A Study of Granix to Disrupt the Bone Marrow Microenvironment in Patients With Multiple Myeloma Undergoing Autologous Stem Cell Transplantation
Trial Snapshot
- Phase
- Phase 2
- Status
- Terminated
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Number of Participants With Complete Response or Stringent Complete Response
Study Overview
Brief Summary
This randomized phase II trial compares how well adding XMO2 Filgrastim (Granix) to melphalan before a stem cell transplant works in treating patients with multiple myeloma. Chemotherapy drugs, such as melphalan, are given to prepare the bone marrow for the stem cell transplant. Giving colony-stimulating factors, such as XMO2 Filgrastim (Granix), may help multiple myeloma cells move from the patient's bone marrow to the blood where they may be more sensitive to treatment with melphalan. It is not yet known whether adding XMO2 Filgrastim (Granix) to melphalan before a stem cell transplant will work better than melphalan alone in treating multiple myeloma
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Symptomatic multiple myeloma requiring treatment
- •Received at least two cycles of any regimen as initial systemic therapy for multiple myeloma and are within 2-12 months of the first dose of initial therapy
- •At least 18 years of age
- •Adequate autologous stem cell collection, defined as an unmanipulated, cryopreserved, peripheral blood stem cell collection containing at least 2 × 10^6 CD34+ cells/kg based on patient body weight.
- •Adequate organ function as measured by:
- •Cardiac function: Left ventricular ejection fraction at rest ≥40%
- •Hepatic function: Bilirubin ≤2 × ULN and aspartate amino transferase/alanine amino transferase (AST/ALT) ≤3 × ULN
- •Renal function: Creatinine clearance ≥40 mL/minute (measured or calculated/estimated)
- •Pulmonary function: Carbon monoxide diffusing capacity (DLCO; corrected for hemoglobin [Hgb]), forced expiratory volume in 1 second (FEV1), forced expiratory vital capacity (FVC) ≥50% of predicted value
- •Oxygen saturation ≥92% on room air
- •Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or
- •Able to understand and willing to sign an IRB-approved written informed consent document
Exclusion Criteria
- •Evidence of multiple myeloma disease progression (as defined by IMWG) any time prior to ASCT
- •Prior stem cell transplant (autologous or allogeneic)
- •Smoldering MM not requiring therapy
- •Plasma cell leukemia
- •Systemic amyloid light chain amyloidosis
- •Active bacterial, viral, or fungal infection
- •Seropositive for human immunodeficiency virus (HIV)
- •Known, active hepatitis A, B, or C Infection
- •Pregnant or breastfeeding.
- •Receiving other concurrent anticancer therapy (including chemotherapy, radiation, hormonal treatment, or immunotherapy, but excluding corticosteroids) within 7 days prior to the ASCT or planning to receive any of these treatments prior to the last study visit on Day +
- •Hypersensitive or intolerant to any component of the study drug(s) formulation
- •Receiving growth factors (filgrastim, XM02-filgrastim, peg-filgrastim, plerixafor, etc) or undergoing apheresis < 14 days prior to the start of treatment on protocol (Day -7).
Arms & Interventions
Experimental: Granix and high dose melphalan (HDM)
Granix on Day -7 through Day -2.
HDM intravenously (IV) on Day -2.
Autologous stem cell transplantation on Day 0
Intervention: Granix (Drug)
Experimental: Granix and high dose melphalan (HDM)
Granix on Day -7 through Day -2.
HDM intravenously (IV) on Day -2.
Autologous stem cell transplantation on Day 0
Intervention: High dose melphalan (HDR) (Drug)
Experimental: Granix and high dose melphalan (HDM)
Granix on Day -7 through Day -2.
HDM intravenously (IV) on Day -2.
Autologous stem cell transplantation on Day 0
Intervention: Autologous Stem Cell Transplant (ASCT) (Procedure)
Control: High dose melphalan (HDM)
HDM intravenously (IV) on Day -2.
Autologous stem cell transplantation on Day 0.
Intervention: High dose melphalan (HDR) (Drug)
Control: High dose melphalan (HDM)
HDM intravenously (IV) on Day -2.
Autologous stem cell transplantation on Day 0.
Intervention: Autologous Stem Cell Transplant (ASCT) (Procedure)
Outcomes
Primary Outcomes
Number of Participants With Complete Response or Stringent Complete Response
Time Frame: Day +100
Complete response (CR) requires all of the following: * Disappearance of monoclonal protein by both protein electrophoresis and immunofixation studies from the blood and urine * \<5% plasma cells in the bone marrow * Disappearance of soft tissue plasmacytomas Stringent complete response (sCR) requires all of the following: * CR as defined above * Normal free light chain ratio * Absence of clonal cells in the bone marrow by immunohistochemistry or immunofluorescence
Secondary Outcomes
- Number of Participants With Platelet Engraftment(Up to Day 100)
- Number of Participants With Adverse Events(Up through Day 30)
- Number of Participants With Overall Response(Up to 2 years)
- Overall Survival as Measured by Number of Participants Alive at Last Follow-up(Up to 2 years)
- Progression-free Survival as Measured by Number of Participants Without Disease Progression at Last Follow-up(Up to 2 years)
- Number of Participants With Neutrophil Engraftment(Up to Day 30)
