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Multiple MyelomaPhase 2BRdNCT01701076

Bendamustine, Lenalidomide (Revlimid®) and Dexamethasone (BRd) as 2nd-line Therapy for Patients With Relapsed or Refractory Multiple Myeloma

A Phase 2 study testing Bendamustine in people with Multiple Myeloma, run by Cantonal Hospital of St. Gallen at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Almost all patients with multiple myeloma who survive initial treatment will eventually relapse and require further therapy. Background: Treatment with lenalidomide and dexamethasone has proven efficacy in two large randomized trials (MM-009 and MM-010) leading to a time to progression (TTP) of 17.1 months for… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Multiple Myeloma
What is being tested?
Bendamustine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteSwitzerland
Study dates
Mar 2012to Feb 2016
Phase
Phase 2
Are there results?
None posted in the registry

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent
  • Patients with first relapsed or refractory multiple myeloma (including patients with relapse after high dose chemotherapy followed by autologous stem cell transplantation) who have received no more than one prior line of anti-myeloma treatment
  • Treatment with a lenalidomide/ dexamethasone-based 2nd-line regimen is indicated and intended
  • Measurable disease as defined by at least one of the following 3 measurements
  • serum monoclonal protein level ≥ 1 g/dl (≥ 10 g/l) or
  • urine M-protein level ≥ 200 mg/24hours or
Show all 29Show fewer
  • serum FLC assay: Involved FLC level ≥ 10 mg/dl (≥ 100 mg/l) provided serum FLC ratio is abnormal
  • ECOG performance status 0, 1, or 2
  • Age ≥ 18 years
  • All previous cancer therapy (except corticosteroid therapy), including radiation, cytostatic therapy and surgery, must have been discontinued at least 4 weeks prior to treatment in this study.
  • No prior treatment with a bendamustine-containing regimen allowed
  • Prior treatment with lenalidomide is allowed if the treatment is completed > 12 month prior to study entry and the patient responded to prior lenalidomide treatment
  • Adequate hematological values:
  • absolute neutrophil count ≥ 1.5 x 109/L
  • platelets ≥ 100 x 109/L
  • hemoglobin > 80 g/L, unless considered to be caused by the underlying hematologic malignancy, based on the investigator's clinical judgement
  • Adequate hepatic function:
  • total bilirubin < 1.2 mg/dL
  • AST (SGOT) ≤ 2.5 x ULN
  • Adequate renal function:
  • o calculated creatinine clearance > 50 ml/min, according to the formula of Cockcroft-Gault
  • Disease free of prior malignancies for > 5 years unless the patient
  • has been treated with a curative intent and is considered to be in complete remission for ≥2 years prior to study enrolment
  • or has a curatively-treated
  • basal cell/ squamous cell carcinoma of the skin,
  • carcinoma "in situ"of the cervix,
  • ductal breast carcinoma in situ with complete surgical resection (i.e. negative margins),
  • medullary or papillary thyroid tumor
  • or low grade, early stage localized prostate cancer treated surgically with curative intent

Who cannot join

  • Pregnant or breast feeding females
  • Any prior use of bendamustine
  • Patients who are unable or unwillingly to undergo antithrombotic therapy
  • Any serious underlying medical condition (at the judgment of the investigator) which impairs the ability of the patient to participate in the trial (e.g. active autoimmune disease, uncontrolled diabetes, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, psychiatric disorder)
  • Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she would participate in the study or any condition significantly confounding the ability to interpret data from the study, based on the local investigator's judgement
  • Severe cardiovascular disease, including myocardial infarction within 6 months before study entry, New York Heart Association Class III or IV heart failure, uncontrolled angina or severe uncontrolled ventricular arrhythmias (≥ Lown 3)
Show all 14Show fewer
  • Use of any other experimental drug or therapy/ treatment in a clinical trial within 30 days prior to trial entry
  • Known hypersensitivity to study drug(s) or hypersensitivity to any other component of the study drugs
  • Any concurrent antineoplastic therapy with chemotherapeutic agents or biologic agents or radiation therapy
  • Any major surgical procedure within 30 days prior to study therapy
  • Known chronic hepatitis B or C, known HIV infection
  • Jaundice or any other severe damage of the liver parenchyma
  • Any contraindication for the treatment with bendamustine, lenalidomide, dexamethasone and / or pegfilgrastim in accordance with the appropriate SmPCs
  • Any other concomitant drugs contraindicated for use with the study drugs according to the national health authorities

