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Multiple Myeloma in RelapseTOMMYNCT01794572

Phase 1-2 Study of Total Bone Marrow Irradiation With Helicoidal Tomotherapy in 1st Myeloma Relapse

A study testing Total Bone Marrow Irradiation (TBMI) 8 Gy, Total Bone Marrow Irradiation (TBMI) 10 Gy and Total Bone Marrow Irradiation (TBMI): 12 Gy in people with Multiple Myeloma in Relapse, run by Institut Cancerologie de l'Ouest at 8 sites in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

In Multiple Myeloma, an adult hematological malignancy, mainly located in the Bone Marrow (BM), dramatic recent progresses have been observed, thanks to new agents (proteasome inhibitors and IMIDs). Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Multiple Myeloma in Relapse
What is being tested?
Total Bone Marrow Irradiation (TBMI) 8 Gy, Total Bone Marrow Irradiation (TBMI) 10 Gy and Total Bone Marrow Irradiation (TBMI): 12 Gy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
13 participants
Where
8 sitesFrance
Study dates
9 Apr 2013to 6 Oct 2020
Phase
Interventional
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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Multiple Myeloma in first relapse.
  • In Complete or very good partial remission
  • Available Collected Autologous Peripheral Stem cells: 2.5x106 CD34+/Kg

Who cannot join

  • Uncontrolled visceral disease: kidney, heart, lung, diabetes mellitus
  • Previous Total body irradiation
  • Any previous radiation dose to the spinal cord which could reach to 45gy equivalent, including the proposed TBMI
  • Amyloidosis
  • Brain localizations

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

France8 sites
  • CLCC Bergonie, service de radiotherapie

    Bordeaux, 33076

  • CHU Haut-Leveque, service d'Hématologie

    Bordeaux, 33604

  • CLCC Oscar Lambret, service de radiothérapie

    Lille, 59020

  • CHU Claude Huriez, service d'hématologie

    Lille, 59037

  • CHU Hotel-Dieu, service d'hématologie

    Nantes, 44093

  • CLCC ICO, service de radiothérapie

    Saint-Herblain, 44805

  • CLCC Paul Strauss, service de radiothérapie

    Strasbourg, 67091

  • CHU Hautepierre, service d'hématologie

    Strasbourg, 67098

Other trials in France

About this study

Official title: Phase 1-2 Study of the Combination of Escalated Total Bone Marrow Irradiation (TBMI) by Helicoidal Tomotherapy and a Fixed High-dose Melphalan (140 mg/m²) Followed by Peripheral Stem Cell Rescue (PSC) in First Relapsed Multiple Myeloma.

In Multiple Myeloma, an adult hematological malignancy, mainly located in the Bone Marrow (BM), dramatic recent progresses have been observed, thanks to new agents (proteasome inhibitors and IMIDs). However, at time of first relapse, high-dose therapy followed by Stem Cell Rescue (SCR) is frequently mandatory as a consolidation in minimal residual disease, to healthy patients under 65 yo, combining Melphalan (MPH) and/or Total Body Irradiation. Modern irradiation modalities are now available by the use of HI-ART Tomotherapy system to realize a Total Bone Marrow Irradiation (TBMI), in order both to limit the dose administered to Organ at Risk (lungs, oral cavity) and to focus efficacy on BM. In this phase-1 study, the conditioning regimen before SCR will combine a fixed high-dose MPH (140 mg/m²) and a dose escalated TBMI, so as to define its Maximal Tolerated Dose (MTD) and the Dose Limiting Toxicities (DLT). An extended cohort will further in a phase-2 setting.

Read the detailed description

Experimental :

Total Bone Marrow Irradiation (TBMI) is delivered by the Tomotherapy HI-ART machine, in 2 fractions per day during 4 consecutive days from d -6 to d -3. The escalated dose levels are determined according to a "3x3" modified Fibonacci method and five dose levels will be explored. The doses per fraction are: 1gy, 1.25gy, 1.5gy, 1.75gy and 2gy, and consequently the cumulative TBMI doses are: 8gy, 10gy, 12gy, 14gy and 16gy.

Drug : Melphalan is infused intravenously in 30 minutes on day -2 after IV anti-emetics.

Autologous Peripheral Stem Cell Rescue : are re-infused in the central line on day "0" after adequate premedication.

