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Study of Bortezomib and Dexamethasone With or Without Elotuzumab to Treat Relapsed or Refractory Multiple Myeloma

Phase 2
Completed
Conditions
Multiple Myeloma
Interventions
Registration Number
NCT01478048
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The purpose of the study is to determine whether the addition of Elotuzumab to Bortezomib/ Dexamethasone will prolong the time before myeloma worsens \[progression free survival (PFS)\].

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
185
Inclusion Criteria
  • Documented progression from most recent line of therapy

  • Measurable disease

  • 1 to 3 prior lines of therapy

    • Subjects may be proteasome inhibitor naive or have received prior proteasome inhibitor therapy provided all the following criteria are met:

      1. The subject did not discontinue any proteasome inhibitor due to intolerance or grade ≥ 3 toxicity
      2. The subject is not refractory to any proteasome inhibitor, defined as progression during treatment or within 60 days after the last dose
      3. The subject previously achieved a partial response (PR) or better to previous proteasome inhibitor (PI)
Exclusion Criteria
  • Monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma, or Waldenstrom's macroglobulinemia
  • Active plasma cell leukemia
  • Known Human immunodeficiency virus (HIV) infection or active hepatitis A, B, or C

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm A: Elotuzumab + Bortezomib + DexamethasoneElotuzumabOn days of Elotuzumab infusion: Dexamethasone (8mg IV + 8mg Oral) will be administered other days Dexamethasone 20 mg Oral will be administered
Arm A: Elotuzumab + Bortezomib + DexamethasoneBortezomibOn days of Elotuzumab infusion: Dexamethasone (8mg IV + 8mg Oral) will be administered other days Dexamethasone 20 mg Oral will be administered
Arm A: Elotuzumab + Bortezomib + DexamethasoneDexamethasoneOn days of Elotuzumab infusion: Dexamethasone (8mg IV + 8mg Oral) will be administered other days Dexamethasone 20 mg Oral will be administered
Arm B: Bortezomib + DexamethasoneBortezomib-
Arm B: Bortezomib + DexamethasoneDexamethasone-
Primary Outcome Measures
NameTimeMethod
Median Investigator-Assessed Progression-free Survival (PFS) Time (Months) From Randomization to Date of First Tumor Progression or Death Due to Any Cause - Randomized ParticipantsRandomization until 111 events (disease progression or death), up to May 2014, approximately 2 years

PE was planned for after at least 103 events; it was analyzed after 111 events. Response was assessed: Day 1 (± 7 days) of each cycle per modified International Myeloma Working Group (IMWG) criteria; assessed using adequate tumor assessment (ATA) (ie, serum and urine M-protein tests performed within 14 days of each other; imaging if baseline measurable extramedullary plasmacytoma existed). Progression: Any of following: Increase of 25% from lowest response in 1 or more: serum and/or urine M-component; in those without measurable serum and urine M-protein levels, difference between involved and uninvolved free light chain (FLC) levels (absolute increase \> 100 mg/L); Bone marrow plasma cell percentage (≥10%). Definite new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing lesions or plasmacytomas. Development of hypercalcemia attributed solely to the plasma cell proliferative disorder.

1 Year Progression-Free Survival Rate - Randomized ParticipantsYear 1 after last participant was randomized

PFS rate=Percentage probability of participants experiencing no progression or death up to 1 year, estimated using the Kaplan-Meier method. Response assessed by the investigator: Day 1 (± 7 days) of each cycle per modified IMWG criteria; assessed using ATA (ie, serum and urine M-protein tests performed within 14 days of each other; imaging done if baseline measurable extramedullary plasmacytoma existed). Progression: Any of the following: Increase of 25% from lowest response in 1 or more: serum and/or urine M-component; in those without measurable serum and urine M-protein levels, difference between involved and uninvolved FLC levels (absolute increase \> 100 mg/L) ; Bone marrow plasma cell percentage (≥10%). Definite new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing lesions or plasmacytomas. Development of hypercalcemia attributed solely to the plasma cell proliferative disorder.

Number of Investigator-Assessed Progression-free Survival Events From Randomization to Date of First Tumor Progression or Death Due to Any Cause - All Randomized ParticipantsRandomization until 111 events, up to May 2014, approximately 2 years

PE planned for after at least 103 events (progression/death); analyzed at 111 events. Those who neither progressed nor died were censored on the date of last adequate tumor assessment (ATA), which requires both serum and urine M-protein tests. If no post-baseline tumor assessments/no death, then censored on randomization day. Response assessed: Day 1 (± 7 days) each cycle; 30 and 60 days post treatment. Modified IMWG criteria used. Progression: Any of following: Increase of 25% in serum and/or urine M-component; if no measurable serum, urine M-protein levels, then difference between involved and uninvolved free light chain (FLC) levels (absolute increase \> 100 mg/L) ; Bone marrow plasma cell percentage (≥10%). New bone lesions or soft tissue plasmacytomas or increase in size of existing lesions, plasmacytomas. Development of hypercalcemia attributed solely to plasma cell proliferative disorder. First dose occurs within 3 days of randomization.

