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Thalidomide + Dexamethasone vs. DOXIL (Doxorubicin HCl Liposome Injection) + Thalidomide + Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma
This study has been completed.

First Received on December 1, 2004.   Last Updated on October 18, 2010   History of Changes
Sponsor: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Collaborator: Tibotec Therapeutics, a Division of Ortho Biotech Products, L.P., USA
Information provided by: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
ClinicalTrials.gov Identifier: NCT00097981
  Purpose

The main purpose of this study is to determine if Thalidomide + Dexamethasone or DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone is more effective in treating patients newly diagnosed with multiple myeloma. The number of patients whose multiple myeloma disappears for a period of time (also called "Complete Response") will be studied to make the determination of which treatment is more effective.


Condition Intervention Phase
Multiple Myeloma
Cancer
Drug: Thalidomide and dexamethasone
Drug: Thalidomide and dexamethasone plus DOXIL
Phase III

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, Multi-Center Trial Comparing Thalidomide Plus Dexamethasone (Thal-Dex) Versus DOXIL plusThalidomide Plus Dexamethasone (DOXIL� -Thal-Dex) in Subjects With Newly Diagnosed Multiple Myeloma

Resource links provided by NLM:


Further study details as provided by Johnson & Johnson Pharmaceutical Research & Development, L.L.C.:

Primary Outcome Measures:
  • Complete Response Rate Defined as the Number of Participants Who Achieve a Complete Response [ Time Frame: Cycle 2 until 28 days following completion of treatment ] [ Designated as safety issue: No ]
    This is assessed at the beginning of every treatment cycle prior to treatment starting at Cycle 2. Complete response must be maintained for at least 6 weeks.


Secondary Outcome Measures:
  • Overall Response [ Time Frame: Cycle 2 until 28 days following completion of treatment ] [ Designated as safety issue: No ]
    Overall response rate defined as the number of participants who achieve a complete response (CR) or partial response (PR).

  • Time to 1st Response [ Time Frame: Cycle 2 until 28 days following completion of treatment ] [ Designated as safety issue: No ]
    Time to 1st response defined as the number of days to achieve a complete response (CR) or partial response (PR).

  • Time to Progression [ Time Frame: Randomization until death or two years post last subject last treatment visit (or clinical cutoff) ] [ Designated as safety issue: No ]
  • Overall Survival [ Time Frame: Randomization until death or two years post last subject last treatment visit (or clinical cutoff) ] [ Designated as safety issue: No ]
  • Achievement of Successful Engraftment After Bone Marrow Transplant [ Time Frame: Randomization until death or two years post last subject last treatment visit (or clinical cutoff) ] [ Designated as safety issue: No ]

Enrollment: 225
Study Start Date: January 2005
Study Completion Date: October 2009
Primary Completion Date: October 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 001
Thalidomide and dexamethasone Thalidomide 200 mg once daily and dex 40 mg on days 1-4, 9-12, 17-20. q28 days
Drug: Thalidomide and dexamethasone
Thalidomide 200 mg once daily and dex 40 mg on days 1-4, 9-12, 17-20. q28 days
Experimental: 002
Thalidomide and dexamethasone plus DOXIL Thalidomide 200 mg once daily and dex 40 mg on days 1-4, 9-12, 17-20. q28 days plus DOXIL 40 mg/m2 on day 1
Drug: Thalidomide and dexamethasone plus DOXIL
Thalidomide 200 mg once daily and dex 40 mg on days 1-4, 9-12, 17-20. q28 days plus DOXIL 40 mg/m2 on day 1

Detailed Description:

