Trial Outcomes & Findings for Carfilzomib + High Dose Melphalan as Preparative Regimen for Autologous Hematopoietic Stem Cell Transplantation (NCT NCT01690143)

NCT ID: NCT01690143

Last Updated: 2018-08-07

Results Overview

The maximum tolerated dose of carfilzomib that can be safely combined with high dose melphalan as conditioning regimen prior to autologous hematopoietic cell transplantation in patients with relapsed multiple myeloma meeting eligibility criteria.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

45 participants

Primary outcome timeframe

Up to 4 1/2 months

Results posted on

2018-08-07

Participant Flow

Participant milestones

Participant milestones
Measure
Carfilzomib + High Dose Melphalan
Single arm. Carfilzomib: Subjects will receive the appropriate dose of carfilzomib (according to assigned cohort in phase 1 and at the determined MTD in phase 2) on days -3 and -2. Carfilzomib will be infused over 30 minutes. Prophylaxis of chemotherapy induced nausea and vomiting will follow institutional guidelines and SOPs. Melphalan: Subjects will receive 200 mg/m2 of intravenous melphalan on Day -2. Administered as an intravenous push or a fast infusion according to institutional standard operating procedure (SOP). Prophylaxis of chemotherapy induced nausea and vomiting will follow institutional guidelines and SOPs.
Overall Study
STARTED
45
Overall Study
COMPLETED
44
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Carfilzomib + High Dose Melphalan
Single arm. Carfilzomib: Subjects will receive the appropriate dose of carfilzomib (according to assigned cohort in phase 1 and at the determined MTD in phase 2) on days -3 and -2. Carfilzomib will be infused over 30 minutes. Prophylaxis of chemotherapy induced nausea and vomiting will follow institutional guidelines and SOPs. Melphalan: Subjects will receive 200 mg/m2 of intravenous melphalan on Day -2. Administered as an intravenous push or a fast infusion according to institutional standard operating procedure (SOP). Prophylaxis of chemotherapy induced nausea and vomiting will follow institutional guidelines and SOPs.
Overall Study
Withdrawal by Subject
1

Baseline Characteristics

Carfilzomib + High Dose Melphalan as Preparative Regimen for Autologous Hematopoietic Stem Cell Transplantation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Carfilzomib + High Dose Melphalan
n=45 Participants
Single arm. Carfilzomib: Subjects will receive the appropriate dose of carfilzomib (according to assigned cohort in phase 1 and at the determined MTD in phase 2) on days -3 and -2. Carfilzomib will be infused over 30 minutes. Prophylaxis of chemotherapy induced nausea and vomiting will follow institutional guidelines and SOPs. Melphalan: Subjects will receive 200 mg/m2 of intravenous melphalan on Day -2. Administered as an intravenous push or a fast infusion according to institutional standard operating procedure (SOP). Prophylaxis of chemotherapy induced nausea and vomiting will follow institutional guidelines and SOPs.
Age, Continuous
58 years
n=99 Participants
Sex: Female, Male
Female
25 Participants
n=99 Participants
Sex: Female, Male
Male
20 Participants
n=99 Participants
Race/Ethnicity, Customized
Non-Hispanic Whites
26 Participants
n=99 Participants
Race/Ethnicity, Customized
Non-Hispanic Blacks
18 Participants
n=99 Participants
Race/Ethnicity, Customized
Other
1 Participants
n=99 Participants

PRIMARY outcome

Timeframe: Up to 4 1/2 months

Population: Patients who underwent transplantation during phase 1

The maximum tolerated dose of carfilzomib that can be safely combined with high dose melphalan as conditioning regimen prior to autologous hematopoietic cell transplantation in patients with relapsed multiple myeloma meeting eligibility criteria.

Outcome measures

Outcome measures
Measure
Patients Undergoing Transplantation
n=15 Participants
All patients who receive transplant in the phase 1 of the study
Maximum Tolerated Dose (MTD) of Carfilzomib Plus Melphalan as Conditioning for Autologous Hematopoietic Cell Transplantation in Patients With Relapsed Multiple Myeloma(MM) [Phase I Portion of Study]
56 mg/m2

PRIMARY outcome

Timeframe: Up to 17 months

Population: All patients who underwent transplantation

VGPR defined as any one of the following: ≥ 90% reduction of serum M-protein; ≥ 90% reduction in 24-hour urinary M-protein or decrease to \< 100 mg per 24 hour; ≥ 50% decrease in the difference between involved and uninvolved FLC levels or a 50% decrease in level of involved FLC with 50% decrease in ratio; ≥ 50% reduction in bone marrow plasma cells; ≥ 50% reduction in the size of soft tissue plasmacytomas.

Outcome measures

Outcome measures
Measure
Patients Undergoing Transplantation
n=44 Participants
All patients who receive transplant in the phase 1 of the study
Very Good Partial Response (VGPR) Rate.
26 Participants

PRIMARY outcome

Timeframe: Up to 17 months

CR defined as the following: Negative immunofixation of the serum and urine. If only the measurable non-bone marrow parameter was free light chain, normalization of free light chain ratio. \< 5% plasma cells in bone marrow. And, disappearance of any soft tissue plasmacytomas.

Outcome measures

Outcome measures
Measure
Patients Undergoing Transplantation
n=44 Participants
All patients who receive transplant in the phase 1 of the study
Complete Response (CR) Rate.
10 Participants

PRIMARY outcome

Timeframe: Up to 1 month.

Population: All patients

Neutrophil engraftment is defined as the first of three consecutive days with absolute neutrophil count \>500/mm3. Platelet engraftment is defined as the first of 3 consecutive days of platelets \> 20,000/mm3 without platelet transfusion in the prior 7 days.

Outcome measures

Outcome measures
Measure
Patients Undergoing Transplantation
n=44 Participants
All patients who receive transplant in the phase 1 of the study
Median Time for Neutrophil and Platelet Engraftment.
10 days
Interval 8.0 to 16.0

PRIMARY outcome

Timeframe: Up to 4 1/2 months

Grading of AE's is performed using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.

Outcome measures

Outcome measures
Measure
Patients Undergoing Transplantation
n=44 Participants
All patients who receive transplant in the phase 1 of the study
Frequency of Grades 3 and 4 Non-hematologic Adverse Events During the Transplant Component ( 135 Days)
22 Participants

Adverse Events

Patients Undergoing Transplantation

Serious events: 1 serious events
Other events: 25 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Patients Undergoing Transplantation
n=44 participants at risk
All patients who receive transplant in the phase 1+2 of the study
Cardiac disorders
heart failure
2.3%
1/44 • Number of events 1 • 12 months
Renal and urinary disorders
renal failure
2.3%
1/44 • Number of events 1 • 12 months

Other adverse events

Other adverse events
Measure
Patients Undergoing Transplantation
n=44 participants at risk
All patients who receive transplant in the phase 1+2 of the study
Infections and infestations
Infection
38.6%
17/44 • Number of events 17 • 12 months
Gastrointestinal disorders
diarrhea
11.4%
5/44 • Number of events 5 • 12 months
Cardiac disorders
hypertension
9.1%
4/44 • Number of events 4 • 12 months
Immune system disorders
rash
6.8%
3/44 • Number of events 3 • 12 months
Endocrine disorders
hyperkalemia
6.8%
3/44 • Number of events 3 • 12 months

Additional Information

Luciano J Costa, Principal Investigator

University of Alabama at Birmingham

Phone: 205-209-6038

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place