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • Kantonsspital St. Gallen

    Sankt Gallen, 9000

Other trials in Switzerland

About this study

Official title: An Open, Multicentric Phase II Trial to Evaluate the Efficacy and Safety of Bendamustine, Lenalidomide (Revlimid®) and Dexamethasone (BRd) as 2nd-line Therapy for Patients With Relapsed or Refractory Multiple Myeloma

Almost all patients with multiple myeloma who survive initial treatment will eventually relapse and require further therapy.

Background: Treatment with lenalidomide and dexamethasone has proven efficacy in two large randomized trials (MM-009 and MM-010) leading to a time to progression (TTP) of 17.1 months for patients with only one prior therapy and a TTP of 10.6 months for 2 and more prior therapies, respectively [1-3]. Continuous treatment with lenalidomide and dexamethasone until disease progression is therefore considered a standard therapy for second line treatment in multiple myeloma patients. However, only a relatively low rate of high quality response (CR, complete response and VGPR, very good partial response) is achieved. High quality responses are associated with with improved progression-free survival and overall survival [4].

Read more

Trial: The aim of this trial is to improve high quality response rates for patients with relapsed or refractory multiple myeloma in the 2nd line treatment. This aim shall be achieved by the addition a third anti-myeloma drug (bendamustine) to the established backbone of lenalidomide/ dexamethasone.

Treatment regimen:

  • Induction Treatment Phase: Cycles 1-6 Bendamustine 75mg/m2/d day 1 and 2, lenalidomide 25mg/d 1-21, dexamethasone 40mg / 20mg (for patients > 75years) d 1, 8, 15, 22.
  • Maintenance Treatment Phase: Cycles 7-18 lenalidomide 25mg/d 1-21, dexamethasone 40mg / 20mg (for patients > 75 years) d 1, 8, 15, 22.

Due to hematoxicity of bendamustine and lenalidomide, administration of pegfilgrastim is mandatory in the induction treatment phase (BRd-regimen)for all patients experiencing severe neutropenia.

The aim of this study is to achieve high quality response rates (CR, VGPR) of ≥ 40%. If this aim is achieved, the treatment of bendamustine in combination with the established lenalidomide/ dexamethasone regimen will be considered promising.

Besides efficacy, the safety of this three-drug regimen is evaluated in this trial.

Read the detailed description

Assessments for efficacy / response evaluation:

  • M-protein quantitation in serum and 24 h urine collection samples by serum- and urine protein electrophoresis
  • Quantitation of immunoglobulin levels by nephelometry
  • Serum and urine immunofixation
  • Free light chain concentrations and ratio in the serum
  • Plasma cell percentage in the bone marrow by conventional cytology and biopsy with immunohistochemistry
  • Radiologic assessments of the skeleton

Response criteria: Response will be assessed according to IMWG criteria

Being tested
Bendamustine
Keywords
Relapsed / refractory multiple myeloma, 2nd line treatment
Medical subject headings
Multiple Myeloma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BendamustineDrug

    Also called Lenalidomide, Dexamethasone, Pegfilgrastim

    Induction treatment phase (cycle 1-6):

    • Bendamustine 75 mg/m2 i.v day 1 and 2
    • Lenalidomide 25 mg p.o. day 1-21
    • Dexamethasone 40/20 mg p.o., day 1, 8, 15, 22
    • Pegfilgrastim 6 mg s.c., day 3 in case of severe neutropenia

    Maintenance treatment phase (cycles 7-18):

    • Lenalidomide 25 mg p.o. day 1-21
    • Dexamethasone 40/20 mg p.o., day 1, 8, 15, 22
Study groups in NCT01701076
Study groupRoleWhat they receive
BendamustineExperimentalAll patients are treated with bendamustine in combination with lenalidomide and dexamethasone for a maximum of 6 cycles.
Receives: Drug: Bendamustine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Efficacy (combined CR-/VGPR-rate) achieved during the induction treatment phase or within four weeks after the last administration of six induction cycles of the BRd regimen

