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Multiple MyelomaPhase 3NCT02659293

Trial of Carfilzomib, Lenalidomide, Dexamethasone Versus Lenalidomide Alone After Stem-cell Transplant for Multiple Myeloma

A Phase 3 study testing Lenalidomide, Carfilzomib and Dexamethasone in people with Multiple Myeloma, run by University of Chicago at 3 sites in 2 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This is a Phase 3 randomized trial of carfilzomib, lenalidomide, dexamethasone versus lenalidomide alone after stem-cell transplant for multiple myeloma, eligible to subjects who completed autologous stem cell transplant for symptomatic myeloma who are considered for lenalidomide maintenance. 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?
Lenalidomide, Carfilzomib and Dexamethasone
Could I receive a placebo?
No, everyone receives an active treatment
How many people
180 participants
Where
3 sitesin 2 countries
Study dates
26 Apr 2016to Nov 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

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

  • Patients who completed single autologous stem cell transplant after completion of at most 2 induction regimens (excluding dexamethasone alone) and are in at least stable disease in the first 100 days after stem cell transplantation.
  • Patients must be within 12 months of initiation of induction therapy and must have had not more than 2 prior induction regimens.
  • Bone marrow specimen will be required at study entry; available DNA sample will be used for calibration step for MRD evaluation by gene sequencing.
  • Males and females ≥ 18 years of age
  • ECOG performance status of 0-1
  • Adequate hepatic function, with bilirubin ≤ 1.5 x ULN and aspirate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x ULN
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  • ANC ≥ 1.0 x 109/L, hemoglobin ≥ 8 g/dL, platelet count ≥ 75 x 109/L.
  • Calculated creatinine clearance (by Cockcroft-Gault) ≥ 50 ml/min or serum creatinine below 2 mg/dL
  • Females of childbearing potential (FCBP) must have 2 negative pregnancy tests (sensitivity of at least 50 mIU/mL) prior to initiating lenalidomide. The first pregnancy test must be performed within 10-14 days before and the second pregnancy test must be performed within 24 hours before lenalidomide is prescribed for Cycle 1 (prescriptions must be filled within 7 days).
  • FCBP must agree to use 2 reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) for at least 28 days before starting lenalidomide; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study.
  • UCM IRB CRd vs. R Version 1.0 Page 11
  • Male subjects must agree to use a latex condom during sexual contact with females of childbearing potential while participating in the study and for at least 28 days following discontinuation from the study even if he has undergone a successful vasectomy.
  • All study participants in the US must be consented to and registered into the mandatory Revlimid REMS® program and be willing and able to comply with the requirements of Revlimid REMS®.
  • Voluntary written informed consent

Who cannot join

  • Patients who have had more than 12 months of prior therapy. Patients outside of this window may be considered for inclusion on a case-by-case basis.
  • Patients who progressed after initial therapy.
  • Subjects whose therapy changed due to suboptimal response, intolerance, etc., remain eligible, provided they do not meet criteria for progression.
  • No more than two regimens for induction will be allowed excluding dexamethasone alone.
  • Evidence of progressive disease as per International Myeloma Working Group (IMWG) criteria
  • Patients who have already started or received post-transplant maintenance or consolidation regimen
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  • Patients not able to tolerate lenalidomide or carfilzomib or dexamethasone
  • POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
  • Plasma cell leukemia
  • Waldenström's macroglobulinemia or IgM myeloma
  • Peripheral neuropathy ≥ Grade 2 at screening
  • Diarrhea > Grade 1 in the absence of antidiarrheals
  • CNS involvement
  • Pregnant or lactating females
  • Radiotherapy within 14 days before randomization. Seven days may be considered if to single area.
  • Major surgery within 3 weeks prior to first dose
  • Myocardial infarction within 6 months prior to enrollment, NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities
  • Prior or concurrent deep vein thrombosis or pulmonary embolism
  • Rate-corrected QT interval of electrocardiograph (QTc) > 470 msec on a 12-lead ECG during screening
  • Uncontrolled hypertension or diabetes
  • Acute infection requiring systemic antibiotics, antivirals, or antifungals within two weeks prior to first dose
  • Known seropositive for or active viral infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV). Patients who are seropositive because of hepatitis B virus vaccine are eligible.
  • Non-hematologic malignancy or non-myeloma hematologic malignancy within the past 3 years except a) adequately treated basal cell, squamous cell skin cancer, thyroid cancer, carcinoma in situ of the cervix, or prostate cancer < Gleason Grade 6 with stable prostate specific antigen levels or cancer considered cured by surgical resection alone
  • Any clinically significant medical disease or condition that, in the Treating Investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent

Trial locations and contacts

3 sites in 2 countries.

