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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT01348919
Registration number
NCT01348919
Ethics application status
Date submitted
4/05/2011
Date registered
6/05/2011
Date last updated
28/06/2023
Titles & IDs
Public title
Delanzomib (CEP-18770) in Combination With Lenalidomide and Dexamethasone in Relapsed or Refractory Multiple Myeloma
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Scientific title
An Open-Label Study to Determine the Maximum Tolerated Dose and Evaluate the Safety and Efficacy of CEP-18770 in Combination With Lenalidomide and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma
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Secondary ID [1]
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2010-020910-27
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Secondary ID [2]
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C18770/2049
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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
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Other cancer types
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - CEP-18770
Treatment: Drugs - Lenalidomide
Treatment: Drugs - Dexamethasone
Experimental: CEP-18770 Dose A - Participants will receive CEP-18770 Dose A intravenously (IV) on Days 1, 8, and 15 in each 28-day cycle. In addition, participants will receive a fixed dose of 25 mg oral lenalidomide on Days 1 through 21 and a fixed dose of 40 mg oral dexamethasone on Days 1, 8, 15, and 22 of each 28-day cycle.
Experimental: CEP-18770 Dose B - Participants will receive CEP-18770 Dose B IV on Days 1, 8, and 15 in each 28-day cycle. In addition, participants will receive a fixed dose of 25 mg oral lenalidomide on Days 1 through 21 and a fixed dose of 40 mg oral dexamethasone on Days 1, 8, 15, and 22 of each 28-day cycle.
Experimental: CEP-18770 Dose C - Participants will receive CEP-18770 Dose C IV on Days 1, 8, and 15 in each 28-day cycle. In addition, participants will receive a fixed dose of 25 mg oral lenalidomide on Days 1 through 21 and a fixed dose of 40 mg oral dexamethasone on Days 1, 8, 15, and 22 of each 28-day cycle.
Treatment: Drugs: CEP-18770
CEP-18770 will be administered per dose and schedule specified in the arm description.
Treatment: Drugs: Lenalidomide
Lenalidomide will be administered per dose and schedule specified in the arm description.
Treatment: Drugs: Dexamethasone
Dexamethasone will be administered per dose and schedule specified in the arm description.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Overall Response Rate (ORR) in Participants Treated at the (Maximum Tolerated Dose) MTD, as Assessed Using International Myeloma Working Group (IMWG) Criteria
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Assessment method [1]
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The ORR is defined as percentage of participants who achieve a best response of stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) during the study. sCR: negative immunofixation in serum and urine; disappearance of any soft tissue plasmacytomas; < 5% plasma cells in bone marrow; normal free light chain (FLC) ratio; and absence of clonal cells in bone marrow. CR: negative immunofixation in serum and urine; disappearance of any soft tissue plasmacytomas; and <5% plasma cells in bone marrow. VGPR: serum and urine M-protein detectable by immunofixation but not on electrophoresis; 90% or greater reduction in serum M-protein level and urine M-protein level less than 100 milligrams (mg)/24 hours. PR: =50% reduction in serum M-protein level; =90% reduction in 24-hour urinary M-protein level or reduction to less than 200 mg per 24 hours; and =50% reduction in the size of any soft tissue plasmacytomas present at baseline.
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Timepoint [1]
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From the first administration of CEP-18770 up to approximately 1.5 years
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Primary outcome [2]
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Maximum Tolerated Dose of CEP-18770
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Assessment method [2]
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MTD was based on the assessment of dose-limiting toxicity (DLT) during cycle 1 only and was defined as the highest dose at which fewer than one-third of participants in a cohort experience DLT. A DLT was defined as any of the following drug-related toxicities occurring during Cycle 1: Hematologic adverse events (AEs) (Grade 4 hematologic AEs, Grade 3 hematologic AEs with sequelae); Grade 3 nonhematologic AEs; Neuropathy (Grade 2 neuropathy, Grade 1 neuropathy with pain, worsening grade of neuropathy or new symptoms of pain associated with neuropathy); Any other toxicity that, in the judgment of the principal investigator, was a DLT; If a participant cannot receive 75% of the planned dose for any of the 3 agents (missing >1 dose of CEP-18770, or >5 doses of lenalidomide, or >1 dose of dexamethasone [either consecutively or separately]), due to a drug-related AE, the event was considered a DLT, even if the grade of toxicity was lower than specified DLT determination as described above.
