Multiple MyelomaPhase 3GMMG-HD6NCT02495922
A Phase III Trial on the Effect of Elotuzumab in VRD Induction /Consolidation and Lenalidomide Maintenance in Patients With Newly Diagnosed Myeloma
A Phase 3 study testing elotuzumab, Lenalidomide and Bortezomib in people with Multiple Myeloma, run by University of Heidelberg Medical Center at 68 sites in Germany.
Trial summary
Trial in patients with newly diagnosed myeloma to evaluate the effect of elotuzumab in induction and consolidation therapy with bortezomib/lenalidomide/dexamethasone and in lenalidomide maintenance treatment Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Multiple Myeloma
- What is being tested?
- elotuzumab, Lenalidomide and Bortezomib
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 564 participants
- Where
- 68 sitesGermany
- Study dates
- Jun 2015to 24 Jun 2021
- Phase
- Phase 3
- 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 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients meeting all of the following criteria will be considered for admission to the trial:
- Confirmed diagnosis of untreated multiple myeloma requiring systemic therapy (diagnostic criteria (IMWG updated criteria (2014) )
- Measurable disease, defined as any quantifiable monoclonal protein value, defined by at least one of the following three measurements:
- Serum M-protein ≥ 10g/l (for IgA ≥ 5g/l)
- Urine light-chain (M-protein) of ≥ 200 mg/24 hours
- Serum FLC assay: involved FLC level ≥ 10 mg/dl provided sFLC ratio is abnormal
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- Age 18 - 70 years inclusive
- WHO performance status 0-3 (WHO=3 is allowed only if caused by MM and not by co-morbid conditions)
- Negative pregnancy test at inclusion (women of childbearing potential)
- For all men and women of childbearing potential: patients must be willing and capable to use adequate contraception during the complete therapy. Patients must agree on the requirements regarding the lenalidomide pregnancy prevention programme described in chapter 6.
- All patients must
- agree to abstain from donating blood while taking lenalidomide and for 28 days following discontinuation of lenalidomide therapy
- agree not to share study drug lenalidomide with another person and to return all unused study drug to the investigator or pharmacist
- Ability of patient to understand character and individual consequences of the clinical trial
- Written informed consent (must be available before enrollment in the trial)
Who cannot join
- Patients presenting with any of the following criteria will not be included in the trial:
- Patient has known hypersensitivity to any drugs given in the protocol, notably bortezomib, lenalidomide, dexamethasone and elotuzumab or to any of the constituent compounds (incl. boron and mannitol).
- Systemic AL amyloidosis (except for AL amyloidosis of the skin or the bone marrow)
- Previous chemotherapy or radiotherapy during the past 5 years except local radiotherapy in case of local myeloma progression.
- Severe cardiac dysfunction (NYHA classification III-IV)
- Significant hepatic dysfunction (serum bilirubin ≥ 1,8mg/dl and/or ASAT and/or ALAT ≥ 2.5 times normal level), unless related to myeloma.
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- Patients with renal insufficiency requiring hemodialysis
- HIV positivity
- Patients with active or history of hepatitis B or C
- Patients with active, uncontrolled infections
- Patients with peripheral neuropathy or neuropathic pain, CTC grade 2 or higher (as defined by the NCI Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.0)
- Patients with a history of active malignancy during the past 5 years with the exception of basal cell carcinoma of the skin or stage 0 cervical carcinoma treated with curative intent
- Patients with acute diffuse infiltrative pulmonary and/or pericardial disease
- Autoimmune hemolytic anemia with positive Coombs test or immune thrombocytopenia
- Platelet count < 75 x 109/l, or, dependent on bone marrow infiltration by plasma cells, platelet count < 30 x 109/l (patients with platelet count < 75 x 109/l, but > 30 x 109/l may be eligible if percentage of plasma cells in bone marrow is ≥ 50%), (transfusion support within 14 days before the test is not allowed)
- Haemoglobin ≤ 8.0 g/dl, unless related to myeloma
- Absolute neutrophil count (ANC) < 1.0 x 10^9/l (the use of colony stimulating factors within 14 days before the test is not allowed), unless related to myeloma
- Pregnancy and lactation
- Participation in other clinical trials. This does not include long-term follow-up periods without active drug treatment of previous studies during the last 6 months.
- No patients will be allowed to enrol in this trial more than once.
Trial locations and contacts
68 sites in 1 country.