Secondary Outcome Measures
NameTimeMethod
Investigator-Assessed Objective Response Rate (ORR) - All Randomized ParticipantsRandomization until 111 events, up to May 2014, approximately 2 years

ORR was calculated for participants with a best overall response (BOR) of partial response (PR) or better, including stringent complete response (sCR), complete response (CR), and very good partial response (VGPR). BOR was determined by the investigator based on myeloma tumor assessments using IMWG criteria: CR=Negative immunofixation of serum and urine and disappearance of any soft tissue plasmacytomas, and \< 5% plasma cells in bone marrow; sCR= CR + normal FLC ratio and absence of clonal cells in bone marrow; VGPR=Serum and urine M-protein detectable by immunofixation but not on electrophoresis or ≥90% reduction in serum M-protein level + urine M-protein level \< 100 mg per 24 hour; PR= ≥50% reduction of serum M-protein and reduction in 24-hour urinary M-protein by ≥ 90% or to \< 200 mg per 24 hour. ORR= number of participants responding divided by total number of participants randomized, measured as a percentage.

Median Progression-free Survival Time (Months) From Randomization to Date of First Tumor Progression or Death Due to Any Cause, in Randomized Participants With at Least One FcγRIIIa V AlleleRandomization until 111 events, up to May 2014, approximately 2 years

PE was planned for after at least 103 events; it was analyzed after 111 events. Response was assessed: Day 1 (± 7 days) of each cycle per modified IMWG criteria; assessed using adequate tumor assessment (ATA) (ie, serum and urine M-protein tests performed within 14 days of each other; imaging if baseline measurable extramedullary plasmacytoma existed). Progression: Any of following: Increase of 25% from lowest response in 1 or more: serum and/or urine M-component; in those without measurable serum and urine M-protein levels, difference between involved and uninvolved FLC levels (absolute increase \> 100 mg/L); Bone marrow plasma cell percentage (≥10%). Definite new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing lesions or plasmacytomas. Development of hypercalcemia attributed solely to the plasma cell proliferative disorder. Randomized participants with at least 1 FcγRIIIa V allele were a sub-set of all randomized participants.

Investigator-Assessed Objective Response Rate in Randomized Participants With at Least One FcγRIIIa V AlleleRandomization until 111 events, up to May 2014, approximately 2 years

ORR was calculated for participants with a BOR of PR or better, sCR, CR, and VGPR. BOR was determined by the investigator based on myeloma tumor assessments using IMWG criteria: CR=Negative immunofixation of serum and urine and disappearance of any soft tissue plasmacytomas, and \< 5% plasma cells in bone marrow; sCR= CR + normal FLC ratio and absence of clonal cells in bone marrow; VGPR=Serum and urine M-protein detectable by immunofixation but not on electrophoresis or ≥90% reduction in serum M-protein level + urine M-protein level \< 100 mg per 24 hour; PR= ≥50% reduction of serum M-protein and reduction in 24-hour urinary M-protein by ≥ 90% or to \< 200 mg per 24 hour. ORR= number of participants responding divided by total number of participants randomized, measured as a percentage. Randomized participants with at least 1 FcγRIIIa V allele were a sub-set of all randomized participants.

Trial Locations

Locations (31)

Cancer Center Of Acadiana

🇺🇸

Lafayette, Louisiana, United States

Medical University Of South Carolina

🇺🇸

Charleston, South Carolina, United States

Ucla Department Of Medicine

🇺🇸

Los Angeles, California, United States

University Of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Local Institution

🇪🇸

Zaragoza, Spain

Pikeville Medical Center Leonard Lawson Cancer Center

🇺🇸

Pikeville, Kentucky, United States

Compassionate Cancer Res Grp

🇺🇸

Corona, California, United States

Mercy Medical Research Institute

🇺🇸

Springfield, Missouri, United States

Waverly Hematology Oncology

🇺🇸

Cary, North Carolina, United States

St. Agnes Hospital

🇺🇸

Baltimore, Pennsylvania, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

The Western Pennsylvania Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Cancer Care Associates

🇺🇸

Bethlehem, Pennsylvania, United States

Washington University School Of Medicine

🇺🇸

Saint Louis, Missouri, United States

Sharp Clinical Oncology Research

🇺🇸

San Diego, California, United States

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

Southern Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

Northwest Cancer Center

🇺🇸

Houston, Texas, United States

USC Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

Medical Oncology Care Associates

🇺🇸

Orange, California, United States

Cancer Specialists of North FL

🇺🇸

Jacksonville, Florida, United States

Mount Sinai Comprehensive Cancer Center

🇺🇸

Miami Beach, Florida, United States

Kaiser Permanente-Moanalua Medical Center

🇺🇸

Honolulu, Hawaii, United States

Palm Beach Cancer Institute

🇺🇸

West Palm Beach, Florida, United States

Oncology Specialists, S.C.

🇺🇸

Park Ridge, Illinois, United States

University Of Kentucky Markey Cancer Center

🇺🇸

Lexington, Kentucky, United States

Investigative Clinical Research Of Indiana, Llc

🇺🇸

Indianapolis, Indiana, United States

Kaiser Permanente Medical Center

🇺🇸

Vallejo, California, United States

Penn State Hershey Cancer Institute

🇺🇸

Hershey, Pennsylvania, United States

Penn State Hershey Cancer Inst

🇺🇸

Hershey, Pennsylvania, United States

Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

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