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Timepoint [2]
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Cycle 1 (28 days)
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Secondary outcome [1]
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Duration of Response (DOR) for Participants Treated With CEP-18770 at the MTD, as Assessed Using IMWG Criteria
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Assessment method [1]
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DOR was defined as the time interval from the date of first response (sCR, CR, VGPR, or PR) to the date of disease progression. sCR, CR, VGPR, and PR as defined in outcome measure 1. Disease progression was defined as any 1 or more of the following: Increase of 25% or more from lowest response level in any 1 or more of the following: - serum M-component (absolute increase must be =0.5 grams [g]/deciliter [dL]), - urine M-component (absolute increase must be =200 mg/24 hours), bone marrow plasma cell percentage =10%; definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas; and development of hypercalcemia (corrected serum calcium >11.5 mg/dL) that could be attributed solely to the plasma cell proliferation disorder.
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Timepoint [1]
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From the date of first response to the date of disease progression (up to approximately 1.5 years)
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Secondary outcome [2]
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Time to Progression (TTP) for Participants Treated With CEP-18770 at the MTD, as Assessed Using IMWG Criteria
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Assessment method [2]
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TTP was defined as the time interval from the date of first dose to the date of disease progression. Disease progression was defined as any 1 or more of the following: Increase of 25% or more from lowest response level in any 1 or more of the following: - serum M-component (absolute increase must be =0.5 g/dL), - urine M-component (absolute increase must be =200 mg/24 hours), bone marrow plasma cell percentage =10%; definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas; and development of hypercalcemia (corrected serum calcium >11.5 mg/dL) that could be attributed solely to the plasma cell proliferation disorder.
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Timepoint [2]
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From the date of first dose of study drug to the date of disease progression (up to approximately 1.5 years)
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Secondary outcome [3]
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Number of Participants With Adverse Events (AEs)
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Assessment method [3]
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An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. SAEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Timepoint [3]
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From the first administration of CEP-18770 up to approximately 1.5 years
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Secondary outcome [4]
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Maximum Observed Plasma Concentration (Cmax) of CEP-18770
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Assessment method [4]
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Timepoint [4]
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Before and immediately after end of infusion (EOI) and at approximately 2, 4, and 8 hours after the EOI on Days 1 and 15 of Cycle 1
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Secondary outcome [5]
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Time to Reach Cmax (Tmax) of CEP-18770
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Assessment method [5]
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Timepoint [5]
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Before and immediately after end of infusion (EOI) and at approximately 2, 4, and 8 hours after the EOI on Days 1 and 15 of Cycle 1
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Secondary outcome [6]
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Area Under the Plasma Concentration-Time Curve From Time 0 to t (AUC0-t) of CEP-18770
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Assessment method [6]
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Timepoint [6]
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Before and immediately after end of infusion (EOI) and at approximately 2, 4, and 8 hours after the EOI on Days 1 and 15 of Cycle 1
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Eligibility
Key inclusion criteria
- The participant is a man or woman at least 18 years of age with documented multiple
myeloma.
- The participant has relapsed or progressive disease after receiving at least 1
previous chemotherapy treatment but no more than 5 previous therapies.
- The participant has measurable disease defined as 1 of the following:
- serum M-protein 0.5 grams (g)/deciliter (dL) or greater
- urine M-protein 200 mg/24 hours or greater
- The participant has a life expectancy of more than 3 months.
- Written informed consent is obtained.
- The participant has an Eastern Cooperative Oncology Group (ECOG) performance status of
0, 1, or 2.
- The participant has adequate hepatic and renal function and hematologic assessments as
specified by the study protocol
- The participant has been independent of support with granulocyte-colony stimulating
factor (G-CSF) or granulocyte macrophage-colony stimulating factor (GM-CSF) for more
than 1 week at the time of screening.
- The participant has been independent of platelet transfusions for 1 week at the time
of screening.
- The participant may have received an allogeneic and/or autologous transplant.