68 sites in 1 country
Germany68 sites
Studienzentrum Aschaffenburg
Aschaffenburg, 63739
MVZ Onkologie gGmbH der Klinikum Mittelbaden gGmbH
Baden-Baden, 76532
HELIOS Klinikum, Klinik für Hämatologie, Onkologie und Immunologie
Berlin, 13125
Onkologisches MVZ Berlin Tegel
Berlin, 13507
Charité Campus Benjamin Franklin, III. Med. Abt. (Hämatologie/Onkologie)
Berlin, D-12200
Klinikum Bielefeld, Klinik für Hämatologie, Onkologie und Palliativmedizin
Bielefeld, D-33604
Studiengesellschaft Onkologie Bielefeld GbR
Bielefeld, D-33604
Hämatologisch-onkologische Schwerpunktpraxis
Bochum, 44787
Medizinische Universitätsklinik, Knappschaftskrankenhaus
Bochum, D-44892
Universitätsklinikum Bonn, Medizinische Klinik und Poliklinik III, Schwerpunkt Onkologie, Hämatologie und Rheumatologie
Bonn, 53105
ZAHO, Zentrum für ambulante Hämatologie und Onkologie
Bonn, 53113
Schwerpunktpraxis für Onkologie/Hämatologie
Bottrop, 46236
Klinikum Chemnitz GmbH, Innere Medizin III
Chemnitz, D-09116
Universitätsklinikum Köln, Klinik I - Innere Medizin
Cologne, D-50937
Onkologisches Studienzentrum Darmstadt
Darmstadt, 64283
Klinikum Darmstadt, Med. Klinik V, Hämatologie/Onkologie
Darmstadt, D-64283
HELIOS St. Johannes Klinik, Akademisches Krankenhaus der Heinrich-Heine-Universität Düsseldorf
Duisburg, 47166
MVZ Düsseldorf GmbH
Düsseldorf, 40235
Sana Kliniken Düsseldorf GmbH
Düsseldorf, 40593
Universitätsklinikum Düsseldorf, Klinik für Hämatologie,Onkologie und Klin. Immunologie
Düsseldorf, D-40225
Universitätsklinik Erlangen
Erlangen, 91054
St.-Antonius-Hospital Klinik f. Hämatologie und Onkologie
Eschweiler, 52249
Universitätsklinikum Essen, Klinik für Hämatologie
Essen, D-45147
Ev. Krankenhaus Essen-Werden gGmbH, Zentrum für Innere Medizin, Klinik für Hämatologie, Onkologie und Stammzelltransplantation
Essen, D-45239
Centrum für Hämatologie und Onkologie Bethanien
Frankfurt am Main, 60389
Agaplesion Markus Krankenhaus
Frankfurt am Main, 60431
Universitätsklinikum Frankfurt, Goethe-Universität Medizinische Klinik II
Frankfurt am Main, 60590
Praxis und Tagesklinik Friedrichshafen
Friedrichshafen, 88045
Gemeinschaftspraxis Schmitt/Eulenbuch
Gerlingen, 70839
Justus-Liebig-Universität, Medizinische Klinik IV
Giessen, 35385
Kath. Krankenhaus Hagen gGmbH, Abt. Hämatologie/Onkologie
Hagen, D-58095
Universitätsklinikum Hamburg-Eppendorf, II - Med. Klinik und Poliklinik
Hamburg, D-20246
Asklepios Klinik Hamburg Altona, II. Med. Klinik
Hamburg, D-22763
Evangelisches Krankhaus Hamm gGmbH
Hamm, 59063
Onkologische Schwerpunktpraxis
Heidelberg, 69115
University Hospital Heidelberg, Med. Klinik V
Heidelberg, D-69120
Onkologische Schwerpunktpraxis
Heilbronn, 74072
SLK Kliniken Heilbronn, Med. Klinik III
Heilbronn, D-74078
Universitätsklinikum des Saarlandes, Innere Medizin I
Homburg, 66421
Westpfalz-Klinikum GmbH
Kaiserslautern, 67655
Onkologische Schwerpunktpraxis Karlsruhe
Karlsruhe, 76135
Onkologische Gemeinschaftspraxis Kassel
Kassel, 34119
Praxisklinik für Hämatologie und Onkologie
Koblenz, D-56068
Onkologisches Zentrum, Gemeinschaftspraxis f. Hämatologie u. Onkologie im Caritas KH
Lebach, 66822
Klinikum Lippe GmbH, Hämatologie-Onkologie
Lemgo, D-32657
Schwerpunktpraxis für Hämatologie und Onkologie
Ludwigsburg, 71636
Med. Klinik A, Klinikum der Stadt Ludwigshafen am Rhein gGmbH
Ludwigshafen am Rhein, 67063
Internistische Schwerpunktpraxis für Hämatologie und Onkologie
Mainz, 55122
Universitätsmedizin der Johannes Gutenberg-Universität Mainz, III. Med. Klinik
