A Study to Compare CNTO 328 (Anti-IL-6 Monoclonal Antibody) and VELCADE-Melphalan-Prednisone (VMP) With VMP Alone in Previously Untreated Multiple Myeloma Patients

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Janssen Research & Development, LLC
ClinicalTrials.gov Identifier:
NCT00911859
First received: May 29, 2009
Last updated: September 3, 2014
Last verified: September 2014
  Purpose

The purpose of this study is to evaluate safety and effectiveness of CNTO 328 when it is administered together with velcade-melphalan-prednisone (VMP) in comparison with VMP alone in patients with multiple myeloma (a type of cancer that affects the blood and bone marrow).


Condition Intervention Phase
Multiple Myeloma
Drug: Siltuximab
Drug: Velcade (bortezomib)
Drug: Melphalan
Drug: Prednisone
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized, Open-Label, Phase 2 Study of CNTO 328 (Anti-IL-6 Monoclonal Antibody) and VELCADE-Melphalan-Prednisone Compared With VELCADE-Melphalan-Prednisone for the Treatment of Previously Untreated Multiple Myeloma

Resource links provided by NLM:


Further study details as provided by Janssen Research & Development, LLC:

Primary Outcome Measures:
  • Percentage of Participants who Achieved Complete Response (CR) - European Group for Blood and Marrow Transplantation (EBMT) Criteria [ Time Frame: Up to disease progression ] [ Designated as safety issue: No ]
    CR is assessed using EMBT criteria: disappearance of the original monoclonal paraprotein from the blood and urine on at least 2 determinations for a minimum of 6 weeks by immunofixation studies, <5% plasma cells in the bone marrow on at least 1 determination, if skeletal survey is available: no increase in the size or number of lytic bone lesions (development of a compression fracture does not exclude response), disappearance of soft tissue plasmacytomas for at least 6 weeks.


Secondary Outcome Measures:
  • Percentage of Participants who Achieved Overall Response ie, Complete Response (CR) or Partial Response (PR) - European Group for Blood and Marrow Transplantation (EBMT) Criteria [ Time Frame: Up to disease progression ] [ Designated as safety issue: No ]
    CR or PR is assessed using EBMT criteria. CR: disappearance of the original monoclonal paraprotein from the blood and urine on at least 2 determinations for a minimum of 6 weeks by immunofixation studies, <5% plasma cells in the bone marrow on at least 1 determination, if skeletal survey is available: no increase in the size or number of lytic bone lesions (development of a compression fracture does not exclude response), disappearance of soft tissue plasmacytomas for at least 6 weeks; PR: >=50% reduction in the level of serum monoclonal paraprotein for at least 2 determinations 6 weeks apart, if present, reduction in 24-hour urinary light chain excretion by either >=90% or to <200 mg for at least 2 determinations 6 weeks apart, >=50% reduction in the size of soft tissue plasmacytomas (by clinical or radiographic examination) for at least 6 weeks, if skeletal survey is available: no increase in size or number of lytic bone lesions.

  • Percentage of Participants who Achieved Stringent Complete Response (sCR) - International Myeloma Working Group (IMWG) Criteria [ Time Frame: Up to disease progression ] [ Designated as safety issue: No ]
    sCR is assessed by IMWG Criteria: Negative immunofixation on the serum and urine, disappearance of any soft tissue plasmacytomas, <=5% plasma cells in bone marrow, normal free light chain ratio, absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescencec. sCR is a CR that has been confirmed by immunofixation + free light chain assay + either bone marrow immunohistochemistry or immunofluorescence.

  • Progression-Free Survival (PFS) [ Time Frame: From the date of randomization until disease progression or death, whichever occurred first, as assessed up to the last efficacy assessment for disease progression ] [ Designated as safety issue: No ]
    PFS is defined as the time between randomization and either disease progression or death, whichever occurred first.

  • 1-year Progression-Free Survival (PFS) Rate [ Time Frame: 1 year ] [ Designated as safety issue: No ]
    The 1-year PFS rate is defined as the percentage of participants surviving 1 year after randomization without disease progression or death.

  • Duration of Response (DOR) [ Time Frame: From the date participants achieved CR or PR to either date for disease progression (including relapse from CR) or the censoring date for progressive disease, as assessed Up to 30 days after last dose of study medication ] [ Designated as safety issue: No ]
    DOR is defined as length from the earliest date a participant achieved a complete response (CR) or partial response (PR) to either date for disease progression (including relapse from CR) or the censoring date for progressive disease. Responders without disease progression is censored at the last efficacy assessment for disease progression.

  • 1-year Survival Rate [ Time Frame: 1 year ] [ Designated as safety issue: No ]
    Percentage of participants who are alive at the end of 1 year after randomization.

  • Overall Survival (OS) [ Time Frame: From the date of randomization till the date of death, as assessed up to the end of study ] [ Designated as safety issue: No ]
    Time interval in days between the date of randomization and the participant's death from any cause.

