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Melphalan, Prednisone, Thalidomide and Defibrotide in Relapsed Multiple Myeloma Patients
This study is currently recruiting participants.
Verified by University of Turin, Italy, November 2006
Sponsored by: University of Turin, Italy
Information provided by: University of Turin, Italy
ClinicalTrials.gov Identifier: NCT00406978
  Purpose

This study will evaluate the safety and the efficacy of the association of Melphalan/ Prednisone/Thalidomide/Defibrotide (MPTD) as salvage treatment in advanced and refractory myeloma patients. This association might further increase the response rate achieved by oral MPT regimen


Condition Intervention Phase
Multiple Myeloma
Drug: Thalidomide
Drug: Defibrotide
Drug: Alkeran
Drug: Prednisone
Phase I
Phase II

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Multiple Myeloma
Drug Information available for: Prednisone Melphalan Thalidomide Melphalan hydrochloride Sarcolysin Defibrotide
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Dose Comparison, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase I/II, Multi-Center, Open Label Study of Melphalan, Prednisone, Thalidomide and Defibrotide in Advanced and Refractory Multiple Myeloma Patients

Further study details as provided by University of Turin, Italy:

Primary Outcome Measures:
  • SAFETY
  • EFFICACY

Secondary Outcome Measures:
  • PROGRESSION FREE SURVIVAL
  • OVERALL SURVIVAL

Estimated Enrollment: 75
Study Start Date: February 2006
Estimated Study Completion Date: October 2006
Detailed Description:

Defibrotide (DF) is a novel orally bioavailable polydisperse oligonucleotide with anti-thrombotic and anti-adhesive effects, which has been shown to be active in various microangiopathies, including the treatment and prophylaxis of veno-occlusive disease. While DF has minimal inhibitory effect on multiple myeloma (MM) in cell isolates, it showed single agent activity on human MM xenografts in SCID/NOD mice and markedly increased responsiveness of MM to cytotoxic agents, including melphalan, cyclophosphamide and dexamethasone in the same models. DF might thus enhance the response rate of Melphalan, Prednisone and Thalidomide, while protecting against the prothrombotic state seen with this combination in the treatment of MM. In this multicenter, open label, non-randomised phase I/II trial, dosing safety and efficacy of melphalan, prednisone, thalidomide, and DF (MPTD) were determined in pts with relapsed/refractory MM.

Primary refractory or pts receiving therapeutic anticoagulation were excluded. Oral melphalan was administered at 0,25 mg/Kg on D1-4, oral prednisone at 1,5 mg/kg on D 1-4, thalidomide was delivered at 50 mg on D1-35 on cycle 1 and at 100 mg from cycle 2 to cycle 6.

Level + 1 DF = 17 mg/Kg i.v. or 2.4 g p.o. D1-4, followed by 1.6 g p.o. through D 35 Level + 2 DF = 34 mg/Kg i.v. or 4.8 g p.o. D 1-4, followed by 3.2 g p.o. through D 35 Level + 3 DF = 51 mg/Kg i.v. or 7.2 g p.o. D 1-4, followed by 4.8 g p.o. through D 35.

Each course was repeated every 35d for a total of 6 courses and no DVT prophylaxis was used.

  Eligibility

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

Inclusion Criteria:

  • Each patient must meet all of the following inclusion criteria to be enrolled in the study:
  • Patient is of a legally consenting age as defined by local regulations.
  • Patient is, in the investigator(s) opinion willing and able to comply with the protocol requirements.
  • Patient has given voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care.
  • Female patient is either post-menopausal or surgically sterilized or willing to use an acceptable method of birth control (i.e., a hormonal contraceptive, intrauterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study.
  • Male patient agrees to use an acceptable method for contraception (i.e., condom or abstinence) for the duration of the study.
  • Patient was previously diagnosed with multiple myeloma based on standard criteria (see Section 13.2).
  • Patient is relapsed after one line of treatment but less than three lines, including high-dose chemotherapy with stem cell support, conventional poli-chemotherapy, thalidomide- and melphalan-based regimens
  • Patient with primary refractory disease will be considered not eligible
  • Patient has measurable disease, defined as follows: any quantifiable serum monoclonal protein value (generally, but not necessarily, greater than 1 g/dL of IgG M-Protein and greater than 0.5 g/dL of IgA M-Protein) and, where applicable, urine light-chain excretion of >200 mg/24 hours.
  • Patient has a Karnofsky performance status ≥60%.
  • Patient has a life-expectancy >3 months.
  • Patient has the following laboratory values within 14 days before Baseline (day 1 of the Cycle 1, before study drug administration):
  • Platelet count ≥90 x 109/L without transfusion support within 7 days before the test.
  • Absolute neutrophil count (ANC) ≥ 1.00 x 109/L without the use of growth factors
  • Corrected serum calcium ≤14 mg/dL (3.5 mmol/L).
  • Aspartate transaminase (AST): ≤ 2.5 x the upper limit of normal (ULN).
  • Alanine transaminase (AST): ≤ 2.5 x the ULN.
  • Total bilirubin: ≤ 1.5 x the ULN.
  • Calculated or measured creatinine clearance: ≥20 mL/minute