3 sites in 2 countries

United States2 sites
  • University of Chicago

    Chicago, Illinois, 60637

  • Wayne State University - Karmanos Cacner Institute

    Detroit, Michigan, 48201

Other trials in United States

Poland1 site
  • Polish Myeloma Consortium

    Poznan

Other trials in Poland

About this study

Official title: Phase 3 Randomized Trial of Carfilzomib, Lenalidomide, Dexamethasone Versus Lenalidomide Alone After Stem-cell Transplant for Multiple Myeloma

This is a Phase 3 randomized trial of carfilzomib, lenalidomide, dexamethasone versus lenalidomide alone after stem-cell transplant for multiple myeloma, eligible to subjects who completed autologous stem cell transplant for symptomatic myeloma who are considered for lenalidomide maintenance.

Read the detailed description

Primary Objective:

  • To compare progression free survival between Kyprolis (Carfilzomib), Revlimid (lenalidomide), Dexamethasone (KRd) arm and lenalidomide arm

Secondary Objectives

  • To determine the rate of minimal residual negative disease (MRD) at 6 and 12 months after randomization
  • To compare the efficacy (rate of partial response, very good partial response, complete response, and stringent complete response) of KRd vs. Lenalidomide alone after randomization
Being tested
Lenalidomide, Carfilzomib, Dexamethasone, Lenalidomide (Control)
Keywords
Multiple myeloma, stem-cell transplant, Symptomatic myeloma, lenalidomide, carfilzomib, 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.

  • LenalidomideDrug

    Also called Revlimid

    • Cycle 1: 15 mg days 1-21
    • Cycles 2-4: 25 mg days 1-21 if tolerated, otherwise continue at lower dose
    • Cycles 5 and beyond: best tolerated dose days 1-21
  • CarfilzomibDrug

    Also called Kyprolis

    • Cycle 1: 20 mg/m2 Days 1, 2; 36 mg/m2 Days 8, 9, 15, 16. Alternatively, intermediate dose escalation (to 27mg/m2 on days 8,9 of cycle 1) will be al12,lowed at the treating physician's discretion.
    • Cycle 2-4: 36 mg/m2 if tolerated Days 1, 2, 8, 9, 15, 16
    • Cycles 5-8 (patients that are MRD- and have no risk factors at the end of cycle 6) and Cycle 5 - 36 (for MRD+ patients and high risk patients at the end of cycle 6): best tolerated dose Days 1, 2, 15, 16
  • DexamethasoneDrug

    • Cycles 1 - 4: 20 mg PO or IV per dose Days 1, 8, 15, 22
    • Cycles 5+: 20 mg or best tolerated dose PO or IV per dose Days 1, 8, 15, 22
  • Lenalidomide (Control)Drug

    Also called Revlimid

    • Cycles 1-4: Days 1-28. Lenalidomide will begin at a dose of 10 mg PO daily (2 capsules per day). After three months, the dose will be increased, provided ANC ≥ 1,000/µL, platelet count ≥ 75,000/µL, and all nonhematologic toxicity is ≤ grade 1, to 15 mg PO daily (3 capsules per day).
    • Cycles 5 and beyond: best tolerated dose days 1-28
Study groups in NCT02659293
Study groupRoleWhat they receive
Lenalidomide (Control)Active comparatorTreatment with lenalidomide only
Receives: Drug: Lenalidomide (Control)
Experimental Combination RegimenExperimentalExperimental arm using a combination of Carfilzomib, Lenalidomide and Dexamethasone
Receives: Drug: Lenalidomide; Drug: Carfilzomib; Drug: Dexamethasone

What is being measured

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

  1. Progression free survival rates in participants receiving drug combination

    Measurement of time to disease worsening as measured by International Myeloma Working Group (IMWG) response criteria.

    Measured: 4 years

Secondary outcomes (3)
  1. Rate of minimal residual negative disease (MRD) in participants receiving drug combination

    Calculation of number of participants with MRD-negative disease.

    Measured: 3 years

  2. Response rate in participants receiving drug combination

    Number of participants with disease response (e.g. improvement) as measured by International Myeloma Working Group (IMWG) response criteria.