  • Change from Baseline to Cycle 9 in Global Health Status/Quality of Life Subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30) [ Time Frame: Baseline (Day 1 predose) and Cycle 9 (Week 54) ] [ Designated as safety issue: No ]
    Global health status/quality of life is a subscale of the EORTC QLQ C30. It is questionnaire with scoring as 1="Not at All," 2="A Little," 3="Quite a Bit," and 4="Very Much" to evaluate participants quality of life as patient reported outcomes. Lower scores indicate worsening.


Enrollment: 118
Study Start Date: June 2009
Study Completion Date: April 2013
Primary Completion Date: April 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Part 1: VMP (Velcade+Melphalan+Prednisone) + Siltuximab
Siltuximab 11 mg/kg as a 1-hour intravenous infusion every 3 weeks along with VMP. VMP: Velcade 1.3 mg/m2 will be administered as an intravenous bolus injection according to the current approved package inserts. Melphalan 9 mg/m2 and prednisone 60 mg/m2 will be taken orally (by mouth)
Drug: Siltuximab
Participants will receive siltuximab 11 mg/kg as a 1-hour intravenous infusion every 3 weeks in Part 1 and participants will receive siltuximab 8.3 mg/kg or 11 mg/kg as a 1-hour intravenous infusion every 3 weeks for 9 cycles of treatment period in Part 2 and in maintenance period
Other Name: CNTO 328
Drug: Velcade (bortezomib)
Participants will receive Velcade 1.3 mg/m2 as an intravenous bolus injection according to the current approved package inserts in Part 1 and for 9 cycles of the treatment period in Part 2. It will be administered twice weekly for first 4 cycles (on Days 1, 4, 8, 11, 22, 25, 29, and 32, followed by a 10-day rest period) and once weekly for next 5 cycles (on Days 1, 8, 22, and 29, followed by a 13-day rest period)
Drug: Melphalan
Participants will receive melphalan according to currently approved package inserts. Melphalan 9 mg/m2 will be administered orally on Days 1 to 4, followed by a 38-day rest period in Part 1 and for 9 cycles of treatment period in Part 2
Drug: Prednisone
Patients will receive prednisone according to currently approved package inserts. Prednisone 60 mg/m2 will be administered orally on Days 1 to 4, followed by a 38-day rest period in Part 1 and for 9 cycles of treatment period in Part 2
Experimental: Part 2: VMP + Siltuximab
Siltuximab 8.3 mg/kg or 11 mg/kg as a 1-hour intravenous infusion every 3 weeks along with VMP. VMP: Velcade 1.3 mg/m2 will be administered as an intravenous bolus injection according to the current approved package inserts. Melphalan 9 mg/m2 and prednisone 60 mg/m2 will be taken orally
Drug: Siltuximab
Participants will receive siltuximab 11 mg/kg as a 1-hour intravenous infusion every 3 weeks in Part 1 and participants will receive siltuximab 8.3 mg/kg or 11 mg/kg as a 1-hour intravenous infusion every 3 weeks for 9 cycles of treatment period in Part 2 and in maintenance period
Other Name: CNTO 328
Drug: Velcade (bortezomib)
Participants will receive Velcade 1.3 mg/m2 as an intravenous bolus injection according to the current approved package inserts in Part 1 and for 9 cycles of the treatment period in Part 2. It will be administered twice weekly for first 4 cycles (on Days 1, 4, 8, 11, 22, 25, 29, and 32, followed by a 10-day rest period) and once weekly for next 5 cycles (on Days 1, 8, 22, and 29, followed by a 13-day rest period)
Drug: Melphalan
Participants will receive melphalan according to currently approved package inserts. Melphalan 9 mg/m2 will be administered orally on Days 1 to 4, followed by a 38-day rest period in Part 1 and for 9 cycles of treatment period in Part 2
Drug: Prednisone
Patients will receive prednisone according to currently approved package inserts. Prednisone 60 mg/m2 will be administered orally on Days 1 to 4, followed by a 38-day rest period in Part 1 and for 9 cycles of treatment period in Part 2
Active Comparator: Part 2: VMP
Velcade 1.3 mg/m2 will be administered as an intravenous bolus injection according to the current approved package inserts. Melphalan 9 mg/m2 and prednisone 60 mg/m2 will be taken orally
Drug: Velcade (bortezomib)
Participants will receive Velcade 1.3 mg/m2 as an intravenous bolus injection according to the current approved package inserts in Part 1 and for 9 cycles of the treatment period in Part 2. It will be administered twice weekly for first 4 cycles (on Days 1, 4, 8, 11, 22, 25, 29, and 32, followed by a 10-day rest period) and once weekly for next 5 cycles (on Days 1, 8, 22, and 29, followed by a 13-day rest period)
Drug: Melphalan
Participants will receive melphalan according to currently approved package inserts. Melphalan 9 mg/m2 will be administered orally on Days 1 to 4, followed by a 38-day rest period in Part 1 and for 9 cycles of treatment period in Part 2
Drug: Prednisone
Patients will receive prednisone according to currently approved package inserts. Prednisone 60 mg/m2 will be administered orally on Days 1 to 4, followed by a 38-day rest period in Part 1 and for 9 cycles of treatment period in Part 2

