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S9628 Dexamethasone Plus Interferon Alfa in Treating Patients With Primary Systemic Amyloidosis

Phase 2
Completed
Conditions
Multiple Myeloma
Interventions
Biological: recombinant interferon alfa
Registration Number
NCT00002849
Lead Sponsor
SWOG Cancer Research Network
Brief Summary

RATIONALE: Chemotherapy plus interferon alfa may be effective for primary systemic amyloidosis.

PURPOSE: Phase II trial to study the effectiveness of dexamethasone plus interferon alfa in treating patients who have primary systemic amyloidosis.

Detailed Description

OBJECTIVES:

* Evaluate M protein and organ dysfunction responses and overall and progression-free survival in patients with primary systemic amyloidosis treated with dexamethasone/interferon alfa.

* Identify prognostic factors that may relate to response and overall survival in these patients.

* Evaluate the qualitative and quantitative toxic effects of this regimen.

OUTLINE: Patients are stratified by prior amyloidosis treatment (yes vs no).

All patients receive induction therapy with oral dexamethasone on days 1-4, 9-12, and 17-20 every 35 days for a total of 3 courses.

Maintenance therapy begins within 5-8 weeks (within 10 weeks if patients undergo stem cell harvest) of initiation of the third course of induction, as follows: oral dexamethasone for 4 days every 4 weeks; and subcutaneous interferon alfa 3 times per week. Patients who achieved less than a 50% reduction in serum M protein or urinary Bence-Jones protein and who experienced less than grade 3 toxicity during induction receive 3 additional courses of pulse dexamethasone concurrently with entry to maintenance therapy and the initiation of interferon alfa.

Combination therapy is continued until 2 years from entry; thereafter, interferon is administered alone for at least 3 years, toxicity permitting. Patients with stable disease after 5 years of therapy may discontinue interferon alfa at the discretion of the treating physician.

Patients are followed every 6 months for 2 years and yearly thereafter.

PROJECTED ACCRUAL: A total of 100 patients (50 with prior melphalan/prednisone or iododoxorubicin treatment and 50 without) will be entered over 3 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
93
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
induction and maintenancerecombinant interferon alfadexamethasone induction followed by alpha interferon maintenance
induction and maintenancedexamethasonedexamethasone induction followed by alpha interferon maintenance
Primary Outcome Measures
NameTimeMethod
response10 months

50% or more reduction in quantitative immunoglobulin, or if the patient has light-chain disease only, a 50% or more reduction in the urine M-component (Bence-Jones protein).

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (40)

Rebecca and John Moores UCSD Cancer Center

🇺🇸

La Jolla, California, United States

Veterans Affairs Medical Center - San Francisco

🇺🇸

San Francisco, California, United States

CCOP - Christiana Care Health Services

🇺🇸

Wilmington, Delaware, United States

Lombardi Cancer Center

🇺🇸

Washington, District of Columbia, United States

Walter Reed Army Medical Center

🇺🇸

Washington, District of Columbia, United States

CCOP - Mount Sinai Medical Center

🇺🇸

Miami Beach, Florida, United States

Veterans Affairs Medical Center - Chicago (Westside Hospital)

🇺🇸

Chicago, Illinois, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

Holden Comprehensive Cancer Center

🇺🇸

Iowa City, Iowa, United States

Marlene and Stewart Greenebaum Cancer Center, University of Maryland

🇺🇸

Baltimore, Maryland, United States

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Rebecca and John Moores UCSD Cancer Center
🇺🇸La Jolla, California, United States

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