The established treatment for newly diagnosed multiple myeloma is vincristine + adriamycin + intermittent high-dose dexamethasone therapy, but it requires a 96-hour continuous infusion of conventional doxorubicin. Newer options can be administered in an out-patient setting, which is more convenient for patients. However, the optimal regimen in producing a high rate of complete response and durable response remains to be established. This is a multi-center, open-label, randomized (patients are assigned different treatment sbased on chance) study to compare the safety and effectiveness of Thalidomide + Dexamethasone vs. DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone in patients with newly diagnosed multiple myeloma. Treatments are administered in 28-day cycles. Patients will receive 4-12 cycles, depending on the response of their multiple myeloma to the treatment they receive (measured according to the European Group for Blood and Marrow Transplant Response Criteria). Thalidomide + Dexamethasone treatment is as follows: Thalidomide by mouth every night without food on Days 1-28. Dosing will be gradually increased during Cycle 1: 50 mg on Days 1-7, 100 mg on Days 8-14, 150 mg on Days 15-21, and 200 mg on Days 22-28. Thereafter, 200 mg daily will be administered for all subsequent cycles. Dexamethasone will be given at 40 mg by mouth on Days 1-4, Days 9-12 and Days 17-20. DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone treatment is as follows: Thalidomide and Dexamethasone will be administered in the same way as described for the Thalidomide + Dexamethasone treatment group. DOXIL (doxorubicin HCl liposome injection) will be administered on Day 1 via intravenous infusion of 40 mg/m2 over 60 minutes (Cycle 1 infusion is over 90 minutes). Patients will be assessed for safety and efficacy by standard evaluations for patients with multiple myeloma at each cycle. Patients will have additional tests that include Multiple Gated Acquisition (MUGA) scans or echocardiograms to assess the patients for potential cardiotoxicity that could be related to treatment with DOXIL (doxorubicin HCl liposome injection) . The study hypothesis is that the DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone treatment will be more effective in the treatment of newly diagnosed multiple myeloma than the Thalidomide + Dexamethasone treatment, as measured by number of complete responses and will be generally well-tolerated. Specific dose adjustments can be made to Thalidomide and/or DOXIL (doxorubicin HCl liposome injection) based upon toxicity. Maximum duration of study participation for patients would be 48 weeks.

  Eligibility

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

Inclusion Criteria:

  • Previously untreated, histologically confirmed multiple myeloma (per International Myeloma Working Group [IMWG] criteria
  • Eastern Cooperative Oncology Group (ECOG) status 0-2
  • Adequate absolute neutrophil count (ANC), platelet count and hemoglobin
  • Adequate serum calcium
  • Enrollment in System for Thalidomide Education and Prescribing Safety Program (S.T.E.P.S.)

Exclusion Criteria:

  • No treatment with dexamethasone for multiple myeloma
  • No peripheral neuropathy of Grade 2 or higher
  • No Left Ventricular Ejection Fraction (LVEF) of < 45%
  • No history of life-threatening thromboembolic events of any kind (i.e., myocardial infarction, pulmonary embolism, stroke or others), within 1 year before enrollment in the study
  • No deep vein thrombosis (DVT) within 1 year of enrollment
  • No current anticoagulation for DVT.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00097981

Sponsors and Collaborators
Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Tibotec Therapeutics, a Division of Ortho Biotech Products, L.P., USA
Investigators
Study Director: Johnson & Johnson Pharmaceutical Research & Development, L.L. C. Clinical Trial Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
  More Information

No publications provided

Responsible Party: Vice President Medical Affairs Oncology/Nephrology, Ortho Biotech Products, L.P.
ClinicalTrials.gov Identifier: NCT00097981     History of Changes
Other Study ID Numbers: CR004579
Study First Received: December 1, 2004
Results First Received: October 2, 2008
Last Updated: October 18, 2010
Health Authority: United States: Food and Drug Administration

Keywords provided by Johnson & Johnson Pharmaceutical Research & Development, L.L.C.:
newly diagnosed multiple myeloma
thalidomide
dexamethasone
DOXIL
pegylated liposomal hydrochloride doxorubicin injection

Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Neoplasms
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
Doxorubicin
Thalidomide
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 February 12, 2012