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Bortezomib, Ascorbic Acid, and Melphalan in Treating Patients With Newly Diagnosed Multiple Myeloma
This study is ongoing, but not recruiting participants.
Sponsored by: Oncotherapeutics
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00317811
  Purpose

RATIONALE: Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as melphalan, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Ascorbic acid may help melphalan work better by making cancer cells more sensitive to the drug. Giving bortezomib together with ascorbic acid and melphalan may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving bortezomib together with ascorbic acid and melphalan works in treating patients with newly diagnosed multiple myeloma.


Condition Intervention Phase
Multiple Myeloma and Plasma Cell Neoplasm
Drug: ascorbic acid
Drug: bortezomib
Drug: melphalan
Phase II

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Cancer Multiple Myeloma
Drug Information available for: Melphalan Bortezomib Melphalan hydrochloride Sarcolysin Ascorbic acid
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Trial of Bortezomib + Ascorbic Acid + Melphalan (BAM) Combination Therapy for Patients With Newly Diagnosed Multiple Myeloma

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Overall response rate (complete response [CR], near CR, partial response, and minimal response) [ Designated as safety issue: No ]
  • Safety and tolerability as assessed by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
  • Proportion of patients responding [ Designated as safety issue: No ]
  • Time to disease progressionin patients receiving maintenance treatment [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to response [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Overall survival as assessed by the Kaplan-Meier method [ Designated as safety issue: No ]
  • Time to disease progression [ Designated as safety issue: No ]

Estimated Enrollment: 35
Study Start Date: November 2005
Detailed Description:

OBJECTIVES:

Primary

  • Determine the overall response rate (combined complete response [CR], near CR, partial response [PR], and minimal response [MR]) and time to progression of disease in patients with newly diagnosed multiple myeloma treated with bortezomib, ascorbic acid, and melphalan.
  • Assess the safety and tolerability of this regimen in these patients.

Secondary

  • Assess the time to response in these patients.
  • Determine progression-free and overall survival of these patients.
  • Assess time to disease progression among subjects who continue to maintenance treatment with bortezomib.

OUTLINE: This is an open-label study.

  • Induction therapy: Patients receive bortezomib IV on days 1, 4, 8, and 11 and oral melphalan and oral ascorbic acid on days 1-4. Treatment repeats every 28 days to maximum response [MR] or for at least 8 courses in the absence of disease progression or unacceptable toxicity. Patients with responding disease receive an additional 2 courses of induction therapy beyond MR and proceed to maintenance therapy. Patients with stable disease or without a maximum reduction in their paraprotein after 8 courses of induction therapy are eligible to receive maintenance therapy.
  • Maintenance therapy: Patients receive bortezomib IV on days 1 and 15. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 35 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Newly diagnosed symptomatic multiple myeloma based on the following criteria:

    • Durie-Salmon staging
    • Measurable disease, defined as a monoclonal immunoglobulin spike on serum electrophoresis of ≥ 1 g/dL and/or urine monoclonal immunoglobulin spike of ≥ 200 mg/24 hours
  • Symptomatic disease
  • No POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein [M-protein], and skin changes)
  • No plasma cell leukemia

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 60-100%
  • Life expectancy > 3 months
  • Platelet count ≥ 50,000/mm³ (30,000/mm³ if the bone marrow is extensively infiltrated)
  • Hemoglobin ≥ 8.0 g/dL
  • Absolute neutrophil count ≥ 1,000/mm³
  • Creatinine ≤ 3 mg/dL
  • Sodium > 130 mmol/L corrected
  • AST and ALT ≤ 3 times upper limit of normal (ULN)
  • Bilirubin ≤ 2 times ULN unless clearly related to the disease
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Any ECG abnormality has to be documented by the investigator as not medically relevant
  • No electrocardiographic evidence of acute ischemia or new conduction system abnormalities
  • No myocardial infarction or EKG evidence of infarction within the past 6 months
  • No active infection
  • No severe hypercalcemia (i.e., serum calcium ≥ 14 mg/dL [3.5 mmol/L])
  • No New York Heart Association class III or IV heart failure
  • No uncontrolled angina
  • No severe uncontrolled ventricular arrhythmias
  • No active conduction system abnormalities
  • No poorly controlled hypertension
  • No diabetes mellitus
  • No known HIV infection
  • No known active hepatitis B or C viral infection
  • No history of grand mal seizures
  • No history of allergic reaction to compounds of similar chemical or biological composition to melphalan, bortezomib, boron, or mannitol
  • No peripheral neuropathy ≥ grade 2 within the past 14 days
  • No other serious medical or psychiatric illness that could potentially interfere with the completion of study treatment

PRIOR CONCURRENT THERAPY:

  • More than 4 weeks since prior immunotherapy, antibody therapy, or radiotherapy
  • More than 4 weeks since prior major surgery
  • No prior therapy for myeloma

    • Prior prednisone at a total of 400mg over ≤ 4 days (or an equivalent potency of another steroid) allowed
  • No concurrent corticosteroids (≥ 10 mg prednisone/day or equivalent)
  • No other concurrent investigational agents
  • No other concurrent antimyeloma therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00317811

Locations
United States, California
Hematology Oncology Medical Group of Orange County, Incorporated
Orange, California, United States, 92868
Hematology-Oncology Medical Group of Fresno, Incorporated
Fresno, California, United States, 93720
Oncotherapeutics
West Hollywood, California, United States, 90069
United States, Florida
Florida Cancer Specialists - Bonita Springs
Bonita Springs, Florida, United States, 34135
Florida Oncology Associates
Orange Park, Florida, United States, 32073
United States, Georgia
Atlanta Cancer Care - Roswell
Roswell, Georgia, United States, 30076
United States, Illinois
University of Chicago Cancer Research Center
Chicago, Illinois, United States, 60637-1470
United States, New York
SUNY Downstate Medical Center
Brooklyn, New York, United States, 11203
Sponsors and Collaborators
Oncotherapeutics
Investigators
Principal Investigator: James R. Berenson, MD Oncotherapeutics
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000479708, ONCOTHER-20052183, ONCOTHER-BAM2005, MILLENNIUM-ONCOTHER-20052183
Study First Received: April 24, 2006
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00317811  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage I multiple myeloma
stage II multiple myeloma
stage III multiple myeloma

Study placed in the following topic categories:
Melphalan
Immunoproliferative Disorders
Blood Protein Disorders
Hematologic Diseases
Blood Coagulation Disorders
Bortezomib
Vascular Diseases
Paraproteinemias
Hemostatic Disorders
Multiple Myeloma
Hemorrhagic Disorders
Multiple myeloma
Lymphoproliferative Disorders
Ascorbic Acid
Neoplasms, Plasma Cell

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Antioxidants
Immunologic Factors
Immune System Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Immunosuppressive Agents
Protective Agents
Pharmacologic Actions
Protease Inhibitors
Neoplasms
Therapeutic Uses
Vitamins
Myeloablative Agonists
Cardiovascular Diseases
Antineoplastic Agents, Alkylating
Micronutrients
Alkylating Agents

ClinicalTrials.gov processed this record on January 16, 2009