    Measured: 3 years

  3. Treatment-related side effects

    Number of participants with grade 2 or greater treatment-related side effects as assessed by Common Terminology Criteria for Adverse Events (CTCAE) v4.0

    Measured: From date of screening until end of treatment

Timeline

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

  1. First posted20 Jan 2016 (estimated)
  2. Study start26 Apr 2016
  3. Primary completionNov 2027 (estimated)
  4. Study completionNov 2027 (estimated)

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
180 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02659293
Sponsor's protocol ID
IRB15-1286
Status last verified
Mar 2026
First submitted
15 Jan 2016
Last updated
4 Mar 2026
Results posted
No
Data monitoring committee
Yes

Publications

  • Dytfeld D, Wrobel T, Jamroziak K, Kubicki T, Robak P, Pula A, Walter-Croneck A, Czyz J, Tyczynska A, Druzd-Sitek A, Giannopoulos K, Nowicki A, Szczepaniak T, Lojko-Dankowska A, Matuszak M, Gil L, Pula B, Rybka J, Majcherek M, Usnarska-Zubkiewicz L, Szukalski L, Konska A, Zaucha JM, Walewski J, Mikulski D, Czabak O, Robak T, Lahoud OB, Zonder JA, Cooperrider JH, Derman BA, Karrison T, Jakubowiak AJ. Carfilzomib, lenalidomide, and dexamethasone compared with lenalidomide treatment after autologous haematopoietic stem-cell transplantation in patients with multiple myeloma (ATLAS): primary analysis of a randomised, open-label, phase 3 trial. Lancet Haematol. 2026 Apr;13(4):e241-e253. doi: 10.1016/S2352-3026(26)00011-6. Epub 2026 Mar 11.

    PubMed 41831471
  • Kubicki T, Jamroziak K, Robak P, Czyz J, Tyczynska A, Druzd-Sitek A, Giannopoulos K, Wrobel T, Nowicki A, Szczepaniak T, Lojko-Dankowska A, Matuszak M, Gil L, Pula B, Szukalski L, Konska A, Zaucha JM, Walewski J, Mikulski D, Czabak O, Robak T, Kruk-Kwapisz D, Derman BA, Major A, Jakubowiak AJ, Dytfeld D. Health-related quality of life in patients with multiple myeloma treated in the phase 3 ATLAS trial of post-transplant maintenance with carfilzomib, lenalidomide, and dexamethasone or lenalidomide alone. Pol Arch Intern Med. 2024 May 28;134(5):16749. doi: 10.20452/pamw.16749. Epub 2024 May 14. No abstract available.

    PubMed 38747414
  • Kubicki T, Dytfeld D, Barnidge D, Sakrikar D, Przybylowicz-Chalecka A, Jamroziak K, Robak P, Czyz J, Tyczynska A, Druzd-Sitek A, Giannopoulos K, Wrobel T, Nowicki A, Szczepaniak T, Lojko-Dankowska A, Matuszak M, Gil L, Pula B, Szukalski L, Konska A, Zaucha JM, Walewski J, Mikulski D, Czabak O, Robak T, Jiang K, Cooperrider JH, Jakubowiak AJ, Derman BA. Mass spectrometry-based assessment of M protein in peripheral blood during maintenance therapy in multiple myeloma. Blood. 2024 Aug 29;144(9):955-963. doi: 10.1182/blood.2024024041.

    PubMed 38713888
  • Dytfeld D, Wrobel T, Jamroziak K, Kubicki T, Robak P, Walter-Croneck A, Czyz J, Tyczynska A, Druzd-Sitek A, Giannopoulos K, Nowicki A, Szczepaniak T, Lojko-Dankowska A, Matuszak M, Gil L, Pula B, Rybka J, Majcherek M, Usnarska-Zubkiewicz L, Szukalski L, Konska A, Zaucha JM, Walewski J, Mikulski D, Czabak O, Robak T, Lahoud OB, Zonder JA, Griffith K, Stefka A, Major A, Derman BA, Jakubowiak AJ. Carfilzomib, lenalidomide, and dexamethasone or lenalidomide alone as maintenance therapy after autologous stem-cell transplantation in patients with multiple myeloma (ATLAS): interim analysis of a randomised, open-label, phase 3 trial. Lancet Oncol. 2023 Feb;24(2):139-150. doi: 10.1016/S1470-2045(22)00738-0. Epub 2023 Jan 12.

    PubMed 36642080

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Lenalidomide, Carfilzomib and Dexamethasone in people with Multiple Myeloma, run by University of Chicago at 3 sites in 2 countries.

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 14 inclusion and 24 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: under way, not looking for participants, as of the sponsor's last update on 4 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States, Poland. 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?

This study is still under way. Results are not available in the source record yet.

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?

Progression free survival rates in participants receiving drug combination (time frame: 4 years). 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 NCT02659293, 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 4 Mar 2026.

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