Evaluation of Safety of Pomalidomide in Combination With Dexamethasone (Low Dose) in Patients With Refractory or Relapsed and Refractory Multiple Myeloma
- Registration Number
- NCT01712789
- Lead Sponsor
- Celgene
- Brief Summary
The primary purpose of the study is to evaluate the safety and efficacy and to generate PK and biomarker data for the combination of pomalidomide and low-dose dexamethasone in patients with refractory or relapsed and refractory multiple myeloma.
The study consists of a Screening phase within 28 days prior to cycle 1 day 1, a Treatment phase and a Follow-up phase which starts within 28 days of discontinuation from study treatment, every 3 months for up to 5 years.
In addition, the collection of steady-state PK data from a large population will enable robust population PK and assess Pomalidomide exposure response analyses.
The exploratory objectives of the study are to investigate potential markers predictive of POM response or resistance and pharmacodynamic markers.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 682
- Patients ≥18 years old, who must understand and voluntarily sign an Informed Consent.
- Patients must have documented diagnosis of Multiple Myeloma and have measurable disease.
- Patients must have undergone prior treatment with ≥ 2 treatments lines, of anti-myeloma therapy.
- Patients must have either refractory or relapsed and refractory disease.
- Patients must have received at least 2 consecutive cycles of prior treatment that include lenalidomide and bortezomib, either alone or in combination regimens.
- Patients must have received adequate alkylator therapy
- Prior history of malignancies, other than Multiple Myeloma.
- Previous therapy with Pomalidomide, hypersensitivity to thalidomide and lenalidomide or dexamethasone.
- Patients who received an allogeneic bone marrow or allogeneic peripheral blood stem cell transplant.
- Patients who are planning for or who are eligible for stem cell transplant.
- Patients who received major surgery and any anti-myeloma drug therapy within the last 14 days of starting study treatment.
- Patients with a current disease that can interfere with protocol procedures or study treatment.
- Patients unable or unwilling to undergo antithrombotic prophylactic treatment.
- Pregnant or breastfeeding females.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Pomalidomide plus Dexamethasone Pomalidomide Pomalidomide 4mg by mouth (PO) daily days 1 through 21 of a 28 day cycle and dexamethasone 40mg/day PO for those ≤75 years of age or 20mg/day for those greater than 75 years of age on Days 1, 8, 15 and 22 of a 28 day cycle. Pomalidomide plus Dexamethasone Dexamethasone Pomalidomide 4mg by mouth (PO) daily days 1 through 21 of a 28 day cycle and dexamethasone 40mg/day PO for those ≤75 years of age or 20mg/day for those greater than 75 years of age on Days 1, 8, 15 and 22 of a 28 day cycle.
- Primary Outcome Measures
Name Time Method Number of Participants With Treatment Emergent Adverse Events (TEAE) From the first dose of study treatment up to 28 days following the last dose of study treatment. The median duration of treatment with pomalidomide and LD-dex was 21.4 weeks. An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a subject during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the subject's health, regardless of etiology. Any worsening (i.e., any significant adverse change in the frequency or intensity of a pre- existing condition) was considered an AE. The severity of AEs were graded based on the symptoms according to version 4.0 of the National Cancer Institute Common Terminology Criteria for Adverse Events. Second primary malignancies were monitored as events of interest and considered as part of the assessment of AEs.
A SAE = AE occurring at any dose that:
* Results in death;
* Is life-threatening
* Requires inpatient hospitalization or prolongation of existing hospitalization
* Results in persistent or significant disability/incapacity
* Is a congenital anomaly/birth defect
- Secondary Outcome Measures
Name Time Method Time to Response Response was assessed at each treatment cycle and at treatment discontinuation; median duration of treatment with pomalidomide and LD-dex was 21.4 weeks Time to response was defined as the time from treatment enrollment to the first documentation of response (sCR, CR, VGPR or PR) based on IMWG criteria.
