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Thalidomide + Dexamethasone Versus DOXIL (Doxorubicin HCl Liposome Injection) + Thalidomide + Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Tibotec Therapeutics, a Division of Ortho Biotech Products, L.P., USA
Information provided by: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
ClinicalTrials.gov Identifier: NCT00097981
  Purpose

The main purpose of this study is to determine if Thalidomide + Dexamethasone or DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone is more effective in treating patients newly diagnosed with multiple myeloma. The number of patients whose multiple myeloma disappears for a period of time (also called "Complete Response") will be studied to make the determination of which treatment is more effective.


Condition Intervention Phase
Cancer
Multiple Myeloma
Drug: Thalidomide and dexamethasone
Drug: Thalidomide and dexamethasone plus DOXIL
Phase III

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Cancer Multiple Myeloma
Drug Information available for: Doxorubicin Doxorubicin hydrochloride Dexamethasone Dexamethasone acetate Dexamethasone Sodium Phosphate Doxiproct plus Thalidomide
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study
Official Title: A Randomized, Open-Label, Multi-Center Trial Comparing Thalidomide Plus Dexamethasone (Thal-Dex) Versus DOXIL Plus Thalidomide Plus Dexamethasone (DOXIL® -Thal-Dex) in Subjects With Newly Diagnosed Multiple Myeloma

Further study details as provided by Johnson & Johnson Pharmaceutical Research & Development, L.L.C.:

Primary Outcome Measures:
  • Complete Response Rate Defined as the Number of Participants Who Achieve a Complete Response [ Time Frame: Cycle 2 until 28 days following completion of treatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall Response [ Time Frame: Cycle 2 until 28 days following completion of treatment ] [ Designated as safety issue: No ]
  • Time to Progression [ Time Frame: Randomization until death or two years post last subject last treatment visit (or clinical cutoff) ] [ Designated as safety issue: No ]
  • Time to 1st Response [ Time Frame: Cycle 2 until 28 days following completion of treatment ] [ Designated as safety issue: No ]
  • Overall Survival [ Time Frame: Randomization until death or two years post last subject last treatment visit (or clinical cutoff) ] [ Designated as safety issue: No ]
  • Achievement of Successful Engraftment After Bone Marrow Transplant [ Time Frame: Randomization until death or two years post last subject last treatment visit (or clinical cutoff) ] [ Designated as safety issue: No ]

Enrollment: 225
Study Start Date: November 2004
Estimated Study Completion Date: September 2009
Primary Completion Date: October 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
001: Active Comparator Drug: Thalidomide and dexamethasone
Thalidomide 200 mg once daily and dex 40 mg on days 1-4, 9-12, 17-20. q28 days
002: Experimental Drug: Thalidomide and dexamethasone plus DOXIL
Thalidomide 200 mg once daily and dex 40 mg on days 1-4, 9-12, 17-20. q28 days plus DOXIL 40 mg/m2 on day 1

Detailed Description:

