzomib/dexamethasone (Isa-KD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

selinexor/bortezomib/dexamethasone (SVD)

Intervention Type DRUG

triple regimen for first relapse should be applied according to latest SmPC version

Interventions

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Allogeneic Stem Cells

Allogeneic Stem Cell Transplantation

Intervention Type DRUG

carfilzomib/lenalidomide/dexamethasone (KRD)

triple regimen for first relapse should be applied according to latest Summary of Product Characteristics (SmPC) version

Intervention Type DRUG

elotuzumab/lenalidomide/dexamethasone (ERD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

daratumumab/bortezomib/dexamethasone (DVD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

daratumumab/lenalidomide/dexamethasone (DRD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

ixazomib/lenalidomide/dexamethasone (IRD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

pomalidomide/bortezomib/dexamethasone (PVD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

carfilzomib/daratumumab/dexamethasone (KDD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

Autologous Stem Cells

Autologous Stem Cell Transplantation

Intervention Type DRUG

daratumumab/pomalidomide/dexamethasone (DPD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

isatuximab/carfilzomib/dexamethasone (Isa-KD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

selinexor/bortezomib/dexamethasone (SVD)

triple regimen for first relapse should be applied according to latest SmPC version

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Patients eligible for study inclusion must meet criteria 1- 7 at registration and all of the following criteria before randomization:

1. Multiple Myeloma
2. Age 18 - 65 years
3. A signed informed consent form must be obtained before participation in the study
4. Age 66 - 70 years, if comorbidity index according to Sorror score = 0 and ECOG ≤ 1
5. 1st relapse/ progression according to IMWG criteria after first-line therapy (consisting of induction therapy followed by autologous transplantation once or twice and maintenance therapy), Additionally: meeting the need for treatment based on the SLiM-CRAB-criteria
6. Negative pregnancy test in female patients
7. Maximum of 1 cycle salvage therapy prior to study inclusion
8. Availability of a fully compatible stem cell donor (HLA-ident. Sibling or 10/10 MUD or 9/10 MMUD if mismatch affects DQB) after 3 cycles salvage therapy
9. CR/PR or SD according to IMWG-criteria after 3 cycles salvage therapy within the study

Exclusion Criteria

Patients are excluded from the study if any one of criteria 1-6 are met at registration and if criterion 7 is met before randomization:

1. Non-sufficient organ function defined as:

Bilirubin (in the absence of Meulengracht's disease), SGPT or SGOT ≥3 higher than normal values Cardiac ejection fraction ≤ 50% GFR \< 30 ml/min DLCO \< 35 % or continuous oxygen dependency
2. Active hepatitis B or C infection or uncontrolled HIV infection
3. Other, active malignant disease
4. Prior treatment with allogeneic stem cells
5. Participation in a clinical trial or taking an IMP within 30 days or five times the half-life of the IMP, whichever is longer, prior to registration
6. Positive serum pregnancy test at screening and before first treatment or breastfeeding
7. PD under salvage therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gemeinsamer Bundesausschuss (G-BA)

UNKNOWN

Sponsor Role collaborator

Staburo GmbH

INDUSTRY

Sponsor Role collaborator

Universitätsklinikum Hamburg-Eppendorf

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Francis Ayuk, Prof. Dr. med.

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Hamburg-Eppendorf, Department of Stem Cell Transplantation

Locations

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University Hospital of Freiburg

Freiburg im Breisgau, Baden-Wurttemberg, Germany

Site Status

University Hospital Heidelberg

Heidelberg, Baden-Wurttemberg, Germany

Site Status

Robert-Bosch Hospital Stuttgart

Stuttgart, Baden-Wurttemberg, Germany

Site Status

University Hospital Tübingen

Tübingen, Baden-Wurttemberg, Germany

Site Status

University Hospital of Ulm

Ulm, Baden-Wurttemberg, Germany

Site Status

University Hospital Augsburg

Augsburg, Bavaria, Germany

Site Status

University Hospital Munich ( LMU)

München, Bavaria, Germany

Site Status

University Hospital of the Technical University Munich rechts der Isar

München, Bavaria, Germany

Site Status

Hospital North Nürnberg

Nuremberg, Bavaria, Germany

Site Status

University Hospital Regensburg

Regensburg, Bavaria, Germany

Site Status

University Hospital of Würzburg

Würzburg, Bavaria, Germany

Site Status

Asklepios Hospital Hamburg St. Georg

Hamburg, Hamburg, Germany

Site Status

University Medical Center Hamburg-Eppendorf

Hamburg, Hamburg, Germany

Site Status

University Hospital Frankfurt/ Main

Frankfurt am Main, Hesse, Germany

Site Status

Philipps University Marburg

Marburg, Hesse, Germany

Site Status

University Medical Center Göttingen

Göttingen, Lower Saxony, Germany

Site Status

University Hospital RWTH Aachen

Aachen, North Rhine-Westphalia, Germany

Site Status

University Hospital Bonn

Bonn, North Rhine-Westphalia, Germany

Site Status

University Hospital Düsseldorf

Düsseldorf, North Rhine-Westphalia, Germany

Site Status

University Hospital Essen

Essen, North Rhine-Westphalia, Germany

Site Status

University Hospital Münster

Münster, North Rhine-Westphalia, Germany

Site Status

Hospital Oldenburg (AöR)

Oldenburg, Oldenburg, Germany

Site Status

University Medical Center Mainz

Mainz, Rhineland-Palatinate, Germany

Site Status

Hospital of Chemnitz gGmbH

Chemnitz, Saxony, Germany

Site Status

University Hospital Carl Gustav Carus

Dresden, Saxony, Germany

Site Status

University Hospital Halle (Saale)

Halle, Saxony-Anhalt, Germany

Site Status

University Hospital of Schleswig-Holstein (Campus Kiel)

Kiel, Schleswig-Holstein, Germany

Site Status

Charité - University of Medicine Berlin

Berlin, State of Berlin, Germany

Site Status

Helios Hospital Berlin-Buch

Berlin, State of Berlin, Germany

Site Status

University Hospital Jena

Jena, Thuringia, Germany

Site Status

Countries

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Germany

References

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Glockner A, Schonland S, Einsele H, Kroger N. Rationale and design of the multicenter, national, randomized, open labeled phase III trial: allogeneic stem cell transplantation as a potential curative treatment for patients with relapsed or progressed multiple myeloma (AlloRelapseMM Study). BMC Cancer. 2025 Jan 27;25(1):147. doi: 10.1186/s12885-025-13503-7.

Reference Type DERIVED
PMID: 39865222 (View on PubMed)

Related Links

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Other Identifiers

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AlloRelapseMMStudy

Identifier Type: -

Identifier Source: org_study_id

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