Multiple MyelomaPhase 2NK2010-35NCT01313897
UARK 2010-35, A Study of Expanded Natural Killer Cell Therapy for Multiple Myeloma
A Phase 2 study testing Bortezomib in people with Multiple Myeloma, run by University of Arkansas at 1 site in United States.
Trial summary
The purpose of this study is to determine the therapeutic efficacy of the exp-NK cell therapy in research participants with relapsed high risk MM [defined as gene expression profile (GEP) 70 gene score ≥0.66 and/or metaphase chromosomal abnormalities and/or high LDH ≥ 360U/L] by establishing the (near) complete… Read more about this study
- Who is it for?
- Ages 18 to 75 yearsHealthy volunteers can take part
- Conditions the study is for
- Multiple Myeloma
- What is being tested?
- Bortezomib
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 2011to Oct 2016
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Patient (Recipient of NK Cells) Inclusion Criteria
- Relapsed patients must have high risk disease as defined by GEP risk score of ≥ 0.66 or metaphase cytogenetic abnormalities or LDH ≥ 360 U/L (Rule out hemolysis, infection and contact PI for clarification if any doubt) Patients must have had at least 1 line of prior chemotherapy and/or have relapsed after auto- PBSCT.
- For subjects who have had a prior transplant, ≥2 months must have relapsed after the last transplant prior to enrollment.
- Zubrod ≤ 2, unless solely due to symptoms of MM-related (bone) disease.
- Patients must have a platelet count of ≥ 50,000/µL within 35 days of registration, unless lower levels are explained by extensive bone marrow plasmacytosis or extensive prior therapy.
- Patients must be at least 18 years of age and not older than 75 years of age at the time of registration.
Show all 31Show fewer
- Participants must have preserved renal function as defined by a serum creatinine level of ≤ 3 mg/dL within 35 days of registration.
- Participants must have an ejection fraction by ECHO or MUGA scan ≥ 40% within 90 days prior to registration.
- Patients must have adequate pulmonary function studies > 50% of predicted on mechanical aspects (FEV1, FVC, etc) and diffusion capacity (DLCO) > 50% of predicted within 90 days prior to registration. If the patient is unable to complete pulmonary function tests due to MM related pain or condition, exception may be granted if the principal investigator documents that the patient is a candidate for high dose therapy.
- Patients must have signed an IRB-approved informed consent and HIPAA authorization form.
- Either a haploidentical family donor fit to undergo leukapheresis is available or the recipient is fit to undergo leukapheresis for exp-NK cell generation (see donor selection).
- Patient (Recipient of NK Cells) Exclusion criteria
- History of poorly controlled hypertension, diabetes mellitus, or any other serious medical illness or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol or could be considered to be an exclusion criterion deemed by the PI.
- Patients must not have prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has not received treatment for one year prior to enrollment. Other cancers will only be acceptable if the patient's life expectancy exceeds three years as determined by the PI.
- Pregnant or nursing women may not participate. Women of childbearing potential must have a negative pregnancy documented within one week of registration. Women/men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method.
- Donor Inclusion Criteria
- The source of the NK cells will be either A) a family member who is HLA haploidentical to the recipient, or B) if a suitable haploidentical donor is not available, the recipient may be the source of the NK cells.
- HLA typing will be performed by the Arkansas Children's Hospital clinical laboratory.
- If the recipient expresses HLA-C group I, HLA-C group II, and Bw4 KIR ligands, then a KIR-ligand mismatched haploidentical donor cannot be found, and the recipient will be the source of the NK cells.
- If the recipient fails to express one or more of the primary KIR ligands (HLA-C group I, HLA-C group II, and Bw4) then family member donors will be HLA typed in an effort to find a haploidentical donor. If multiple haploidentical donors are available, KIR phenotyping will be performed in Dr. van Rhee's research laboratory to select a KIR mismatched donor whenever possible.
- Donor selection will be performed by the PI or one of the MD co-investigators if Dr. van Rhee is not available.
- Signed IRB approved consent and HIPAA authorization form.
- Donor is not HIV I/II (+).
- Donor is not HTLV-I/II (+).
- Donor is not Hepatitis B or C (+) unless positive due to previous vaccination or has received therapy and is negative for Hepatitis B or C by RT-PCR.
- Donor is a suitable candidate for insertion of apheresis catheter. Donors with unusual anatomy or vascular anomalies preventing insertion of a pheresis catheter will be rejected.
- Age 18 years or greater or has signed an Assent and be age ≥16 years.
- Donor has a negative pregnancy test by serum or urine test.
- In preparation for the peripheral blood mononuclear cell donation, the donor will undergo a detailed medical history and physical examination. Clinical studies will include blood chemistries (electrolytes, liver function and CRP) CBC with differential and platelets, PT/PTT, viral panel, EKG (age over 40 yrs), and chest x-ray (age over 40yrs). Fitness to donate cells for NK expansion will be evaluated by a physician not involved in the initial assessment of the exp-NK cell recipient for enrollment onto the protocol.