The established treatment for newly diagnosed multiple myeloma is vincristine + adriamycin + intermittent high-dose dexamethasone therapy, but it requires a 96-hour continuous infusion of conventional doxorubicin. Newer options can be administered in an out-patient setting, which is more convenient for patients. However, the optimal regimen in producing a high rate of complete response and durable response remains to be established. This is a multi-center, open-label, randomized (patients are assigned different treatments based on chance) study to compare the safety and effectiveness of Thalidomide + Dexamethasone vs. DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone in patients with newly diagnosed multiple myeloma. Treatments are administered in 28-day cycles. Patients will receive 4-12 cycles, depending on the response of their multiple myeloma to the treatment they receive (measured according to the European Group for Blood and Marrow Transplant Response Criteria). Thalidomide + Dexamethasone treatment is as follows: Thalidomide by mouth every night without food on Days 1-28. Dosing will be gradually increased during Cycle 1: 50 mg on Days 1-7, 100 mg on Days 8-14, 150 mg on Days 15-21, and 200 mg on Days 22-28. Thereafter, 200 mg daily will be administered for all subsequent cycles. Dexamethasone will be given at 40 mg by mouth on Days 1-4, Days 9-12 and Days 17-20. DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone treatment is as follows: Thalidomide and Dexamethasone will be administered in the same way as described for the Thalidomide + Dexamethasone treatment group. DOXIL (doxorubicin HCl liposome injection) will be administered on Day 1 via intravenous infusion of 40 mg/m2 over 60 minutes (Cycle 1 infusion is over 90 minutes). Patients will be assessed for safety and efficacy by standard evaluations for patients with multiple myeloma at each cycle. Patients will have additional tests that include Multiple Gated Acquisition (MUGA) scans or echocardiograms to assess the patients for potential cardiotoxicity that could be related to treatment with DOXIL (doxorubicin HCl liposome injection) . The study hypothesis is that the DOXIL (doxorubicin HCl liposome injection) + Thalidomide + Dexamethasone treatment will be more effective in the treatment of newly diagnosed multiple myeloma than the Thalidomide + Dexamethasone treatment, as measured by number of complete responses and will be generally well-tolerated.

Specific dose adjustments can be made to Thalidomide and/or DOXIL (doxorubicin HCl liposome injection) based upon toxicity. Maximum duration of study participation for patients would be 48 weeks.

  Eligibility

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

Inclusion Criteria:

  • Previously untreated, histologically confirmed multiple myeloma (per International Myeloma Working Group [IMWG] criteria
  • Eastern Cooperative Oncology Group (ECOG) status 0-2
  • Adequate absolute neutrophil count (ANC), platelet count and hemoglobin
  • Adequate serum calcium
  • Enrollment in System for Thalidomide Education and Prescribing Safety Program (S.T.E.P.S.)

Exclusion Criteria:

  • No treatment with dexamethasone for multiple myeloma
  • No peripheral neuropathy of Grade 2 or higher
  • No Left Ventricular Ejection Fraction (LVEF) of < 45%
  • No history of life-threatening thromboembolic events of any kind (i.e., myocardial infarction, pulmonary embolism, stroke or others), within 1 year before enrollment in the study
  • No deep vein thrombosis (DVT) within 1 year of enrollment
  • No current anticoagulation for DVT
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00097981

Sponsors and Collaborators
Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Tibotec Therapeutics, a Division of Ortho Biotech Products, L.P., USA
Investigators
Study Director: Johnson & Johnson Pharmaceutical Research and Development, L.L.C. Clinical Trial Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
  More Information

Responsible Party: Ortho Biotech Products, L.P. ( Vice President Medical Affairs Oncology/Nephrology )
Study ID Numbers: CR004579
Study First Received: December 1, 2004
Results First Received: October 2, 2008
Last Updated: November 26, 2008
ClinicalTrials.gov Identifier: NCT00097981  
Health Authority: United States: Food and Drug Administration

Keywords provided by Johnson & Johnson Pharmaceutical Research & Development, L.L.C.:
pegylated liposomal hydrochloride doxorubicin injection
newly diagnosed multiple myeloma
dexamethasone
DOXIL
thalidomide

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

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Anti-Infective Agents
Immunologic Factors
Antineoplastic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Antibiotics, Antineoplastic
Hormones
Anti-Bacterial Agents
Therapeutic Uses
Cardiovascular Diseases
Growth Inhibitors
Angiogenesis Modulating Agents
Neoplasms by Histologic Type
Immune System Diseases
Antineoplastic Agents, Hormonal
Growth Substances
Gastrointestinal Agents
Glucocorticoids
Immunosuppressive Agents
Angiogenesis Inhibitors
Pharmacologic Actions
Neoplasms
Autonomic Agents
Peripheral Nervous System Agents
Central Nervous System Agents
Leprostatic Agents

ClinicalTrials.gov processed this record on January 16, 2009