Status:

UNKNOWN

High-Dose Melphalan and a Second Stem Cell Transplant or Low-Dose Cyclophosphamide in Treating Patients With Relapsed Multiple Myeloma After Chemotherapy

Lead Sponsor:

Leeds Cancer Centre at St. James's University Hospital

Conditions:

Multiple Myeloma and Plasma Cell Neoplasm

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

RATIONALE: Giving chemotherapy and bortezomib before a peripheral stem cell transplant stops the growth of cancer cells by stopping them from dividing or killing them. Giving colony-stimulating factor...

Detailed Description

OBJECTIVES: Primary * To determine the effect on freedom from disease progression in patients with relapsed multiple myeloma treated with re-induction therapy comprising bortezomib, doxorubicin hydr...

Eligibility Criteria

Inclusion

  • DISEASE CHARACTERISTICS:
  • Diagnosis of relapsed multiple myeloma
  • Symptomatic disease, including non-secretory
  • Previously treated with standard chemotherapy and autologous stem cell transplantation
  • Requires therapy for first progressive disease AND at least 18 months since first stem cell transplantation
  • Patients who were previously immunofixation-negative and are now immunofixation-positive must have \> 5 g/L absolute increase in paraprotein
  • Registered in the Myeloma X Relapse (Intensive) Trial and received 2-4 courses of PAD re-induction chemotherapy according to the protocol (consolidation phase)
  • Adequate stem cell mobilization available for transplantation defined as ≥ 2x10\^6 CD34 + cells/kg or ≥ 2x10\^8 PBMC/kg including cells stored from a previous harvest (consolidation phase)
  • PATIENT CHARACTERISTICS:
  • ECOG performance status 0-2
  • ANC ≥ 1 x 10\^9/L
  • Platelet count ≥ 50 x 10\^9/L
  • Creatinine clearance ≥ 30 mL/min
  • Total bilirubin \< 2 times upper limit of normal (ULN)
  • ALT or AST \< 2.5 times ULN
  • History of pulmonary disease allowed provided carbon monoxide diffusion in the lungs (KCO/DLCO) is ≥ 50% and/or no requirement for supplementary continuous oxygen
  • Left ventricular ejection fraction ≥ 40% by ECG or MUGA scan
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after completion of study treatment
  • No peripheral neuropathy ≥ grade 2
  • No known HIV or Hepatitis B or C positivity (testing is not required)
  • No known resistance to combined bortezomib, doxorubicin hydrochloride, and dexamethasone therapy
  • No known history of allergy to compounds containing boron or mannitol
  • No other previous or concurrent malignancies except for appropriately treated localized epithelial skin cancer or carcinoma in situ of the cervix, or remote histories of other cured tumors within the past 5 years
  • No medical or psychiatric condition which, in the opinion of the investigator, contraindicates the patient's participation in the study
  • No other contra-indication to treatment that would make the patient ineligible for consolidation phase
  • PRIOR CONCURRENT THERAPY:
  • See Disease Characteristics
  • No other prior therapy for relapsed disease except for local radiotherapy, therapeutic plasma exchange, or ≤ 200 mg of dexamethasone
  • Radiotherapy since prior transplantation sufficient to alleviate or control pain of local invasion is permitted
  • No hemi-body radiation since prior transplantation (consolidation phase)
  • At least 4 weeks since prior and no concurrent investigational drugs

Exclusion

    Key Trial Info

    Start Date :

    April 1 2008

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    Estimated Enrollment :

    460 Patients enrolled

    Trial Details

    Trial ID

    NCT00747877

    Start Date

    April 1 2008

    Last Update

    August 12 2013

    Active Locations (53)

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    Page 1 of 14 (53 locations)

    1

    Basingstoke and North Hampshire NHS Foundation Trust

    Basingstoke, England, United Kingdom, RG24 9NA

    2

    Queen Elizabeth Hospital at University Hospital of Birmingham NHS Trust

    Birmingham, England, United Kingdom, B15 2TH

    3

    Birmingham Heartlands Hospital

    Birmingham, England, United Kingdom, B9 5SS

    4

    Royal Bournemouth Hospital

    Bournemouth, England, United Kingdom, BH7 7DW