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Trial registered on ANZCTR
Registration number
ACTRN12606000231549
Ethics application status
Approved
Date submitted
17/05/2006
Date registered
7/06/2006
Date last updated
3/05/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pharmacokinetics and pharmacodynamics of high dose melphalan in myeloma patients undergoing an autograft.
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Scientific title
Using blood melphalan concentrations to reduce toxicity and improve outcome in myeloma autograft recipients
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Secondary ID [1]
268
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Cancer Trials NSW: PK-10-01
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Multiple myeloma
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Condition category
Condition code
Cancer
1294
1294
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0
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Myeloma
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is a multi-institutional study in which a single high dose of melphalan will be administered intravenously over 30 minutes and plasma melphalan concentrations will be measured following the dose to see whether there is a relationship with disease response or toxicity post transplant.. The standard melphalan dose is 200 mg/m2, but some patients will have reduced doses due to renal dysfunction or obesity and this will be according to existing protocols at each participating institution. This is an observational study with no control group.
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Intervention code [1]
1033
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Treatment: Drugs
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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1. We will be establishing the pharmacokinetics of melphalan in a large population of patients with myeloma. Total exposure (or area-under-the-concentration-versus-time curve, AUC) and other pharmacokinetic parameters will be determined for each individual using the blood concentrations.
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Assessment method [1]
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Timepoint [1]
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Measured after a single dose.
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Primary outcome [2]
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2. Data about the patient (e.g. weight, height, surface area, renal function, laboratory values, disease stage and other details, prior chemotherapy) to allow an assessment of the factors that may contribute to the variability in melphalan pharmacokinetic parameters and transplant outcome.
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Assessment method [2]
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Timepoint [2]
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Collected prior to the melphalan dose and autologous transplant, on study enrolment.
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Primary outcome [3]
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3. Transplant related toxicity including mucositis, gastrointestinal toxicity, haematological toxicity, and other toxicities
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Assessment method [3]
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Timepoint [3]
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Followed for up to 4 weeks post the melphalan dose and autologous transplant.
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Primary outcome [4]
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4. Disease response and survival
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Assessment method [4]
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Timepoint [4]
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Followed for up to 2 years post transplant.
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Primary outcome [5]
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5. Statistical methods will be used to identify a target AUC range that is associated with a good outcome with acceptable toxicity.
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Assessment method [5]
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Timepoint [5]
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Analysis will be performed when data on all 140 patients has been collected. This will be approximately 2 years after the transplant date of the last patient recruited into the study.
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Primary outcome [6]
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6. The population pharmacokinetic model can then be used to design a dosing schedule the will aim to provide patients, including those who are heavy or who have renal impairment, with an AUC within the target range to provide the optimal outcome.
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Assessment method [6]
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Timepoint [6]
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When data from 60 patients has been collected. This analysis is currently being performed.
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
All myeloma patients scheduled to receive high dose melphalan followed by an autologous transplant.
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Minimum age
18
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
The only patients that will be exluded from the study are those unable to give informed consent.
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2006
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Actual
21/04/2004
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Date of last participant enrolment
Anticipated
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Actual
29/06/2010
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Date of last data collection
Anticipated
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Actual
1/08/2013
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Sample size
Target
140
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Accrual to date
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Final
120
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
356
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61
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NHMRC project grant 396702
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Address [1]
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MDP 70,
GPO Box 9848
Canberra, ACT, 2601
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
The Childrens Hospital at Westmead
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Address
Hawkesbury Rd. Westmead, NSW, 2145
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Concord Hospital
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Address [1]
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Hospital Rd.
Concord, NSW, 2139
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Country [1]
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Australia
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Secondary sponsor category [2]
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Other Collaborative groups
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Name [2]
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Cancer Trials NSW
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Address [2]
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153 Dowling St.