- Serologic evaluation will be used to assess exposure to syphilis, West Nile Virus, Chagas, CMV IgG, hepatitis B, and C, HIV I and II, and HTLV I/II. An HIV-I/II[+] and HTLV-1/II (+) donor will be rejected on medical grounds. Donors who been vaccinated against hepatitis B and who have antibodies against hepatitis B surface antigen are allowed.
- Haplo-identical donor must not have prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has not received treatment for one year prior to donation.
Who cannot join
- Patient (Recipient of NK Cells) Exclusion criteria
- History of poorly controlled hypertension, diabetes mellitus, or any other serious medical illness or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol or could be considered to be an exclusion criterion deemed by the PI.
- Patients must not have prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has not received treatment for one year prior to enrollment. Other cancers will only be acceptable if the patient's life expectancy exceeds three years as determined by the PI.
- Pregnant or nursing women may not participate. Women of childbearing potential must have a negative pregnancy documented within one week of registration. Women/men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method.
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
About this study
Official title: UARK 2010-35, A Phase II Study of Expanded Natural Killer Cell Therapy for Multiple Myeloma
The purpose of this study is to determine the therapeutic efficacy of the exp-NK cell therapy in research participants with relapsed high risk MM [defined as gene expression profile (GEP) 70 gene score ≥0.66 and/or metaphase chromosomal abnormalities and/or high LDH ≥ 360U/L] by establishing the (near) complete response rate. Response rate will be compared to case matched historical controls (patients who relapsed on Total Therapy 2 or 3 with high-risk MM defined as above). Disease-free survival and overall survival will be captured but are not primary or secondary endpoints.
Read the detailed description
The use of auto-exp-NK cells in this protocol makes therapy available to all refractory high risk MM patients, 2/3 of whom would otherwise not have a suitable haploidentical donor. We have shown that NK cells can be expanded both from newly diagnosed high risk MM patients and from refractory, previously heavily treated patients, the very individuals in need of novel therapies such as exp-NK cell infusions. Furthermore, we observed that exp-NK cells have the ability to kill auto-MM cells in vitro compared to no killing with resting auto-NK cells. This may be due to the elevated activation state of exp-NK cells, which allows them to overcome otherwise dominant inhibitory signaling. The incorporation of the proteasome inhibitor bortezomib, which down regulates the principal NK cell inhibitory ligands on MM cells should further increase the efficacy of auto-exp-NK cells. Because there is no risk for GvHD, CD3+ T cell depletion will not be necessary for auto-exp-NK cell products.
- Conditions
- Multiple Myeloma
- Being tested
- Bortezomib
- Keywords
- Multiple Myeloma
- Medical subject headings
- Multiple Myeloma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BortezomibDrug
Also called Velcade
bortezomib to be given days -9, -6, and -2 at 1.0mg/m2, i.v.
| Study group | Role | What they receive |
|---|---|---|
| Velcade for Anti-MM therapy | Experimental | Day(s) -9,-6,-2 3 doses of Bortezomib at 1.0 mg/m2, i.v. Receives: Drug: Bortezomib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Therapeutic Efficacy
Number of participants with an objective response of Partial Response (PR) or better according to European Society for Blood and Marrow Transplantation (EBMT) criteria within 180 days post Expanded Natural Killer Cell Infusion. The minimum criteria to meet the EBMT definition of PR or better included: >= 50% reduction in size of soft tissue plasmacytomas (if assessed); AND >= 50% reduction in plasma cells in bone marrow biopsy (if biopsy was performed and if >= 30% plasma cells at baseline); AND >=50% reduction in serum M protein and reduction in urine M protein >= 90% or to 200 mg/24hr OR >= 50% decrease in the difference between involved and uninvolved serum free light chain levels (if serum M protein < 1 g/dL, urine < 200 mg/24 hrs, and an involved serum free light chain level >= 10 mg/dL at baseline).