Kaplan Meier Estimate of Duration of Response From enrollment to the end of follow-up; median time on follow-up was 10.9 (range 0 - 81) months Duration of response, calculated for responders only, was defined as time from the initial documented response (SCR, CR, VGPR or PR) to the first confirmed disease progression, or death if no disease progression was recorded. Participants without a documented progression were censored at the time of their last tumor assessment.
Kaplan Meier Estimate of Progression Free Survival (PFS) According to the European Medicines Agency Guidelines From enrollment to the end of follow-up; median time on follow-up was 10.9 (range 0 - 81) months Progression free survival was calculated as the time from study enrollment, defined as the IVRS enrollment date, until either PD or death (any cause). Participants without an event (either a documented PD or death) at the time of study end were censored at the time of their last documented disease assessment or at the IVRS enrollment date if no disease assessment was conducted.
Kaplan Meier Estimate of Overall Survival (OS) From enrollment to the end of follow-up; median time on follow-up was 10.9 (range 0 - 81) months Overall survival was calculated as the time from study enrollment, defined as the IVRS enrollment date, until death due to any cause. Participants who did not have death data at the time of study end/analysis were censored at the time they were last known to be alive.
Cytogenetic Analysis Study entry Cytogenetic analysis was to be performed using fluorescence in situ hybridization (FISH) methodology at a local laboratory, to evaluate the relationship between cytogenetic profiles and the combination of POM and LD-DEX in terms of response and outcome.
Pomalidomide Exposure - Apparent Volume of Distribution (V/F) Cycles 1, 2, 3, 4, 5, 6 Pharmacokinetic (PK) parameters are derived from Pomalidomide concentration versus time data.
Overall Response Response was assessed at each treatment cycle and at treatment discontinuation; median duration of treatment with pomalidomide and LD-dex was 21.4 weeks Overall response rate (ORR) was defined as the percentage of participants with a stringent complete response (sCR), complete response (CR), very good partial response (VGPR) or partial response (PR) according to the International Myeloma Working Group uniform response criteria (IMWG URC) assessed by the Investigator. Responses must have been confirmed at at least 2 consecutive assessments before the institution of any new therapy with no known evidence of progressive or new bone lesions
Kaplan Meier Estimate of Time to Progression From enrollment to the end of follow-up; median time on follow-up was 10.9 (range 0 - 81) months Time to progression was calculated as the time from study enrollment until first recorded disease progression as determined by the site investigator based on the IMWG criteria, or until death due to progression. Participants not experiencing a documented progression were censored at the time of their last tumor assessment (or at the time of trial enrollment if no assessment was conducted).