Mainz, D-55131
III. Medizinische Klinik Hämatologie und Internistische Onkologie
Mannheim, 68167
Mannheimer Onkologie Praxis
Mannheim, D-68161
Philipps-Universität Marburg, Hämatologie/Onkologie/Immunologie
Marburg, 35032
Mühlenkreiskliniken (AöR) Johannes Wesling Klinikum Minden, Hämatologie/Onkologie, Hämostaseologie und Palliativmedizin
Minden, 32429
Krankenhaus Maria Hilf GmbH, Franziskuskrankenhaus, Med. Klinik I
Mönchengladbach, D-41063
Praxis für Hämatologie und internistische Onkologie
Oberhausen, 46145
Internistisch, Onkologische Gemeinschaftspraxis Dres. Balló
Offenbach, 63065
Onkologische Praxis Oldenburg
Oldenburg, 26121
Krankenhaus Barmherzige Brüder, Klinik für Onkologie und Hämatologie
Regensburg, 93049
Klinikum am Steinenberg, Ermstalklinik, Medizinische Klinik I
Reutlingen, 72764
Diakonie-Klinikum Schwäbisch Hall gGmbH, Innere Medizin III
Schwäbisch Hall, 74523
ZAHO-Zentrum für ambulante Hämatologie und Onkologie, Standort Siegburg
Siegburg, D-53721
Diakonie Klinikum Jung-Stilling-Krankenhaus, Medizinische Klinik
Siegen, 57074
Onkologische Schwerpunktpraxis für Onkologie und Gastroenterologie
Singen, 78224
Onkologische Schwerpunktpraxis Speyer
Speyer, D-67346
Klinikum Mutterhaus der Borromäerinnen gGmbH
Trier, 54290
University Hospital Tübingen, Med. Klinik und Poliklinik, Abt. II
Tübingen, D-72076
Schwarzwald-Baar Klinikum, Klinik für Innere Medizin II
Villingen-Schwenningen, 78052
Rems-Murr-Klinikum gGmbH Winnenden
Winnenden, 71364
About this study
Official title: A Randomized Phase III Trial on the Effect of Elotuzumab in VRD Induction /Consolidation and Lenalidomide Maintenance in Patients With Newly Diagnosed Myeloma
Trial in patients with newly diagnosed myeloma to evaluate the effect of elotuzumab in induction and consolidation therapy with bortezomib/lenalidomide/dexamethasone and in lenalidomide maintenance treatment
Read the detailed description
Prospective, multicentre, randomised, parallel group, open, phase III clinical trial, for patients with confirmed diagnosis of untreated multiple myeloma requiring systemic therapy .
Investigational Medicinal Products:Elotuzumab, lenalidomide
Patients are randomized in one of 4 study arms (A1, A2, B1, B2). Patients randomized in arm A1 or A2 will receive 4 cycles VRD (Bortezomib (Velcade®), Lenalidomide (Revlimid®), Dexamethasone). Patients in arm B1 or B2 will additionally receive the monoclonal antibody Elotuzumab in the 4 cycles VRD. After induction therapy patients undergo intensifying therapy according to GMMG standard (usually mobilization therapy followed by stem cell collection and autologous stem cell transplantation). After intensification a consolidation therapy will be performed with two cycles VRD (A1 und B1) or VRD+ Elotuzumab (A2 und B2), followed by Lenalidomide maintenance therapy with (arm A2 and B2) or without (arm A1 and B1) additional Elotuzumab. Maintenance therapy will be performed for 2 years.
Primary objective is the determination of the best of four treatment strategies regarding progression-free survival (PFS), defined as time from randomisation to progression or death from any cause whichever occurs first.
The duration of the trial for each patients is expected to be 36-39 months (induction and intensification treatment: 7-10 months, 3 months rest between intensification and start of consolidation, consolidation 2 months, maintenance phase 24 months).