Measured: 180 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Mar 2011 (estimated)
- Study startJan 2011
- Primary completionOct 2016
- Study completionOct 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Multiple MyelomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 10 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Arkansas
- Sponsor type
- University, hospital or other
- Collaborators
- National Institutes of Health (NIH)
- Responsible party
- Sponsor
- Investigators
- Frits van Rhee, M.D., PHD., Principal investigator, University of Arkansas
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01313897
- Sponsor's protocol ID
- 114344
- Other IDs
- IND 14560
- Acronym
- NK2010-35
- Status last verified
- Apr 2017
- First submitted
- 1 Dec 2010
- Last updated
- 19 May 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 19 May 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- UARK 2010-35, A Phase II Study of Expanded Natural Killer Cell Therapy for Multiple Myeloma
- ClinicalTrials.gov ID
- NCT01313897
- Acronym / sponsor ID
- NK2010-35 / 114344
- Conditions
- Multiple Myeloma
- Keywords
- Multiple Myeloma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 10 participants (actual)
- Lead sponsor
- University of ArkansasUniversity, hospital or other
- Collaborators
- National Institutes of Health (NIH)
- Study start
- Jan 2011
- Primary completion
- Oct 2016 (actual)
- Study completion
- Oct 2016 (actual)
- First posted
- 14 Mar 2011 (estimated)
- Results
- Posted 13 Apr 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine the therapeutic efficacy of the exp-NK cell therapy in research participants with relapsed high risk MM [defined as gene expression profile (GEP) 70 gene score ≥0.66 and/or metaphase chromosomal abnormalities and/or high LDH ≥ 360U/L] by establishing the (near) complete response rate. Response rate will be compared to case matched historical controls (patients who relapsed on Total Therapy 2 or 3 with high-risk MM defined as above). Disease-free survival and overall survival will be captured but are not primary or secondary endpoints.
Detailed description
The use of auto-exp-NK cells in this protocol makes therapy available to all refractory high risk MM patients, 2/3 of whom would otherwise not have a suitable haploidentical donor. We have shown that NK cells can be expanded both from newly diagnosed high risk MM patients and from refractory, previously heavily treated patients, the very individuals in need of novel therapies such as exp-NK cell infusions. Furthermore, we observed that exp-NK cells have the ability to kill auto-MM cells in vitro compared to no killing with resting auto-NK cells. This may be due to the elevated activation state of exp-NK cells, which allows them to overcome otherwise dominant inhibitory signaling. The incorporation of the proteasome inhibitor bortezomib, which down regulates the principal NK cell inhibitory ligands on MM cells should further increase the efficacy of auto-exp-NK cells. Because there is no risk for GvHD, CD3+ T cell depletion will not be necessary for auto-exp-NK cell products.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Velcade for Anti-MM therapy | Experimental | Drug: BortezomibDay(s) -9,-6,-2 3 doses of Bortezomib at 1.0 mg/m2, i.v. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (31 listed)
- Patient (Recipient of NK Cells) Inclusion Criteria
- Relapsed patients must have high risk disease as defined by GEP risk score of ≥ 0.66 or metaphase cytogenetic abnormalities or LDH ≥ 360 U/L (Rule out hemolysis, infection and contact PI for clarification if any doubt) Patients must have had at least 1 line of prior chemotherapy and/or have relapsed after auto- PBSCT.
- For subjects who have had a prior transplant, ≥2 months must have relapsed after the last transplant prior to enrollment.
- Zubrod ≤ 2, unless solely due to symptoms of MM-related (bone) disease.
- Patients must have a platelet count of ≥ 50,000/µL within 35 days of registration, unless lower levels are explained by extensive bone marrow plasmacytosis or extensive prior therapy.
Key exclusion criteria (4 listed)
- Patient (Recipient of NK Cells) Exclusion criteria
- History of poorly controlled hypertension, diabetes mellitus, or any other serious medical illness or psychiatric illness that could potentially interfere with the completion of treatment according to this protocol or could be considered to be an exclusion criterion deemed by the PI.
- Patients must not have prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has not received treatment for one year prior to enrollment. Other cancers will only be acceptable if the patient's life expectancy exceeds three years as determined by the PI.
- Pregnant or nursing women may not participate. Women of childbearing potential must have a negative pregnancy documented within one week of registration. Women/men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| BortezomibAlso: Velcadebortezomib to be given days -9, -6, and -2 at 1.0mg/m2, i.v. | Drug | Velcade for Anti-MM therapy |
Primary outcome
Therapeutic Efficacy
Time frame: 180 days
Number of participants with an objective response of Partial Response (PR) or better according to European Society for Blood and Marrow Transplantation (EBMT) criteria within 180 days post Expanded Natural Killer Cell Infusion. The minimum criteria to meet the EBMT definition of PR or better included: >= 50% reduction in size of soft tissue plasmacytomas (if assessed); AND >= 50% reduction in plasma cells in bone marrow biopsy (if biopsy was performed and if >= 30% plasma cells at baseline); AND >=50% reduction in serum M protein and reduction in urine M protein >= 90% or to 200 mg/24hr OR >= 50% decrease in the difference between involved and uninvolved serum free light chain levels (if serum M protein < 1 g/dL, urine < 200 mg/24 hrs, and an involved serum free light chain level >= 10 mg/dL at baseline).
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 May 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Frits van Rhee, M.D., PHD. principal investigator
University of Arkansas
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Bortezomib in people with Multiple Myeloma, run by University of Arkansas at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 31 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 May 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 13 Apr 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Therapeutic Efficacy (time frame: 180 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 May 2017.