Pomalidomide Exposure - Apparent (Oral) Clearance (CL/F) Cycles 1, 2, 3, 4, 5, 6 Pharmacokinetic (PK) parameters are derived from pomalidomide concentration versus time data.
Trial Locations
- Locations (112)
Medical University of Graz
🇦🇹Graz, Austria
Medizinische Universitat Innsbruck
🇦🇹Innsbruck, Austria
Wilhelminenspital Vienna
🇦🇹Vienna, Austria
Medical University of Vienna
🇦🇹Vienna, Austria
AZ St-Jan Brugge Oostende AV
🇧🇪Brugge, Belgium
Institut Jules Bordet
🇧🇪Brussels, Belgium
UZ Gent
🇧🇪Gent, Belgium
UZ Leuven
🇧🇪Leuven, Belgium
Centre Hospitalier Universitaire de Liege
🇧🇪Liege, Belgium
CHU Mont -Godinne
🇧🇪Yvoir, Belgium
Aarhus University Hospital
🇩🇰Aarhus, Denmark
Tartu University Hospital Clinic
🇪🇪Tartu, Estonia
Helsingin yliopistollinen keskussairaala
🇫🇮Helsinki, Finland
Turku University Hospital
🇫🇮Turku, Finland
Centre Hospitalier de la cote basque
🇫🇷Bayonne, France
Hopital Henri Mondor
🇫🇷Créteil, France
Institut Paoli Calmette Hematologie
🇫🇷Marseille cedex, France
CHU Hotel Dieu
🇫🇷Nantes, France
Service Hemato-Immunologie Hopital St Louis
🇫🇷Paris, France
Centre Hospitalier Lyon Sud
🇫🇷Pierre Bénite, France
Hematologie - CHU Purpan
🇫🇷Toulouse, France
Charite, Campus Benjamin Franklin Universitatsmedizin Berlin
🇩🇪Berlin, Germany
CHU Nancy Hematology
🇫🇷Vandoeuvre les Nancy, France
Universitatsklinkikum DusseldorfKlinik fur Hamatologie, Onkologie und klin. Immunoligie
🇩🇪Dusseldorf, Germany
Klinikum Chemnitz
🇩🇪Chemnitz, Germany
Universitatsklinikum Carl Gustav Carus
🇩🇪Dresden, Germany
Klinikum der Universitat zu Koln
🇩🇪Köln, Germany
Universitatsklinikum Freiburg Medizinische Klinik und Poliklinik
🇩🇪Freiburg, Germany
Universitatsklinikum Jena
🇩🇪Jena, Germany
Universitatsklinikum Heidelberg
🇩🇪Heidelberg, Germany
University of Schleswig Holstein
🇩🇪Kiel, Germany
Universitatsklinikum Essen-
🇩🇪Essen, Germany
Universitatsklinikum Leipzig
🇩🇪Leipzig, Germany
Universitatsklinik MuensterMedizinische Klinik A
🇩🇪Muenster, Germany
UKT Universitaetsklinikum Tuebingen
🇩🇪Tuebingen, Germany
TU München - Klinikum rechts der Isar
🇩🇪München, Germany
University Hospital of Ulm
🇩🇪Ulm, Germany
University of Athens
🇬🇷Athens, Greece
Universitatsklinikum Wurzburg
🇩🇪Würzburg, Germany
Cork University HospitalHaematology Consultant
🇮🇪Wilton, Cork, Ireland
University Hospital Galway
🇮🇪Galway, Ireland
Mater Misericordiae University Hospital
🇮🇪Dublin, Ireland
Ospedali Riuniti di Ancona
🇮🇹Ancona, Italy
A.O. Policlinico - Università di Bari
🇮🇹Bari, Italy
ASST Grande Ospedale Metropolitano Niguarda, Milano
🇮🇹Milano, Italy
Ospedale Civile di Piacenza
🇮🇹Piacenza, Italy
Ospedale Sant'Eugenio
🇮🇹Rome, Italy
Universita degli Studi di Roma La Sapienza - Azienda Policlinico Umberto I
🇮🇹Roma, Italy
Azienda Ospedaliera San Giovanni Battista - Ospedale Molinette
🇮🇹Torino, Italy
Ospedale San Bortolo
🇮🇹Vicenza, Italy
Azienda Ospedaliero-Universitaria Santa Maria della Misericordia die Udine
🇮🇹Udine, Italy
St. Olavs Hospital Trondheim
🇳🇴Trondheim, Norway
Haga Hospital
🇳🇱Den Haag, Netherlands
Universitair Medisch Centrum Groningen
🇳🇱Groningen, Netherlands
Erasmus Medical Center
🇳🇱Rotterdam, Netherlands
Oslo University Hospital, Rikshospitalet HF
🇳🇴Oslo, Norway
