Melflufen for Elderly Patients With Relapsed Myeloma

NCT ID: NCT06682637

Last Updated: 2025-04-01

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: PHASE2
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-26
• Study Completion Date: 2025-03-26

Brief Summary

This is a pilot study aimed to evaluate the efficacy and tolerability of melflufen plus dexamethasone in elderly patients at second relapse.

Thirty elderly patients at second or subsequent relapse.

Conditions

Relapse Multiple Myeloma

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Melflufen and Dexamethasone

• Melflufen 40 mg total dose (30 mg in patients with body weight ≤60 kg and/or in patients with eGFR<45 mL/min) intravenously on day 1.
• Dexamethasone 10 mg orally or intravenously on day 1-2, 8-9, 15-16, 22-23.

Group Type: EXPERIMENTAL

Melflufen

Intervention Type: DRUG

Pepaxti 20 mg powder for concentrate for solution for infusion

Dexamethasone

Intervention Type: DRUG

SOLDESAM 8 mg/2 ml solution for injection SOLDESAM 0.2% oral drops, solution

Interventions

Melflufen

Pepaxti 20 mg powder for concentrate for solution for infusion

Intervention Type: DRUG

Dexamethasone

SOLDESAM 8 mg/2 ml solution for injection SOLDESAM 0.2% oral drops, solution

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Patients affected by MM progressed or relapsed after 2 or more previous lines of therapy.
• Patient is, in the investigator's opinion, willing and able to comply with the study visits and procedures required per protocol.
• Patient has provided written informed consent in accordance with federal, local, and institutional guidelines prior to initiation of any study-specific activities or procedures. Subject does not have kind of condition that, in the opinion of the Investigator, may compromise the ability of the subject to give written informed consent and patient is, in the investigator(s) opinion, willing and able to comply with the protocol requirements.
• Life expectancy ≥ 3 months
• Previous exposure to, at least, one drug of all the following categories: an anti-CD38 MoAbs, an IMiD, and a proteasome inhibitor.
• Age ≥ 70 and ≤ 85 years.
• ECOG performance status ≤2.
• Subject must have serum monoclonal paraprotein (M-protein) level ≥0.5 g/dL or urine M-protein level ≥200 mg/24 hours, or serum immunoglobulin involved free light chain ≥10 mg/dL and abnormal serum immunoglobulin kappa lambda free light chain ratio.
• LVEF ≥40% as determined by a MUGA scan or ECHO.
• Adequate hepatic function characterized by the following:

oTotal bilirubin ≤1.5 x ULN. oAST ≤2.5 x ULN oALT ≤2.5 x ULN.

• Estimated creatinine clearance ≥30 mL/min (according to the Cockcroft Gault formula, by 24-hour urine collection for creatinine clearance, or per the local institutional standard method).
• Adequate BM function characterized by the following:

• Absolute neutrophil count ≥1.0 × 109/L (use of granulocyte-colony stimulating factors is permitted if completed at least 7 days prior to planned start of dosing).
• Platelet count ≥50 × 109/L (transfusion support is not permitted).
• Hemoglobin ≥8 g/dL (transfusion support is permitted).
• Non-vasectomized male patients agree to practice appropriate methods of birth control

Exclusion Criteria

• Previous exposure to chemotherapy (i.e. melphalan, high-dose melphalan and/or cyclophosphamide) with the exception of patients who have received an autologous stem cell transplantion with a progression free survival of at least 36 month.
• Plasma cell leukemia.
• Systemic amyloid light chain amyloidosis.
• POEMS Syndrome.
• Central Nervous System (CNS) disease localization.
• Subject with another tumor, not including MM, that required ongoing treatment or therapy completed less than 6 months before eligibility confirmation, and considered at substantial risk of relapse in the following 12 months.
• Active HBV, HCV, SARS-CoV2, HIV, or any active, uncontrolled bacterial, fungal, or viral infection. Active infections must be resolved at least 14 days prior to eligibility confirmation.
• Subject has any concurrent medical condition or disease (e.g. active systemic infection) that is likely to interfere with study procedures or results, or that in the opinion of the investigator would constitute a hazard for participating in this study.
• Subject has clinically significant cardiac disease, including:

• Myocardial infarction within 6 months before trial eligibility
• Uncontrolled disease/condition related to or affecting cardiac function (e.g. unstable angina, congestive heart failure, New York Heart Association Class III-IV)
• Clinically significant ECG abnormalities.

• Minimum Eligible Age: 70 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Fondazione EMN Italy Onlus

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

A.O.U. delle Marche

Ancona, , Italy

Ospedale Nuovo di Legnano

Legnano, , Italy

Ospedale Niguarda

Milan, , Italy

Ospedale S. Carlo Borromeo

Milan, , Italy

Policlinico Giaccone Divisione Ematologia e Centro Trapianti di Midollo

Palermo, , Italy

A.O.U. di Parma

Parma, , Italy

A.O.U. Pisana

Pisa, , Italy

I.R.C.C.S. Ospedale Casa Sollievo della Sofferenza

San Giovanni Rotondo, , Italy

A.O.U. Città della Salute e della Scienza di Torino-SSD Clinical trials

Torino, , Italy

Ospedale S. Maria della Misericordia di Udine

Udine, , Italy

Countries

Italy

Other Identifiers

MELISSA

Identifier Type: -

Identifier Source: org_study_id