- Conditions
- Multiple Myeloma
- Being tested
- elotuzumab, Lenalidomide, Bortezomib, Dexamethasone
- Medical subject headings
- Multiple Myeloma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
elotuzumabDrug
10 mg/kg in the vein( i.v) on day 1,8 and 15 in induction cycle 1 and 2, on day 1 and 11 in induction cycle 3 and 4 (Arm B1 and B2). 10 mg/kg i.v. on day 1,8 and 15 in consolidation cycle 1 and 2 (Arm A2 and B2), 10 mg/kg i.v. on day 1 and15 in maintenance cycle 1-6, 10 mg/kg i.v. on day 1 in maintenance cycle 7-26 (Arm A2 and B2)
LenalidomideDrug
Also called Revlimid
25 mg per os on day 1-14 in induction cycle 1-4, 25 mg p.o. on day 1-14 in consolidation cycle 1 and 2, 10 mg p.o. on day 1-28 in maintenance cycle 1-3, 15 mg p.o. on day 1-28 in maintenance cycle 4-26 (all arms)
BortezomibDrug
Also called Velcade
all arms: 1,3 mg/m^2 subcutaneous on day 1, 4, 8 and 11 in 4 induction cycles, 1,3 mg/m^2 subcutaneous on day 1, 8 and 15 in 2 cycles of consolidation
DexamethasoneDrug
20 mg per os on day 1,2 and 4,5 and 8,9 and 11,12 and 15 in induction cycles 1 and 2. 20 mg per os on day 1,2 and 4,5 and 8,9 and 11,12 in induction cycles 3 and 4 (Arms A1 and A2).
8 mg per os and 12 mg i.v. on day 1, 8 and 15 and 20 mg per os on days 2,4,5, 9, 11 and 12 in induction cycles 1 and 2. 8 mg per os and 12 mg i.v. on day 1, and 11, 20 mg per os on days 2,4,5,8, 9, and 12 in induction cycles 3 and 4 (Arms B1 and B2).
20 mg per os on days 1,2, 8,9, 15 and 16 in both cycles of consolidation (Arms A1 and B1). 8 mg per os and 12 mg i.v. on days 1, 8 and 15 and 20 mg per os on days 2, 9 and 16 in both consolidation cycles (Arms A2 and B2).
12 mg per os on day 1 and 15 in maintenance cycles 1-6, 12 mg per os on day 1 of maintenance cycles 7 and following (Arms A1 and B1). 4 mg per os and 8 mg i.v. on day 1 and 15 in maintenance cycles 1-6, 4 mg per os and 8 mg i.v. on day 1 of maintenance cycles 7 and following (Arms A2 and B2).
| Study group | Role | What they receive |
|---|---|---|
| A1 | Active comparator | Induction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone), 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone), 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). Receives: Drug: Lenalidomide; Drug: Bortezomib; Drug: Dexamethasone |
| A2 | Experimental | Induction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone) 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab, 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide + elotuzumab (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). Receives: Drug: elotuzumab; Drug: Lenalidomide; Drug: Bortezomib; Drug: Dexamethasone |
| B1 | Experimental | Induction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab , 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone) 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). Receives: Drug: elotuzumab; Drug: Lenalidomide; Drug: Bortezomib; Drug: Dexamethasone |
| B2 | Experimental | Induction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab, 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab, 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide + elotuzumab (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). Receives: Drug: elotuzumab; Drug: Lenalidomide; Drug: Bortezomib; Drug: Dexamethasone |
What is being measured
The primary outcome is the main question the study is designed to answer.
the best of four treatment strategies regarding Progression Free Survival (PFS)
response evaluation
Measured: time from randomization to progression or death from any cause whichever comes first, censored after two years of maintenance therapy (i.e. approx. after 36 months after randomisation)
Secondary outcomes (9)
overall survival
survival status
Measured: time from randomisation to time of death from any cause. Patients still being alive at the time of the analysis will be censored at the date last known to be alive. (assessed up to 80 months)
complete response rates after induction
response evaluation
Measured: approx. after 3 months (after induction therapy)
complete response rates after consolidation
response evaluation
Measured: approx. after 9 months (after consolidation therapy)
Progression Free Survival after end of trial
response evaluation
Measured: time from randomisation to progression or death from any cause whichever comes first, censored at the end date of the trial (i.e. assessed up to 80 months)
best response to treatment during the study
response evaluation
Measured: response assessment after ca. 3 months, 4 months, 7 months, 9 months,11 months, 14 months, and subsequently every 3 months during maintenance treatment, up to 35 months after start of study treatment.