Despite the recent finding of new drugs (proteasome inhibitors and IMIDs), Multiple Myeloma still remain uncurable, especially after the first relapse, even in responding disease under conventional chemotherapy. In the healthy youngest patients (<65 yo), when peripheral stem cells collection is available, a high-dose therapy is often proposed in consolidation of complete or very good partial remission: the conditioning regimen usually includes high dose alkylating agent (mostly Melphalan) and/or Total Body Irradiation. The new Tomotherapy HI-ART technology allows irradiating on a 1.6m length field all the bone marrow sites together with optimal respect of the Organ at Risk (lungs, oral cavity, heart, liver, kidneys…). The proposed phase-1 study will explore the safety and efficacy of escalated dose of Total Bone-Marrow Irradiation in combination with a fixed dose of Melphalan (140mg/m²), followed by autologous SCR. To determine the MTD is the main objective of the study, then the toxicity profile (DLTs) and the RP2D in an extended cohort at the MTD dose.

Being tested
Total Bone Marrow Irradiation (TBMI) 8 Gy, Total Bone Marrow Irradiation (TBMI) 10 Gy, Total Bone Marrow Irradiation (TBMI): 12 Gy, Total Bone Marrow Irradiation (TBMI): 14 Gy, Total Bone Marrow Irradiation (TBMI): 16 Gy
Keywords
Multiple Myeloma, Relapse, Complete Remission, Very Good Partial Remission
Medical subject headings
Multiple Myeloma, Recurrence, Pathologic Complete Response

What participants receive

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

  • Total Bone Marrow Irradiation (TBMI) 8 GyRadiation

    Total Bone Marrow Irradiation (TBMI): 8 Gy

  • Total Bone Marrow Irradiation (TBMI) 10 GyRadiation

    Total Bone Marrow Irradiation (TBMI): 10 Gy

  • Total Bone Marrow Irradiation (TBMI): 12 GyRadiation

    Total Bone Marrow Irradiation (TBMI): 12 Gy

  • Total Bone Marrow Irradiation (TBMI): 14 GyRadiation

    Total Bone Marrow Irradiation (TBMI): 14 Gy

  • Total Bone Marrow Irradiation (TBMI): 16 GyRadiation

    Total Bone Marrow Irradiation (TBMI): 16 Gy

Study groups in NCT01794572
Study groupRoleWhat they receive
Total Bone Marrow Irradiation (TBMI): 8 GyExperimentalCohort 1: Total Bone Marrow Irradiation (TBMI): 8 Gy delivered by the Tomotherapy HI-ART machine, in 2 fractions per day during 4 consecutive days from d -6 to d -3. Melphalan 140 mg/m² infused intravenously during 30 minutes on day -2 after IV anti-emetics. Autologous Peripheral Stem Cell Rescue : re-infused in the central line on day "0" after adequate premedication.
Receives: Radiation: Total Bone Marrow Irradiation (TBMI) 8 Gy
Total Bone Marrow Irradiation (TBMI): 10 GyExperimentalCohort 2: Total Bone Marrow Irradiation (TBMI): 10 Gy delivered by the Tomotherapy HI-ART machine, in 2 fractions per day during 4 consecutive days from d -6 to d -3. Melphalan 140 mg/m² infused intravenously during 30 minutes on day -2 after IV anti-emetics. Autologous Peripheral Stem Cell Rescue : re-infused in the central line on day "0" after adequate premedication.
Receives: Radiation: Total Bone Marrow Irradiation (TBMI) 10 Gy
Total Bone Marrow Irradiation (TBMI): 12 GyExperimentalCohort 3: Total Bone Marrow Irradiation (TBMI): 12 Gy delivered by the Tomotherapy HI-ART machine, in 2 fractions per day during 4 consecutive days from d -6 to d -3. Melphalan 140 mg/m² infused intravenously during 30 minutes on day -2 after IV anti-emetics. Autologous Peripheral Stem Cell Rescue : re-infused in the central line on day "0" after adequate premedication.
Receives: Radiation: Total Bone Marrow Irradiation (TBMI): 12 Gy
Cohort 4: Total Bone Marrow Irradiation (TBMI): 14 GyExperimentalCohort 4: Total Bone Marrow Irradiation (TBMI): 14 Gy delivered by the Tomotherapy HI-ART machine, in 2 fractions per day during 4 consecutive days from d -6 to d -3. Melphalan 140 mg/m² infused intravenously during 30 minutes on day -2 after IV anti-emetics. Autologous Peripheral Stem Cell Rescue : re-infused in the central line on day "0" after adequate premedication.
Receives: Radiation: Total Bone Marrow Irradiation (TBMI): 14 Gy
Total Bone Marrow Irradiation (TBMI): 16 GyExperimentalCohort 5: Total Bone Marrow Irradiation (TBMI): 16 Gy delivered by the Tomotherapy HI-ART machine, in 2 fractions per day during 4 consecutive days from d -6 to d -3. Melphalan 140 mg/m² infused intravenously during 30 minutes on day -2 after IV anti-emetics. Autologous Peripheral Stem Cell Rescue : re-infused in the central line on day "0" after adequate premedication.
Receives: Radiation: Total Bone Marrow Irradiation (TBMI): 16 Gy