    Measured: Every 4 weeks up to 7 months

Secondary outcomes (5)
  1. Objective response rates (sCR, CR, VGPR, PR, MR)

    Measured: Every 4 weeks up to 7 months

  2. Best response (sCR, CR, VGPR, PR, MR)

    Measured: Every 4 weeks up to 36 months

  3. Time to progression (TTP)

    Measured: Every 4 weeks up to 36 months

  4. Overall survival (OS)

    Measured: Every 8 weeks up to 36 months

  5. Safety and tolerability

    • Type, frequency, severity, and relationship of adverse events to study therapy
    • According to NCI CTCAE v4.0

    Measured: Every 4 weeks until 30 days after completion of study treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Oct 2012 (estimated)
  2. Study startMar 2012
  3. Primary completionFeb 2016
  4. Study completionFeb 2016

Resources

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
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01701076
Sponsor's protocol ID
CTU10.041/BRd
Other IDs
2010-022253-42
Acronym
BRd
Status last verified
Aug 2016
First submitted
27 Sep 2012
Last updated
24 Aug 2016
Results posted
No
Data monitoring committee
No

Publications

  • Weber DM, Chen C, Niesvizky R, Wang M, Belch A, Stadtmauer EA, Siegel D, Borrello I, Rajkumar SV, Chanan-Khan AA, Lonial S, Yu Z, Patin J, Olesnyckyj M, Zeldis JB, Knight RD; Multiple Myeloma (009) Study Investigators. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med. 2007 Nov 22;357(21):2133-42. doi: 10.1056/NEJMoa070596.

    PubMed 18032763
  • Dimopoulos M, Spencer A, Attal M, Prince HM, Harousseau JL, Dmoszynska A, San Miguel J, Hellmann A, Facon T, Foa R, Corso A, Masliak Z, Olesnyckyj M, Yu Z, Patin J, Zeldis JB, Knight RD; Multiple Myeloma (010) Study Investigators. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med. 2007 Nov 22;357(21):2123-32. doi: 10.1056/NEJMoa070594.

    PubMed 18032762
  • Dimopoulos MA, Chen C, Spencer A, Niesvizky R, Attal M, Stadtmauer EA, Petrucci MT, Yu Z, Olesnyckyj M, Zeldis JB, Knight RD, Weber DM. Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma. Leukemia. 2009 Nov;23(11):2147-52. doi: 10.1038/leu.2009.147. Epub 2009 Jul 23.

    PubMed 19626046
  • Harousseau JL, Attal M, Avet-Loiseau H. The role of complete response in multiple myeloma. Blood. 2009 Oct 8;114(15):3139-46. doi: 10.1182/blood-2009-03-201053. Epub 2009 Jul 28.

    PubMed 19638622
  • Lentzsch S, O'Sullivan A, Kennedy RC, Abbas M, Dai L, Pregja SL, Burt S, Boyiadzis M, Roodman GD, Mapara MY, Agha M, Waas J, Shuai Y, Normolle D, Zonder JA. Combination of bendamustine, lenalidomide, and dexamethasone (BLD) in patients with relapsed or refractory multiple myeloma is feasible and highly effective: results of phase 1/2 open-label, dose escalation study. Blood. 2012 May 17;119(20):4608-13. doi: 10.1182/blood-2011-12-395715. Epub 2012 Mar 26.

    PubMed 22451423
  • Pönisch W, Heyn S, Wagner I, et al. Combined Bendamustine, Prednisolone and Lenalidomide (RBP) In Refractory or Relapsed Multiple Myeloma. First Results of a Phase I Clinical Trial. Blood, Nov 2010; 116: 1971

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Bendamustine in people with Multiple Myeloma, run by Cantonal Hospital of St. Gallen at 1 site in Switzerland.

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 29 inclusion and 14 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 24 Aug 2016. 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 Switzerland. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Efficacy (combined CR-/VGPR-rate) achieved during the induction treatment phase or within four weeks after the last administration of six induction cycles of the BRd regimen (time frame: Every 4 weeks up to 7 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01701076, which also lists 6 linked publications.

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 24 Aug 2016.

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BRd Clinical Trial NCT01701076 | AzTrials