time to progression, censored at end of the trial
Response evaluation
Measured: From date of randomization until the date of first documented progression, assessed up to 80 months
duration of response, censored at end of the trial
response evaluation
Measured: assessed up to 80 months
toxicity during induction treatment, consolidation and maintenance treatment with respect to adverse Events of CTCAE grade 3 or higher
toxicity according CTCAE Version 4.0
Measured: from first administration of study drug until 40 days after last administration of study drug or any drug of the study treatment or upon start of a new subsequent chemotherapy, whichever occurs first
Quality of Life assessment
Questionnaires EORTC-QLQC30 and EORTC-QLQMY20
Measured: assessed at baseline, after ca. 3 months, 7 months, 9 months, subsequently every 6 months, up to 36 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jul 2015 (estimated)
- Study startJun 2015
- Primary completion24 Jun 2021
- Study completion24 Jun 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 564 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Heidelberg Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Prof. Dr. Hartmut Goldschmidt, University of Heidelberg Medical Center
- Investigators
- Hartmut Goldschmidt, Prof. Dr., Principal investigator, Med. Klinik V, University Hospital Heidelberg
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02495922
- Sponsor's protocol ID
- GMMG HD6
- Acronym
- GMMG-HD6
- Status last verified
- Sep 2021
- First submitted
- 24 Jun 2015
- Last updated
- 10 Sep 2021
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Mai EK, Goldschmid H, Miah K, Bertsch U, Besemer B, Hanel M, Krzykalla J, Fenk R, Schlenzka J, Munder M, Durig J, Blau IW, Huhn S, Hose D, Jauch A, Kunz C, Mann C, Weinhold N, Scheid C, Schroers R, von Metzler I, Schieferdecker A, Thomalla J, Reimer P, Mahlberg R, Graeven U, Kremers S, Martens UM, Kunz C, Hensel M, Benner A, Seidel-Glatzer A, Weisel KC, Raab MS, Salwender HJ; German-speaking Myeloma Multicenter Group (GMMG) HD6 investigators. Elotuzumab, lenalidomide, bortezomib, dexamethasone, and autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GMMG-HD6): results from a randomised, phase 3 trial. Lancet Haematol. 2024 Feb;11(2):e101-e113. doi: 10.1016/S2352-3026(23)00366-6.
PubMed 38302221Maura F, Rajanna AR, Ziccheddu B, Poos AM, Derkach A, Maclachlan K, Durante M, Diamond B, Papadimitriou M, Davies F, Boyle EM, Walker B, Hultcrantz M, Silva A, Hampton O, Teer JK, Siegel EM, Bolli N, Jackson GH, Kaiser M, Pawlyn C, Cook G, Kazandjian D, Stein C, Chesi M, Bergsagel L, Mai EK, Goldschmidt H, Weisel KC, Fenk R, Raab MS, Van Rhee F, Usmani S, Shain KH, Weinhold N, Morgan G, Landgren O. Genomic Classification and Individualized Prognosis in Multiple Myeloma. J Clin Oncol. 2024 Apr 10;42(11):1229-1240. doi: 10.1200/JCO.23.01277. Epub 2024 Jan 9.
PubMed 38194610Kauer J, Freundt EP, Schmitt A, Weinhold N, Mai EK, Muller-Tidow C, Goldschmidt H, Raab MS, Kriegsmann K, Sauer S. Stem cell collection after lenalidomide, bortezomib and dexamethasone plus elotuzumab or isatuximab in newly diagnosed multiple myeloma patients: a single centre experience from the GMMG-HD6 and -HD7 trials. BMC Cancer. 2023 Nov 21;23(1):1132. doi: 10.1186/s12885-023-11507-9.
