NCT03952832撤回2 期
Phase 2 Trial of Leflunomide in Patients With High-Risk Smoldering Multiple Myeloma
City of Hope Medical Center1 个研究点 分布在 1 个国家开始时间: 2019年12月11日最近更新:
适应症
干预措施
相关药物
试验速览
- 阶段
- 2 期
- 状态
- 撤回
- 发起方
- 试验地点
- 1
- 主要终点
- Overall survival
研究概览
简要总结
This phase II trial studies how well leflunomide works in treating patients with high-risk smoldering multiple myeloma. Leflunomide may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
详细描述
PRIMARY OBJECTIVES:
I. To evaluate the anti-myeloma activity of leflunomide, when given as a single agent, as assessed by freedom from progression at 2-years.
SECONDARY OBJECTIVES:
I. To evaluate the safety and tolerability of single agent leflunomide. II. To summarize and assess toxicities by type, frequency, severity, attribution, time course and duration.
III. To estimate overall and progression-free survival probabilities. IV. To estimate response rate and duration of response. V. To describe the impact of treatment on quality of life, as assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Score version (v)3.0.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All subjects must have the ability to understand and the willingness to sign a written informed consent
- •Patients must have a life expectancy of > 3 months
- •Patients must exhibit an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- •Patients must have a diagnosis of high risk smoldering multiple myeloma, as defined below:
- •The presence of >= 2 of the following risk factors:
- •Bone marrow plasma cell percentage (BMPC%) > 20%
- •Serum M-protein > 2 g/dL
- •Free light chain ratio (FLCr) > 20
- •At least 2 weeks from prior therapy to time of start of treatment; prior therapy includes steroids (except prednisone or equivalent - up to 10 mg per day is allowed)
- •Platelet count >= 50,000/uL. Platelet transfusions are not allowed within 14 days of platelet assessment
- •Absolute neutrophil count (ANC) >= 1000/mm^3
- •Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.0 x upper limits of normal (ULN)
- •Total bilirubin < 1.5 x ULN
- •Calculated creatinine clearance (CrCl) >= 30 mL/min per 24-hour urine collection or the Cockcroft-Gault formula
- •Negative serum or urine beta-human chorionic gonadotropin (HCG) test (female patient of childbearing potential* only), to be performed locally within the screening period
- •A female of childbearing potential is defined as a sexually mature woman who: has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months
- •Negative for tuberculosis antigen (e.g. T-Spot test)
- •Negative for hepatitis A, B, or C infection
- •Adequate pulmonary function as defined by forced vital capacity (FVC) and diffusion capacity of the lung for carbon monoxide (DLCO) >= 50% of predicted by pulmonary function testing
- •Agreement by females of childbearing potential* and sexually active males to use an effective method of contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for three months following duration of study participation. The effects of study treatment on a developing fetus have the potential for teratogenic or abortifacient effects. Should a woman become pregnant or suspect that she is pregnant while participating on the trial, she should inform her treating physician immediately
- •A female of childbearing potential is defined as a sexually mature woman who has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months
排除标准
- •Prior treatment with leflunomide
- •Prior treatment for smoldering multiple myeloma
- •Current or planned use of other investigational agents, or concurrent biological, chemotherapy, or radiation therapy during the study treatment period; current or planned growth factor or transfusion support until after initiation of treatment; if growth factor or transfusion support is provided between screening and start of treatment, the participant will no longer be eligible
- •Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically:
- •Hypercalcemia: serum calcium > 0.25 mmol/L (> 1 mg/dL) higher than the upper limit of normal or > 2.75 mmol/L (> 11 mg/dL)
- •Renal insufficiency: creatinine clearance < 40 mL per min or serum creatinine > 177 umol/L (> 2 mg/dL)
- •Anemia: hemoglobin value of > 20 g/L below the lower limit of normal, or a hemoglobin value < 10 g/dL
- •Bone lesions: one or more osteolytic lesions on skeletal radiography, computer tomography (CT), or positron emission tomography (PET)-CT
- •Any one or more of the following biomarkers of malignancy:
- •Clonal bone marrow plasma cell percentage >= 60%
- •Involved: uninvolved serum free light chain ratio >= 100 (Involved free light chain must be >= 100 mg/L) >= 1 focal lesions on magnetic resonance imaging (MRI) studies (>=5 mm in size each)
- •Participants with increased calcium level, renal dysfunction, anemia, and destructive bone lesions (CRAB) criteria that are attributable to conditions other than the disease under study may be eligible
- •Prior diagnosis of rheumatoid arthritis
- •Prior allogeneic transplant
- •Acute active infection requiring systemic therapy within 2 weeks prior to enrollment
- •Pre-existing liver disease
- •Known human immunodeficiency virus (HIV) infection
- •History of allergic reactions attributed to compounds of similar chemical or biologic composition to leflunomide and cholestyramine
- •Non-hematologic malignancy within the past 3 years aside from the following exceptions:
- •Adequately treated basal cell or squamous cell skin cancer
- •Carcinoma in situ of the cervix
- •Prostate cancer < Gleason grade 6 with a stable PSA
- •Successfully treated in situ carcinoma of the breast
- •Clinically significant medical disease or condition that, in the investigator's opinion, may interfere with protocol adherence or the patient's ability to give informed consent
- •Pregnant women and women who are lactating; leflunomide has potential for teratogenic or abortifacient effects. Because there is a potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breastfeeding should be discontinued if the mother is enrolled on this study
- •Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures, e.g., infection/inflammation, intestinal obstruction, unable to swallow medication, social/ psychological issues, etc.
- •Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
研究组 & 干预措施
Treatment (leflunomide)
Experimental
Patients receive leflunomide PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
干预措施: Leflunomide (Drug)
Treatment (leflunomide)
Experimental
Patients receive leflunomide PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
干预措施: Quality-of-Life Assessment (Other)
Treatment (leflunomide)
Experimental
Patients receive leflunomide PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
干预措施: Questionnaire Administration (Other)
结局指标
主要结局
Overall survival
时间窗: Up to 2 years
Overall survival will be estimated using the product-limit method of Kaplan and Meier.
Progression to multiple myeloma
时间窗: Up to 2 years
Progression to multiple myeloma in the absence of increased calcium level, renal dysfunction, anemia, and destructive bone lesions (CRAB) features, orto symptomatic multiple myeloma that requires therapy will be assessed.
次要结局
- Incidence of adverse events (AEs)(Up to 30 days post treatment)
- Overall response rate (ORR)(Up to 2 years)
- Freedom from progression(Up to 2 years)
- Change in quality of life(Baseline up to 2 years)
研究者
研究点 (1)
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