What is being measured

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

  1. Maximal Tolerated Dose, Type of DLTs

    Maximal Tolerated Dose Type of Dose-limiting Toxicities The escalated dose levels are determined according to a "3x3" modified Fibonacci method and five dose levels will be explored. The doses per fraction are: 1gy, 1.25gy, 1.5gy, 1.75gy and 2gy, and consequently the cumulative TBMI doses are: 8gy, 10gy, 12gy, 14gy and 16gy.

    Measured: 1 year

Secondary outcomes (1)
  1. Safety Profile Recommended Dose for Phase-2 (RDP2)

    Safety profile: acute, short and middle term toxicities Recommended Dose for Phase-2 (RDP2) and Extended Cohort for 14 patients at this dose

    Measured: 1 year

Timeline

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

  1. First posted20 Feb 2013 (estimated)
  2. Study start9 Apr 2013
  3. Primary completion6 Oct 2020
  4. Study completion6 Oct 2020

Why it stopped: Low patient recruitement rate and modification of the therapeutic standard

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 N/A
Primary purpose
Other
Allocation
Non-randomised
Intervention model
Single group
Model description
Total Bone Marrow Irradiation (TBMI) dose escalation
Masking
None (open label)
Enrolment
13 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01794572
Sponsor's protocol ID
ICO-2012-04
Other IDs
2012-001473-91
Acronym
TOMMY
Status last verified
Nov 2025
First submitted
15 Feb 2013
Last updated
12 Dec 2025
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Wong JY, Rosenthal J, Liu A, Schultheiss T, Forman S, Somlo G. Image-guided total-marrow irradiation using helical tomotherapy in patients with multiple myeloma and acute leukemia undergoing hematopoietic cell transplantation. Int J Radiat Oncol Biol Phys. 2009 Jan 1;73(1):273-9. doi: 10.1016/j.ijrobp.2008.04.071. Epub 2008 Sep 9.

    PubMed 18786784
  • Somlo G, Spielberger R, Frankel P, Karanes C, Krishnan A, Parker P, Popplewell L, Sahebi F, Kogut N, Snyder D, Liu A, Schultheiss T, Forman S, Wong JY. Total marrow irradiation: a new ablative regimen as part of tandem autologous stem cell transplantation for patients with multiple myeloma. Clin Cancer Res. 2011 Jan 1;17(1):174-82. doi: 10.1158/1078-0432.CCR-10-1912. Epub 2010 Nov 3.

    PubMed 21047977

Questions about this trial

What is this clinical trial studying?

A study testing Total Bone Marrow Irradiation (TBMI) 8 Gy, Total Bone Marrow Irradiation (TBMI) 10 Gy and Total Bone Marrow Irradiation (TBMI): 12 Gy in people with Multiple Myeloma in Relapse, run by Institut Cancerologie de l'Ouest at 8 sites in France.

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 3 inclusion and 5 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: stopped early, as of the sponsor's last update on 12 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in France. 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.

Are results available for this study?

Yes. Results are posted in the registry (first posted 12 Dec 2025). 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?

Maximal Tolerated Dose, Type of DLTs (time frame: 1 year). 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 NCT01794572, which also lists 2 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 12 Dec 2025.

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