PubMed 37990162Salwender H, Bertsch U, Weisel K, Duerig J, Kunz C, Benner A, Blau IW, Raab MS, Hillengass J, Hose D, Huhn S, Hundemer M, Andrulis M, Jauch A, Seidel-Glaetzer A, Lindemann HW, Hensel M, Fronhoffs S, Martens U, Hansen T, Wattad M, Graeven U, Munder M, Fenk R, Haenel M, Scheid C, Goldschmidt H. Rationale and design of the German-speaking myeloma multicenter group (GMMG) trial HD6: a randomized phase III trial on the effect of elotuzumab in VRD induction/consolidation and lenalidomide maintenance in patients with newly diagnosed myeloma. BMC Cancer. 2019 May 28;19(1):504. doi: 10.1186/s12885-019-5600-x.
PubMed 31138244
Study at a glance
From the registry record, last updated by the sponsor on 10 Sep 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase III Trial on the Effect of Elotuzumab in VRD Induction /Consolidation and Lenalidomide Maintenance in Patients With Newly Diagnosed Myeloma
- ClinicalTrials.gov ID
- NCT02495922
- Acronym / sponsor ID
- GMMG-HD6 / GMMG HD6
- Conditions
- Multiple Myeloma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 564 participants (actual)
- Lead sponsor
- University of Heidelberg Medical CenterUniversity, hospital or other
- Study start
- Jun 2015
- Primary completion
- 24 Jun 2021 (actual)
- Study completion
- 24 Jun 2021 (actual)
- First posted
- 13 Jul 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Trial in patients with newly diagnosed myeloma to evaluate the effect of elotuzumab in induction and consolidation therapy with bortezomib/lenalidomide/dexamethasone and in lenalidomide maintenance treatment
Detailed description
Prospective, multicentre, randomised, parallel group, open, phase III clinical trial, for patients with confirmed diagnosis of untreated multiple myeloma requiring systemic therapy .
Investigational Medicinal Products:Elotuzumab, lenalidomide
Patients are randomized in one of 4 study arms (A1, A2, B1, B2). Patients randomized in arm A1 or A2 will receive 4 cycles VRD (Bortezomib (Velcade®), Lenalidomide (Revlimid®), Dexamethasone). Patients in arm B1 or B2 will additionally receive the monoclonal antibody Elotuzumab in the 4 cycles VRD. After induction therapy patients undergo intensifying therapy according to GMMG standard (usually mobilization therapy followed by stem cell collection and autologous stem cell transplantation). After intensification a consolidation therapy will be performed with two cycles VRD (A1 und B1) or VRD+ Elotuzumab (A2 und B2), followed by Lenalidomide maintenance therapy with (arm A2 and B2) or without (arm A1 and B1) additional Elotuzumab. Maintenance therapy will be performed for 2 years.
Primary objective is the determination of the best of four treatment strategies regarding progression-free survival (PFS), defined as time from randomisation to progression or death from any cause whichever occurs first.
The duration of the trial for each patients is expected to be 36-39 months (induction and intensification treatment: 7-10 months, 3 months rest between intensification and start of consolidation, consolidation 2 months, maintenance phase 24 months).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| A1 | Active comparator | Drug: Lenalidomide, Drug: Bortezomib, Drug: DexamethasoneInduction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone), 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone), 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). |
| A2 | Experimental | Drug: elotuzumab, Drug: Lenalidomide, Drug: Bortezomib, Drug: DexamethasoneInduction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone) 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab, 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide + elotuzumab (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). |
| B1 | Experimental | Drug: elotuzumab, Drug: Lenalidomide, Drug: Bortezomib, Drug: DexamethasoneInduction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab , 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone) 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). |
| B2 | Experimental | Drug: elotuzumab, Drug: Lenalidomide, Drug: Bortezomib, Drug: DexamethasoneInduction therapy with 4 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab, 21 days per cycle, intensification (mobilization and autologous stem cell transplantation), consolidation therapy with 2 cycles VRD (Velcade, Revlimid, Dexamethasone) + elotuzumab, 21 days per cycle. Maintenance therapy: 26 cycles (28 days) with lenalidomide + elotuzumab (Dexamethasone on day 1 and 15 in cycles 1-6 and on day 1 in cycles 7 to 26). |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (15 listed)
- Patients meeting all of the following criteria will be considered for admission to the trial:
- Confirmed diagnosis of untreated multiple myeloma requiring systemic therapy (diagnostic criteria (IMWG updated criteria (2014) )
- Measurable disease, defined as any quantifiable monoclonal protein value, defined by at least one of the following three measurements:
- Age 18 - 70 years inclusive
- WHO performance status 0-3 (WHO=3 is allowed only if caused by MM and not by co-morbid conditions)
Key exclusion criteria (20 listed)
- Patients presenting with any of the following criteria will not be included in the trial:
- Patient has known hypersensitivity to any drugs given in the protocol, notably bortezomib, lenalidomide, dexamethasone and elotuzumab or to any of the constituent compounds (incl. boron and mannitol).