Instytut Hematologii i Transfuzjologii w Warszawie
🇵🇱Warszawa, Poland
Akademia Medyczna w Gdansku Katedra i Klinika Hematologii i Transplantologii
🇵🇱Gdansk, Poland
Szpitala Uniwersyteckiego w. Krakowie
🇵🇱Kraków, Poland
Instituto Portugues de Oncologia de Lisboa
🇵🇹Lisboa, Portugal
Hospital de Santa Maria
🇵🇹Lisboa, Portugal
Hospital Geral de Santo António - Serviço de Hematologia Clínica
🇵🇹Porto, Portugal
Hospital Universitari Germans Trias i Pujol
🇪🇸Badalona (Barcelona), Spain
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Hospital Universitario de Canarias
🇪🇸La Laguna (Tenerife), Spain
Hospital de La Princesa
🇪🇸Madrid, Spain
Hospital Clinico San Carlos
🇪🇸Madrid, Spain
Hospital Universitario Virgen De La Victoria
🇪🇸Malaga, Spain
Hospital 12 de Octubre
🇪🇸Madrid, Spain
Hospital Morales Meseguer
🇪🇸Murcia, Spain
Clinica Universidad de Navarra
🇪🇸Pamplona, Spain
Hospital Universitario de Salamanca
🇪🇸Salamanca, Spain
Hospital Clinico Universitario De Santiago De Compostela
🇪🇸Santiago De Compostela, Spain
Hospital Virgen de la Salud
🇪🇸Toledo, Spain
Hospital de Donosti
🇪🇸San Sebastián (Guipuzcoa), Spain
Hospital Universitari i Politecnic La Fe de Valencia
🇪🇸Valencia, Spain
Universitetssjukhuset i Lund
🇸🇪Lund, Sweden
Karolinska University HospitalSolna
🇸🇪Stockholm, Sweden
Leeds Teaching Hospitals Trust
🇬🇧Leeds, United Kingdom
Universitatsspital Bern
🇨🇭Bern, Switzerland
Hopitaux Universitaires de Geneve-HUG
🇨🇭Genèva, Switzerland
University Hospital Zurich
🇨🇭Zurich, Switzerland
Ankara University Medical Faculty Cebeci Hospital
🇹🇷Ankara, Turkey
Kent and Canterbury Hospital
🇬🇧Canterbury/Kent, United Kingdom
Ege University Medical School
🇹🇷Izmir, Turkey
Newcastle Hospital Foundation Trust
🇬🇧Newcastle upon Tyne, United Kingdom
Christie Hospital NHS Foundation Trust
🇬🇧Manchester, United Kingdom
Royal Marsden Hospital
🇬🇧Sutton (Surrey), United Kingdom
Odense University Hospital
🇩🇰Odense, Denmark
Vejle Hospital
🇩🇰Vejle, Denmark
Belfast City Hospital Haematology Department
🇬🇧Belfast Northern Ireland, United Kingdom
Southmead Hospital
🇬🇧Westbury-on-Trym/ Bristol, United Kingdom
New Cross Hospital
🇬🇧Wolverhampton, United Kingdom
VUB Vrije Universiteit Brussel
🇧🇪Brussel, Belgium
Hopital Saint Antoine
🇫🇷Paris, France
University of Bologna
🇮🇹Bologna, Italy
Ospedale Ferrarotto
🇮🇹Catania, Italy
Azienda Ospedaliero-Universitaria Pisana
🇮🇹Pisa, Italy
Hopital A. Michallon
🇫🇷La Tronche, France
Fondazione IRCCS Istituto Nazionale dei Tumori
🇮🇹Milano, Italy
VU University Medical Center VU Medisch Centrum
🇳🇱Amsterdam, Netherlands
CHRU Claude Huriez
🇫🇷Lille, France
Universita degli Studi di Padova
🇮🇹Padova, Italy
Casa di Cura La Maddalena
🇮🇹Palermo, Italy
Hospital Universitario de Coimbra- Hospitais de Universidade de Coimbra
🇵🇹Coimbra, Portugal
CHU de Reims
🇫🇷Reims cedex, France
University Hospital Bratislava - Hospital Ss Cyril and Methodius
🇸🇰Bratislava, Slovakia
CHRU Hopital Bretonneau
🇫🇷Tours cedex, France
Abt Haematologie - Onkologie / Allg. Krankenhaus Altona
🇩🇪Hamburg, Germany
Hospital Ramon y Cajal
🇪🇸Madrid, Spain
University Medical Center Utrecht
🇳🇱Utrecht, Netherlands
Royal Liverpool University Hospital
🇬🇧Liverpool, United Kingdom