Woolloomooloo,
NSW, 2011
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Country [2]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Concord Hospital
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Ethics committee address [1]
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Hospital Rd. Concord, NSW, 2139
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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16/03/2004
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Ethics approval number [1]
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CH62/6/2004-016
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Ethics committee name [2]
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Wollongong Hospital
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Ethics committee address [2]
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Loftus St. Wollongong, NSW, 2500
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
2782
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Approval date [2]
2782
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05/04/2005
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Ethics approval number [2]
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HE05/075
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Ethics committee name [3]
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Royal Prince Alfred Hospital
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Ethics committee address [3]
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Missenden Rd. Camperdown, NSW, 2050
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
2783
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Approval date [3]
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02/06/2004
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Ethics approval number [3]
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X04-0105
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Ethics committee name [4]
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St George Hospital
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Ethics committee address [4]
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South St. Kogarah, NSW, 2217
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Ethics committee country [4]
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Australia
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Date submitted for ethics approval [4]
2784
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Approval date [4]
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08/02/2005
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Ethics approval number [4]
2784
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05/06
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Ethics committee name [5]
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Westmead Hospital
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Ethics committee address [5]
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Hawkesbury Rd. Westmead, NSW, 2145
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Ethics committee country [5]
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Australia
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Date submitted for ethics approval [5]
2785
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Approval date [5]
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09/06/2004
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Ethics approval number [5]
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2004/4/4.13(1831)
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Ethics committee name [6]
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Gosford Hospital
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Ethics committee address [6]
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Cnr Holden Street and Racecourse Road, GOSFORD NSW 2250
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Ethics committee country [6]
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Australia
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Date submitted for ethics approval [6]
2786
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Approval date [6]
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19/01/2006
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Ethics approval number [6]
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05/65
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Summary
Brief summary
This study is measuring blood levels of the medication melphalan to improve the way to adjust the dose for people with myeloma. Who is it for? You can join the this study if you have myeloma (a cancer which affects plasma cells in the bone marrow) and are undergoing a bone marrow transplant. Trial details Participants will receive the drug melphalan and will be tested to see how their body breaks down and gets rid of the medication. This study does not replace other studies, but simply investigates key medication widely used in the treatment of myeloma. Participants will be followed for several years after the study to monitor their health. This study will help to define the best way to adjust doses of the drug melphalan, a key medication in helping to control myeloma. Too much causes toxicity and too little risks the disease being more likely to return.
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Trial website
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Trial related presentations / publications