- Systemic AL amyloidosis (except for AL amyloidosis of the skin or the bone marrow)
- Previous chemotherapy or radiotherapy during the past 5 years except local radiotherapy in case of local myeloma progression.
- Severe cardiac dysfunction (NYHA classification III-IV)
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 |
|---|---|---|
| elotuzumab10 mg/kg in the vein( i.v) on day 1,8 and 15 in induction cycle 1 and 2, on day 1 and 11 in induction cycle 3 and 4 (Arm B1 and B2). 10 mg/kg i.v. on day 1,8 and 15 in consolidation cycle 1 and 2 (Arm A2 and B2), 10 mg/kg i.v. on day 1 and15 in maintenance cycle 1-6, 10 mg/kg i.v. on day 1 in maintenance cycle 7-26 (Arm A2 and B2) | Drug | A2, B1, B2 |
| LenalidomideAlso: Revlimid25 mg per os on day 1-14 in induction cycle 1-4, 25 mg p.o. on day 1-14 in consolidation cycle 1 and 2, 10 mg p.o. on day 1-28 in maintenance cycle 1-3, 15 mg p.o. on day 1-28 in maintenance cycle 4-26 (all arms) | Drug | A1, A2, B1, B2 |
| BortezomibAlso: Velcadeall arms: 1,3 mg/m^2 subcutaneous on day 1, 4, 8 and 11 in 4 induction cycles, 1,3 mg/m^2 subcutaneous on day 1, 8 and 15 in 2 cycles of consolidation | Drug | A1, A2, B1, B2 |
| Dexamethasone20 mg per os on day 1,2 and 4,5 and 8,9 and 11,12 and 15 in induction cycles 1 and 2. 20 mg per os on day 1,2 and 4,5 and 8,9 and 11,12 in induction cycles 3 and 4 (Arms A1 and A2). 8 mg per os and 12 mg i.v. on day 1, 8 and 15 and 20 mg per os on days 2,4,5, 9, 11 and 12 in induction cycles 1 and 2. 8 mg per os and 12 mg i.v. on day 1, and 11, 20 mg per os on days 2,4,5,8, 9, and 12 in induction cycles 3 and 4 (Arms B1 and B2). 20 mg per os on days 1,2, 8,9, 15 and 16 in both cycles of consolidation (Arms A1 and B1). 8 mg per os and 12 mg i.v. on days 1, 8 and 15 and 20 mg per os on days 2, 9 and 16 in both consolidation cycles (Arms A2 and B2). 12 mg per os on day 1 and 15 in maintenance cycles 1-6, 12 mg per os on day 1 of maintenance cycles 7 and following (Arms A1 and B1). 4 mg per os and 8 mg i.v. on day 1 and 15 in maintenance cycles 1-6, 4 mg per os and 8 mg i.v. on day 1 of maintenance cycles 7 and following (Arms A2 and B2). | Drug | A1, A2, B1, B2 |
Primary outcome
the best of four treatment strategies regarding Progression Free Survival (PFS)
Time frame: time from randomization to progression or death from any cause whichever comes first, censored after two years of maintenance therapy (i.e. approx. after 36 months after randomisation)
response evaluation
9 secondary outcomes
overall survival
Time frame: time from randomisation to time of death from any cause. Patients still being alive at the time of the analysis will be censored at the date last known to be alive. (assessed up to 80 months)
complete response rates after induction
Time frame: approx. after 3 months (after induction therapy)
complete response rates after consolidation
Time frame: approx. after 9 months (after consolidation therapy)
Progression Free Survival after end of trial
Time frame: time from randomisation to progression or death from any cause whichever comes first, censored at the end date of the trial (i.e. assessed up to 80 months)
best response to treatment during the study
Time frame: response assessment after ca. 3 months, 4 months, 7 months, 9 months,11 months, 14 months, and subsequently every 3 months during maintenance treatment, up to 35 months after start of study treatment.
time to progression, censored at end of the trial
Time frame: From date of randomization until the date of first documented progression, assessed up to 80 months
duration of response, censored at end of the trial
Time frame: assessed up to 80 months
toxicity during induction treatment, consolidation and maintenance treatment with respect to adverse Events of CTCAE grade 3 or higher
Time frame: from first administration of study drug until 40 days after last administration of study drug or any drug of the study treatment or upon start of a new subsequent chemotherapy, whichever occurs first
Quality of Life assessment
Time frame: assessed at baseline, after ca. 3 months, 7 months, 9 months, subsequently every 6 months, up to 36 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Sep 2021.
