An Open Label, Single Arm, Multi-Center Exploratory Study to Evaluate the Efficacy and Safety of SVRd for the Treatment of Newly Diagnosed Multiple Myeloma Patients Presenting With Extramedullary Disease.
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 29
- 试验地点
- 12
- 主要终点
- Number of Participants With Overall Response Rate (ORR)
研究概览
简要总结
The purpose of this study is to evaluate the efficacy and safety of SVRd in NDMM patients presenting with extramedullary disease.
详细描述
Study Design:
This protocol corresponds to a multicenter, open-label, single arm, exploratory study designed to determine the safety of the combination of selinexor combined with VRd in NDMM patients presenting with EMD. The patients who respond to this combination treatment will undergo allogeneic hematopoietic stem cell transplantation or no ASCT and followed by consolidation and maintenance treatment.
All patients will receive 4 courses of SVRd induction therapy, each cycle of treatment will compromise 4 weeks of Selinexor 60mg QW treatment. Transplantation could be performed after 2 courses of VRd consolidation therapy. If not receive transplantation will give 4 cycles of SVRd consolidation therapy. Maintenance treatment will continued for a maximum of 2 years.
Study design allows 35 patients. Induction treatment will consist of Selinexor 60 mg/day orally on d1,8,15,22, Bortezomib 1.3mg/m2 intravenously on d1,8,15,22, Lenalidomide 25 mg/d ( the dose will be adjusted according to creatinine clearance), orally on days 1 to14, Dexamethasone 20 mg/day orally on d1-2, d8-9,d15-16,d22-23
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 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Men and women aged with18-75 years old.
- •Confirmed diagnosis of Multiple Myeloma(MM) (IMWG consensus guidelines)
- •Newly diagnosed patients presenting with extramedullary disease (EMD) including solely paraskeletal plasmacytoma, plasmacytoma of soft tissue and other special sites detected by physical exam and confirmed by CT/MRI/PET-CT and/or biopsy (≥2cm).
- •ANC≥1.0*10^9/L, HGB≥75*10^9/L, PLT≥50*10^9/L (≥50% of bone marrow nucleated cells are plasma cells).
- •Patients whose expecting survival time will be more than 3 months.
- •Without active infectious disease.
- •Female patients of child-bearing potential must have a negative serum pregnancy test at screening and all patients agree to use two reliable methods of contraception for six months after their last dose of medication.
- •Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests and other study procedures.
- •Each patient must sign an informed consent form (ICF) indicating that he or she understands the purpose of and procedures required for the study and are willing to participate in the study.
排除标准
- •Patients who have HBV, HCV, and other acquired and congenital immunodeficiency diseases.
- •Patients who have grade 2 or higher of peripheral neuropathy or neuralgia according to the definition of NCI CTCAE version 4.
- •Plasma cell leukemia.
- •Serious thrombotic events.
- •Active, unstable cardiovascular dysfunction: a. symptomatic ischemia; b. Uncontrolled, clinically significant conduction abnormalities (except antiarrhythmic ventricular tachycardia), but patients with first-degree atrioventricular block or asymptomatic left anterior bundle/right fascicular block cannot be excluded. c. New York Heart Association (NYHA) Class III - IV or left ventricular ejection fraction (LVEF) <40%; d. Myocardial infarction Within 3 months before C1D
- •Significant hepatic dysfunction (ALT and AST ≥ 3 times the upper limit of normal (ULN)).
- •Serum bilirubin≥1.5 × ULN.
- •creatinine clearance <30 ml/min.
- •History of active malignancy during the past 5 years with the exception of basal carcinoma of the skin or stage 0 cervical carcinoma.
- •Previous major operation within 30 days before C1D
- •Patients who have epilepsy, dementia requiring medication, or other mental disorders who are unable to understand or adhere to the study protocol.
- •According to the study protocol or in the opinion of the investigator,serious physical or mental illness that is likely to interfere with the study procedures/results.
- •Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
- •Current participation in another clinical trial.
- •Pregnant or lactating women.
- •Patients with other commodities that the investigators considered not suitable for the enrollment.
研究组 & 干预措施
study group
SVRd induction treatment
干预措施: Lenalidomide (Drug)
study group
SVRd induction treatment
干预措施: Selinexor (Drug)
study group
SVRd induction treatment
干预措施: Dexamethasone (Drug)
study group
SVRd induction treatment
干预措施: Bortezomib (Drug)
结局指标
主要结局
Number of Participants With Overall Response Rate (ORR)
时间窗: End of induction treatment (4 cycles, each cycle is 28 days)
ORR: defined as the proportion of patients who will achieve PR or better, as per IMWG criteria.
次要结局
- Overall Survival (OS)(5 years)
- Number of adverse events(During of induction treatment (4 cycles, each cycle is 28 days))
- Number of Participants With Complete Response Rate (CR)(End of induction treatment (4 cycles, each cycle is 28 days))
- Duration of Response (DOR)(5 years)
- Progression-Free Survival (PFS)(5 years)