Exclusion Criteria:

Patients meeting any of the following exclusion criteria are not to be enrolled in the study.

  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Pregnant or beast feeding females.
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Use of any other concomitant standard/experimental anti-myeloma drug or therapy
  • Known positive for HIV or active infectious hepatitis, type B or C
  • Other concurrent anticoagulation treatment
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00406978

Contacts
Contact: ANTONIO PALUMBO, MD 011 6336107 ext +39 gismm2001@yahoo.com

Locations
Italy
Dip. Scienze Mediche & IRCAD-Università, UDA Ematologia Recruiting
Novara, Italy, 28100
Contact: Gianluca Gaidano, MD            
Contact: Davide Rossi, MD         rossidav@med.unipmn.it    
Principal Investigator: Gianluca Gaidano, MD            
Policlinico Monteluce, Clinica Medica I Recruiting
Perugia, Italy, 06123
Contact: Anna Marina Liberati, MD     075/5783631     marinal@unipg.it    
Principal Investigator: Anna Marina Liberati, MD            
Divisione Di Ematologia, Ospedali Riuniti Recruiting
REGGIO CALABRIA, Italy
Contact: VINCENZO CALLEA, MD     0965/397222     calleamd@tin.it    
Principal Investigator: VINCENZO CALLEA, MD            
Servizio di Ematologia, Azienda Ospedaliera S. Maria Nuova Recruiting
Reggio Emilia, Italy, 42100
Contact: Luigi Gugliotta, MD         gugliotta.luigi@asmn.re.it    
Contact: Luciano Masini, MD         masini.luciano@asmn.re.it    
Principal Investigator: Luigi Gugliotta, MD            
Italy, to
Div. Univ. Di Ematologia, Az. Osp. San Giovanni Battista Recruiting
TORINO, to, Italy, 10126
Contact: Mario Boccadoro, MD     011 6336107     gismm2001@yahoo.com    
Contact: Antonio Palumbo, MD            
Principal Investigator: MARIO BOCCADORO, MD            
Sponsors and Collaborators
University of Turin, Italy
Investigators
Principal Investigator: MARIO BOCCADORO, MD DIVISIONE DI EMATOLOGIA DELL'UNIVERSITA' DI TORINO, AZIENDA OSPEDALIERA SAN GIOVANNI BATTISTA, TORINO, ITALY
  More Information

Publications:
Study ID Numbers: MM2005
Study First Received: November 30, 2006
Last Updated: November 30, 2006
ClinicalTrials.gov Identifier: NCT00406978  
Health Authority: Italy: Ministry of Health

Keywords provided by University of Turin, Italy:
MYELOMA
THALIDOMIDE
DEFIBRODITE

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

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Anti-Infective Agents
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Hematologic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Fibrinolytic Agents
Hormones
Anti-Bacterial Agents
Fibrin Modulating Agents
Therapeutic Uses
Cardiovascular Diseases
Angiogenesis Modulating Agents
Growth Inhibitors
Neoplasms by Histologic Type
Antineoplastic Agents, Hormonal
Immune System Diseases
Growth Substances
Cardiovascular Agents
Glucocorticoids
Immunosuppressive Agents
Angiogenesis Inhibitors
Pharmacologic Actions
Neoplasms
Platelet Aggregation Inhibitors
Leprostatic Agents

ClinicalTrials.gov processed this record on January 16, 2009