SCIENTIFIC PUBLICATIONS 1. Nath CE, Trotman J, Tiley C, Presgrave P, Joshua D, Kerridge I, Kwan YL, Gurney H, McLachlan A, Earl J, Nivison-Smith I, Zeng L, Shaw PJ. High melphalan exposure is associated with improved overall survival in myeloma patients receiving high dose melphalan and autologous transplantation. Br J. Clin Pharmacol. 2016, 82: 149-159. 2. Nath CE, Shaw PJ, Trotman J, Zeng L, Duffull SB, Hegarty G, McLachlan AJ, Gurney H, Kerridge I, Kwan Y, Presgrave P, Tiley C, Joshua D, Earl J. (2010) Population pharmacokinetics of melphalan in patients with multiple myeloma undergoing high dose therapy. British Journal of Clinical Pharmacology. 69: 484 – 497. 3. Nath CE, Zeng L, Eslick A, Trotman J and Earl J. (2008) An isocratic UV HPLC Assay for the determination of total and free melphalan concentrations in human plasma. Acta Chromatographica. 20(3); 383 – 398. 4. Nath CE, Shaw PJ, Trotman J and Zeng L. (2007) Pharmacokinetics of melphalan in myeloma patients undergoing an autograft. Bone Marrow Transplant. 40: 707 – 708. Conference Presentations 1. Shaw PJ, Nath CE, Nivison-Smith I, Joshua DE, Kerridge IH, Presgrave P, Tiley CR, Kwan YL and Trotman J. Higher Melphalan exposure is associated with improved overall survival for myeloma patients undergoing autologous transplant. Biol Blood Marrow Transplant (2012) : 18 (2) Suppl 2 Pages: S207 Meeting Abstract: 13 2. PJ Shaw, CE Nath, J Trotman, H Gurney, L Zeng, Y Kwan, P Presgrave, C Tiley, D Joshua, I Kerridge, AJ McLachlan, JW Earl. Actual weight to calculate surface area provides the best estimate for AUC in myeloma. ASBMT Feb 2010. Biol Blood Marrow Transplant 2010; 16(2): S180. DOI: 10.1016/j.bbmt.2009.12.088. 3. SB Duffull, G Hegarty, CE Nath, PJ Shaw and J Trotman. Evaluation of an optimal design for examining melphalan pharmacokinetics in patients with multiple myeloma. PAGANZ Feb 2010. 4. CE Nath, PJ Shaw , J Trotman , L Zeng, S Duffull, AJ McLachlan, H Gurney , Y Kwan, P Presgrave, C Tiley, D Joshua, I Kerridge and J Earl. Population pharmacokinetics of melphalan in patients with multiple myeloma. PAGANZ Feb 2010. 5. CE Nath, PJ Shaw, J Trotman, L Zeng, S Duffull, AJ McLachlan, H Gurney, I Kerridge, Y Kwan, P Presgrave, C Tiley, D Joshua, JW Earl, Renal function, haematocrit and body size affect total and unbound melphalan clearance in patients with multiple myeloma. ASCEPT. December 2009. Sydney. 6. Nath CE, Shaw PJ, Trotman J, Zeng L , Joshua D, Kerridge I, Kwan Y, Presgrave P, Tiley C, McLachlan AJ, Gurney H, Earl JW. Pharmacodynamics of high dose melphalan in myeloma. CLINICAL LYMPHOMA & MYELOMA Volume: 9 Pages: S34-S35 Supplement: Suppl. 1. Feb 2009. 12th International Myeloma Workshop. USA. 7. Nath CE, Shaw PJ, Trotman J, Zeng L, Tiley C, Joshua D, Kerridge I, Kwan Y, Presgrave P, Gurney H, McLachlan AJ and Earl JW. (2008). Optimising High Dose Melphalan in patients with multiple Myeloma: Preliminary results from a multi-centre trial. Invited oral presentation at Ehrlich II Conference in Nuremburg in October. Awarded the Paul Ehrlich Magic Bullet Award 2008. 8. Nath CE, Shaw PJ, Trotman J, Zeng L, Gurney H, McLachlan AJ, Presgrave P, Tiley C, Joshua D, Kerridge I, Kwan Y and Earl J (2008). Population pharmacokinetics of melphalan in myeloma patients. Poster presentation at AAPS, Atlanta, USA. 9. Nath CE, Shaw PJ, Trotman J, Zeng L, McLachlan AJ, Gurney H, Kwan YL, Presgrave P, Tiley C, Joshua D, Kerridge I, Kwan YL and Earl J. (2008).Population pharmacokinetics of melphalan in myeloma patients. AACB conference. Newcastle. 10. Nath CE, Shaw PJ, Trotman J, Zeng L, McLachlan AJ, Gurney H, Kwan YL, Presgrave P, Tiley C, Joshua D, Kerridge I and Earl J. (2008) Population pharmacokinetics of melphalan in myeloma patients. ASMR, Sydney. 11. Nath CE, Shaw PJ, Trotman J, Zeng L, Gurney H, McLachlan AJ, Kerridge I, Kwan Y, Presgrave P, Tiley C, Joshua D and Earl J (2008) Population pharmacokinetics of melphalan in myeloma patients undergoing an autograft. PAGANZ (Dunedin, New Zealand). 12. Nath CE, Shaw PJ, Trotman J, Zeng L, Joshua D, Kerridge I, Presgrave P, Kwan YL, Tiley C, Nivivon-Smith I, McLachlan AJ, gurney H, Booth A and Earl JW. (2007). Melphalan pharmacokinetics in myeloma. XIth International Myeloma Workshop. Haematologica - The hematology journal; 92: (6): 188 (Suppl.2).
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Judith Trotman
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Address
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Department of Haematology,
Concord Hospital,
Hospital Rd,
Concord, 2139
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Country
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Australia
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Phone
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61-2-97675000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Christa Nath
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Address
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Department of Biochemistry
The Childrens Hospital at Westmead
Hawkesbury Rd
Locked Bag 4001
Westmead NSW 2145
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Country
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Australia
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Phone
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+61 2 98453287
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Fax
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+61 2 98453332
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Email
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[email protected]
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Contact person for scientific queries
Name
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Christa Nath
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Address
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Department of Biochemistry
The Childrens Hospital at Westmead
Hawkesbury Rd
Locked Bag 4001
Westmead NSW 2145
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Country
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Australia
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Phone
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+61 2 98453287
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Fax
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+61 2 98453332
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF