S0232 Dexamethasone With or Without Lenalidomide in Treating Patients With Previously Untreated Stage I, Stage II, or Stage III Multiple Myeloma
The recruitment status of this study is unknown because the information has not been verified recently.
Verified December 2008 by Southwest Oncology Group.
Recruitment status was Active, not recruiting
Recruitment status was Active, not recruiting
Sponsor:
Southwest Oncology Group
Collaborator:
Information provided by:
Southwest Oncology Group
ClinicalTrials.gov Identifier:
NCT00064038
First received: July 8, 2003
Last updated: July 19, 2011
Last verified: December 2008
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
RATIONALE: Drugs used in chemotherapy such as dexamethasone use different ways to stop cancer cells from dividing so they stop growing or die. Lenalidomide may stop the growth of multiple myeloma by stopping blood flow to the tumor. It is not yet known whether dexamethasone is more effective with or without lenalidomide in treating multiple myeloma.
PURPOSE: This randomized phase III trial is studying dexamethasone and lenalidomide to see how well they work compared to dexamethasone alone in treating patients with previously untreated stage I, stage II, or stage III multiple myeloma.
| Condition | Intervention | Phase |
|---|---|---|
|
Multiple Myeloma and Plasma Cell Neoplasm |
Drug: dexamethasone Drug: lenalidomide Other: placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | Phase III Trial Comparing Dexamethasone (DEX) to the Combination of DEX + CC-5013 in Patients With Previously Untreated Multiple Myeloma |
Resource links provided by NLM:
Drug Information available for:
Dexamethasone
Dexamethasone acetate
Dexamethasone sodium phosphate
Lenalidomide
U.S. FDA Resources
Further study details as provided by Southwest Oncology Group:
Primary Outcome Measures:
- Progression-free survival [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Overall response rates [ Designated as safety issue: No ]
- Major response rate as measured by a decrease in m-protein > 75% [ Designated as safety issue: No ]
- Time to best response [ Designated as safety issue: No ]
- Overall survival [ Designated as safety issue: No ]
- Toxicity as measured by CTCAE v. 3.0 [ Designated as safety issue: Yes ]
- Biological endpoints including effects on gene expression and proteomic analysis at baseline and after 3 courses of treatment [ Designated as safety issue: No ]
| Estimated Enrollment: | 500 |
| Study Start Date: | November 2004 |
| Primary Completion Date: | May 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I
Patients receive induction therapy comprising oral dexamethasone (DM) on days 1-4, 9-12, and 17-20 and oral lenalidomide on days 1-28. Treatment repeats every 35 days for up to 3 courses in the absence of disease progression or unacceptable toxicity. Patients then receive maintenance therapy comprising oral DM on days 1-4 and 15-18 and oral lenalidomide on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
|
Drug: dexamethasone
Given orally
Drug: lenalidomide
Given orally
|
|
Active Comparator: Arm II
Patients receive induction therapy comprising DM as in arm I induction and oral placebo on days 1-28. Treatment repeats as in arm I induction. Some patients may then receive maintenance therapy comprising oral DM as in arm I maintenance and oral placebo on days 1-21. Courses repeat as in arm I maintenance.
|
Drug: dexamethasone
Given orally
Other: placebo
Given orally
|
Detailed Description:
OBJECTIVES:
- Compare the progression-free survival of patients with previously untreated stage I, II, or III multiple myeloma treated with dexamethasone with or without lenalidomide.
- Compare the overall response rate in patients treated with these regimens.
- Compare the major response rate (indicated by greater than 75% decrease in M-protein) in patients treated with these regimens.
- Compare the overall survival and time to best response in patients treated with these regimens.
- Compare the toxicity profile of these regimens, including thrombotic complications, in these patients.
- Compare the effect of these regimens on gene expression and proteomic analysis in these patients.
OUTLINE: This is a randomized, double-blind, crossover, multicenter study. Patients are stratified according to disease stage by the International Staging System (I vs II vs III) and Zubrod performance status (0-1 vs 2-3). Patients are randomized to 1 of 2 treatment arms.
Arm I
- Induction therapy: Patients receive oral dexamethasone (DM) on days 1-4, 9-12, and 17-20 and oral lenalidomide on days 1-28. Treatment repeats every 35 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
- Maintenance therapy: Patients receive oral DM on days 1-4 and 15-18 and oral lenalidomide on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Arm II
- Induction therapy: Patients receive DM as in arm I induction and oral placebo on days 1-28. Treatment repeats as in arm I induction.
Patients with responding or stable disease proceed to maintenance therapy. Patients with disease progression during induction therapy cross over and receive unblinded treatment with DM and lenalidomide as in arm I induction. Patients with responding or stable disease after unblinded induction therapy receive unblinded maintenance therapy with DM and lenalidomide as in arm I maintenance.
- Maintenance therapy: Patients receive oral DM as in arm I maintenance and oral placebo on days 1-21. Courses repeat as in arm I maintenance.
Patients with disease progression during maintenance therapy cross over and receive unblinded treatment with DM and lenalidomide as in arm I induction. Patients with responding or stable disease after unblinded induction therapy proceed to unblinded maintenance therapy with DM and lenalidomide as in arm I maintenance.
Patients are followed periodically for up to 5 years.
PROJECTED ACCRUAL: A total of 500 patients (250 per treatment arm) will be accrued for this study within 4 years.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
DISEASE CHARACTERISTICS:
Previously untreated multiple myeloma
- Stage I, II, or III disease by the International Staging System
Measurable M-protein as defined by 1 of the following:
- Serum M-protein at least 1.0 g/dL by serum protein electrophoresis or immunoelectrophoresis
- Urinary M-protein excretion at least 200 mg/24 hours
- No nonsecretory multiple myeloma
- Not planning to undergo future autologous stem cell transplantation
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Zubrod 0-3* NOTE: *Zubrod 3 allowed only if multiple myeloma is the central cause of disability
Life expectancy
- Not specified
Hematopoietic
- Platelet count at least 80,000/mm^3*
- Absolute neutrophil count at least 1,000/mm^3*
- Hemoglobin at least 9 g/dL* (epoetin alfa or transfusion allowed) NOTE: *Unless due to greater than 50% marrow involvement by myeloma on biopsy
Hepatic
- AST/ALT no greater than 3 times upper limit of normal* NOTE: *Values outside of this range are allowed at the investigator's discretion
Renal
- Creatinine no greater than 2.5 mg/dL* NOTE: *Values outside of this range are allowed at the investigator's discretion
Cardiovascular
- No New York Heart Association class III or IV heart failure
- No myocardial infarction within the past 6 months
- No poorly controlled hypertension
Other
- Not pregnant or nursing
- Negative pregnancy test
Fertile patients must use effective contraception for 4 weeks before, during, and for 4 weeks after study treatment
- Female patients must use 2 reliable forms of contraception simultaneously
- Male patients must use effective barrier contraception
- No uncontrolled active infection requiring IV antibiotics
- No poorly controlled diabetes mellitus that would preclude ability to take oral glucocorticoids
- No other serious medical condition that would preclude study participation
- No psychiatric illness that would preclude study participation
- No other malignancy within the past 3 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
- Must be able to take aspirin by mouth at a dose of 325 mg per day or enoxaparin subcutaneously at a dose of 40 mg per day as a form of thrombotic prophylaxis, except if already on therapeutic anticoagulant medication
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior interferon or thalidomide
Chemotherapy
- No prior chemotherapy
Endocrine therapy
- Prior high-dose dexamethasone allowed provided duration of administration was no more than 4 days
Radiotherapy
- Prior localized radiotherapy allowed provided it was not to the sole site of evaluable disease
Surgery
- Not specified
Other
- No prior treatment for clinically significant ventricular cardiac arrhythmias
- Concurrent bisphosphonates allowed
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00064038
Locations
| United States, Michigan | |
| William Beaumont Hospital - Royal Oak Campus | |
| Royal Oak, Michigan, United States, 48073 | |
| United States, Utah | |
| Utah Cancer Specialists at UCS Cancer Center | |
| Salt Lake City, Utah, United States, 84106 | |
Sponsors and Collaborators
Southwest Oncology Group
Investigators
| Study Chair: | Jeffrey A. Zonder, MD | Barbara Ann Karmanos Cancer Institute |
More Information
Additional Information:
Publications:
Zonder JA, Crowley JJ, Bolejack V, et al.: A randomized Southwest Oncology Group study comparing dexamethasone (D) to lenalidomide + dexamethasone (LD) as treatment of newly-diagnosed multiple myeloma (NDMM): impact of cytogenetic abnormalities on efficacy of LD, and updated overall study results. [Abstract] J Clin Oncol 26 (Suppl 15): A-8521, 2008.
Zonder JA, Crowley J, Hussein MA, et al.: Superiority of lenalidomide (Len) plus high-dose dexamethasone (HD) compared to HD alone as treatment of newly-diagnosed multiple myeloma (NDMM): results of the randomized, double-blinded, placebo-controlled SWOG trial S0232. [Abstract] Blood 110 (11): A-77, 2007.
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Laurence H. Baker, Southwest Oncology Group - Group Chair's Office |
| ClinicalTrials.gov Identifier: | NCT00064038 History of Changes |
| Other Study ID Numbers: | CDR0000306449, U10CA032102, S0232 |
| Study First Received: | July 8, 2003 |
| Last Updated: | July 19, 2011 |
| Health Authority: | United States: Federal Government United States: Food and Drug Administration |
Keywords provided by Southwest Oncology Group:
|
stage I multiple myeloma stage II multiple myeloma stage III multiple myeloma |
Additional relevant MeSH terms:
|
Neoplasms Multiple Myeloma Neoplasms, Plasma Cell Plasmacytoma Neoplasms by Histologic Type Hemostatic Disorders Vascular Diseases Cardiovascular Diseases Paraproteinemias Blood Protein Disorders Hematologic Diseases Hemorrhagic Disorders Lymphoproliferative Disorders Immunoproliferative Disorders Immune System Diseases |
Dexamethasone acetate Dexamethasone Dexamethasone 21-phosphate Lenalidomide BB 1101 Anti-Inflammatory Agents Therapeutic Uses Pharmacologic Actions Antiemetics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Central Nervous System Agents Gastrointestinal Agents Glucocorticoids |
ClinicalTrials.gov processed this record on May 16, 2013