- Derived from this study: PubMed 38302221Mai EK, Goldschmid H, Miah K, Bertsch U, Besemer B, Hanel M, Krzykalla J, Fenk R, Schlenzka J, Munder M, Durig J, Blau IW, Huhn S, Hose D, Jauch A, Kunz C, Mann C, Weinhold N, Scheid C, Schroers R, von Metzler I, Schieferdecker A, Thomalla J, Reimer P, Mahlberg R, Graeven U, Kremers S, Martens UM, Kunz C, Hensel M, Benner A, Seidel-Glatzer A, Weisel KC, Raab MS, Salwender HJ; German-speaking Myeloma Multicenter Group (GMMG) HD6 investigators. Elotuzumab, lenalidomide, bortezomib, dexamethasone, and autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GMMG-HD6): results from a randomised, phase 3 trial. Lancet Haematol. 2024 Feb;11(2):e101-e113. doi: 10.1016/S2352-3026(23)00366-6.
- Derived from this study: PubMed 38194610Maura F, Rajanna AR, Ziccheddu B, Poos AM, Derkach A, Maclachlan K, Durante M, Diamond B, Papadimitriou M, Davies F, Boyle EM, Walker B, Hultcrantz M, Silva A, Hampton O, Teer JK, Siegel EM, Bolli N, Jackson GH, Kaiser M, Pawlyn C, Cook G, Kazandjian D, Stein C, Chesi M, Bergsagel L, Mai EK, Goldschmidt H, Weisel KC, Fenk R, Raab MS, Van Rhee F, Usmani S, Shain KH, Weinhold N, Morgan G, Landgren O. Genomic Classification and Individualized Prognosis in Multiple Myeloma. J Clin Oncol. 2024 Apr 10;42(11):1229-1240. doi: 10.1200/JCO.23.01277. Epub 2024 Jan 9.
- Derived from this study: PubMed 37990162Kauer J, Freundt EP, Schmitt A, Weinhold N, Mai EK, Muller-Tidow C, Goldschmidt H, Raab MS, Kriegsmann K, Sauer S. Stem cell collection after lenalidomide, bortezomib and dexamethasone plus elotuzumab or isatuximab in newly diagnosed multiple myeloma patients: a single centre experience from the GMMG-HD6 and -HD7 trials. BMC Cancer. 2023 Nov 21;23(1):1132. doi: 10.1186/s12885-023-11507-9.
- Derived from this study: PubMed 31138244Salwender H, Bertsch U, Weisel K, Duerig J, Kunz C, Benner A, Blau IW, Raab MS, Hillengass J, Hose D, Huhn S, Hundemer M, Andrulis M, Jauch A, Seidel-Glaetzer A, Lindemann HW, Hensel M, Fronhoffs S, Martens U, Hansen T, Wattad M, Graeven U, Munder M, Fenk R, Haenel M, Scheid C, Goldschmidt H. Rationale and design of the German-speaking myeloma multicenter group (GMMG) trial HD6: a randomized phase III trial on the effect of elotuzumab in VRD induction/consolidation and lenalidomide maintenance in patients with newly diagnosed myeloma. BMC Cancer. 2019 May 28;19(1):504. doi: 10.1186/s12885-019-5600-x.
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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.
Hartmut Goldschmidt, Prof. Dr. principal investigator
Med. Klinik V, University Hospital Heidelberg
68 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing elotuzumab, Lenalidomide and Bortezomib in people with Multiple Myeloma, run by University of Heidelberg Medical Center at 68 sites in Germany.
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 15 inclusion and 20 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 10 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 68 sites in Germany. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
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?
the best of four treatment strategies regarding Progression Free Survival (PFS) (time frame: time from randomization to progression or death from any cause whichever comes first, censored after two years of maintenance therapy (i.e. approx. after 36 months after randomisation)). 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 NCT02495922, which also lists 4 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 10 Sep 2021.