Detailed Description:

The study will be conducted in 2 parts (Part 1 and Part 2) and will consist of screening period up to 2 weeks; treatment period; maintenance period (CNTO 328) for a maximum of 18 months and follow up period until the study ends. Part 1 is an open-label (all people know the identity of the intervention), single group safety lead-in part to evaluate the safety of CNTO 328. Approximately 12 patients will be treated with CNTO 328 in combination with VMP. If the safety profile of the combination is acceptable, the study will proceed to Part 2. Part 2 is a randomized (the study medication is assigned by chance), open-label, 2-arm (Arm A: CNTO 328 + VMP; Arm B: VMP alone) study. Approximately 104 patients will be equally randomized, followed by a maintenance period with CNTO 328 in patients in Arm A who achieve a partial response (PR) or better. Patients in both parts of the study will be treated up to a maximum of nine 6-weeks cycles provided there is no evidence of disease progression, unacceptable toxicity, or withdrawal from treatment. Study medication will be continued for at least 2 additional cycles after confirmation of complete response, and preferably for the full 9 cycles of the treatment period. Patients who will be receiving maintenance treatment after the 12-month effectiveness analysis may continue to receive treatment with CNTO 328 only after careful consideration by the treating physician and on evidence of clinical benefit and in the absence of unwarranted toxicities. Safety assessments will include evaluation of adverse events, clinical laboratory tests, eastern cooperative oncology group performance status, electrocardiogram, vital signs, and physical examination which will be monitored throughout the study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Confirmed diagnosis of previously untreated multiple myeloma and not a candidate for high dose chemotherapy with stem cell transplantation
  • Eastern cooperative oncology group performance status score of less than or equal to 2
  • Measurable secretory disease, defined as either serum monoclonal paraprotein greater than or equal to 1 g/dL or urine monoclonal protein greater than 200 mg/24 hours
  • Adequate laboratory results that will be confirmed by a study physician
  • Agrees to protocol-defined use of effective contraception

Exclusion Criteria:

  • Diagnosed with primary amyloidosis, asymptomatic or smoldering multiple myeloma or monoclonal gammopathy of undetermined significance
  • Diagnosed with Waldenstrom's disease, or other conditions in which IgM M-protein is present in the absence of a clonal plasma cell infiltration with lytic bone lesions
  • Received prior or current systemic therapy or stem cell transplantation for multiple myeloma
  • Peripheral neuropathy or neuropathic pain (Grade 2 or higher)
  • Received radiation therapy, plasmapheresis or surgery within 14 days
  • Transplanted solid organ, with the exception of a corneal transplant
  • Serious concurrent illness or history of uncontrolled heart disease
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00911859

  Show 37 Study Locations
Sponsors and Collaborators
Janssen Research & Development, LLC
Investigators
Study Director: Janssen Research & Development L.L.C Clinical Trial Janssen Research & Development L.L.C
  More Information

No publications provided by Janssen Research & Development, LLC

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Janssen Research & Development, LLC
ClinicalTrials.gov Identifier: NCT00911859     History of Changes
Obsolete Identifiers: NCT01710241
Other Study ID Numbers: CR015901, CNTO328MMY2001, 2008-007157-12
Study First Received: May 29, 2009
Last Updated: September 3, 2014
Health Authority: Italy: Ministry of Health
United States: Food and Drug Administration
United States: Federal Government

Keywords provided by Janssen Research & Development, LLC:
Multiple Myeloma
CNTO328
Interleukin-6 (IL-6)
Monoclonal antibody
Anti-IL-6 monoclonal antibody
Bortezomib
Velcade
Melphalan
Prednisone

Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Blood Protein Disorders
Cardiovascular Diseases
Hematologic Diseases
Hemorrhagic Disorders
Hemostatic Disorders
Immune System Diseases
Immunoproliferative Disorders
Lymphoproliferative Disorders
Neoplasms
Neoplasms by Histologic Type
Paraproteinemias
Vascular Diseases
Antibodies
Antibodies, Monoclonal
Bortezomib
Immunoglobulins
Melphalan
Prednisone
Alkylating Agents
Anti-Inflammatory Agents
Antineoplastic Agents
Antineoplastic Agents, Alkylating
Antineoplastic Agents, Hormonal
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Immunologic Factors
Immunosuppressive Agents

ClinicalTrials.gov processed this record on October 22, 2014