- The participant must agree to register into the mandatory risk evaluation and
mitigation program for receiving lenalidomide if required by local regulations.
- Agreement by women of childbearing potential (not surgically sterile or 24 months
postmenopausal) to use 2 medically accepted methods of contraception and must agree to
continue use of these methods from 4 weeks prior to treatment to 4 weeks after
treatment. Acceptable methods of contraception include at least one highly effective
method (for example, intrauterine device [IUD], non-combination hormonal
contraception, tubal ligation, or partner's vasectomy) and one additional method (for
example, latex condom, diaphragm, or cervical cap).
- Agreement by men who are sexually active with a woman of childbearing potential (as
defined in the criterion above), to use a condom during any sexual contact for the
duration of the study and for 4 weeks after the last administration of study drug.
This requirement applies even if the man has had a vasectomy.
- The participant may not donate blood, semen or sperm while taking lenalidomide or for
4 weeks after the last administration of lenalidomide.
- The participant may not breastfeed while taking lenalidomide or for 4 weeks after the
last administration of lenalidomide.
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Minimum age
18
Years
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Maximum age
No limit
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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 participant has nonmeasurable multiple myeloma, defined as less than 0.5 g/dL
M-protein in the serum, and less than 200 mg/24 hours M-protein in the urine.
- The participant could not tolerate previous lenalidomide or low-dose dexamethasone
treatment.
- The participant had previous treatment with CEP-18770.
- The participant has POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy,
monoclonal gammopathy or monoclonal proliferative disorder, and skin changes
[increased skin pigment, increased body hair, thickening of the skin, whitening of the
nails, etc]).
- The participant has plasma cell leukemia or primary amyloidosis.
- The participant received chemotherapy with approved or investigative anticancer
therapeutics within 3 weeks before the first dose of study drug.
- The participant received radiation therapy or immunotherapy within 4 weeks or
localized radiation therapy within 1 week prior to the first dose of study drug.
- The participant had major surgery within 3 weeks before the first dose of study drug.
- The participant has congestive heart failure (New York Heart Association Class III to
IV) or had symptomatic ischemia, conduction abnormalities uncontrolled by conventional
intervention, or myocardial infarction within the last 6 months.
- The participant had an acute infection requiring systemic antibiotics, antiviral
agents, or antifungal agents within 2 weeks before the first dose of study drug.
- The participant has a known or suspected human immunodeficiency virus (HIV) infection,
acute or chronic hepatitis B virus or hepatitis C virus on the basis of their medical
history.
- The participant has myelodysplastic or myeloproliferative syndrome.
- The participant has significant neuropathy (at least grade 2, or grade 1 with pain).
- The participant is a pregnant or lactating woman.
- The participant has known hypersensitivity to CEP-18770, lenalidomide, thalidomide,
dexamethasone, mannitol, or hydroxypropyl betadex.
- The participant received glucocorticoid therapy (prednisone >10 mg/day orally or
equivalent) within the last 2 weeks prior to the first dose of study drug.
- The participant has a history of malignancy, other than multiple myeloma, within the
last 5 years excluding adequately treated curable disease or indolent disease that is
not likely to require therapy during the conduct of the study.
- The participant has known central nervous system (CNS) involvement.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
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Phase
Phase 1/Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
3/08/2011
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
14/03/2013
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Sample size
Target
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Accrual to date
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Final
11
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Georgia
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United States of America
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State/province [2]
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Kentucky
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Country [3]
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United States of America
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State/province [3]
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Texas
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Country [4]
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New Zealand
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State/province [4]
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Auckland
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Country [5]
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New Zealand
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State/province [5]
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Christchurch
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Country [6]
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New Zealand
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State/province [6]
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Hamilton
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Country [7]
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New Zealand
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State/province [7]
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Newtown
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Teva Branded Pharmaceutical Products R&D, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The primary objective of the study is to determine the maximum tolerated dose (MTD) of
CEP-18770 in combination with lenalidomide and dexamethasone in participants with relapsed or
refractory multiple myeloma.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT01348919
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Teva Medical Expert
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Address
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Teva Branded Pharmaceutical Products R&D, Inc.
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT01348919
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