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Multiple MyelomaPhase 1NCT03657420

Safety and Efficacy of ABI-009 (Nab-rapamycin) in Combination With Pomalidomide and Dexamethasone for Relapsed and Refractory Multiple Myeloma

A Phase 1 study testing ABI-009, Pomalidomide and Dexamethasone in people with Multiple Myeloma, run by Massachusetts General Hospital at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This research study is studying a combination of drugs as a possible treatment for multiple myeloma. The drugs that will be administered are: ABI-009 (nab-rapamycin) Pomalidomide Dexamethasone 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?
ABI-009, Pomalidomide and Dexamethasone
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited States
Study dates
30 May 2019to 30 Sep 2024
Phase
Phase 1
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

  • Previously treated relapsed and refractory multiple myeloma. Relapsed and refractory is defined per International Myeloma Working Group Criteria (Rajkumar et al., 2011).
  • Patients must have received at least two prior therapies with at least 2 cycles of lenalidomide and at least 2 cycles of a proteasome inhibitor (either in separate regimens or within the same regimen)
  • Disease progression on or within 60 days of completion of last therapy.
  • All laboratory assessments should be performed within 21 days of initiation of protocol therapy unless otherwise specified.
  • Participant has given voluntary signed written informed consent before performance of any study-related procedure that is not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to their future medical care.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (see Appendix A).
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  • Age ≥ 18 years
  • Measurable disease of multiple myeloma as defined by at least one of the following:
  • Serum monoclonal protein ≥ 0.5 g/dL
  • ≥ 200 mg of monoclonal protein in the urine on 24-hour electrophoresis
  • Serum free light chain ≥ 100 mg/L (10 mg/dL) and abnormal serum free kappa to serum free kappa light chain ratio
  • ANC ≥ 1000/μL. G-CSF is not permitted within 14 days of screening.
  • Platelet count ≥ 75,000/µL. Platelet transfusions are not permitted within 7 days of screening.
  • Hemoglobin ≥ 8 g/dL. Red blood cell transfusions are permitted to meet eligibility criteria.
  • Calculated creatinine clearance of ≥ 30 mL/min according to Cockroft-Gault equation
  • Patient has adequate hepatic function, as evidenced by the following:
  • Serum bilirubin values < 2 mg/dL, and serum alanine transaminase (ALT), and serum aspartate transaminase (AST) values < 3 × the institutional upper limit of normal (ULN).
  • Patients with elevated bilirubin due to Gilbert's syndrome may be permitted with PI approval
  • Must be able to take acetylsalicylic acid (ASA) daily as prophylactic anticoagulation. Patients intolerant to ASA may use low molecular weight heparin or equivalent. Warfarin will be allowed provided patient is fully anticoagulated, with an INR of 2-3.
  • All study participants must be registered into the mandatory POMALYST REMS program and be willing and able to comply with the requirements of the POMALYST REMS program.
  • Females of reproductive potential must adhere to the scheduled pregnancy testing as required in the POMALYST REMS program.
  • Able to swallow capsules whole (pomalidomide capsules cannot be crushed, dissolved or broken).

Who cannot join

  • Prior therapy with mTOR inhibitor (e.g. everolimus, sirolimus). Note, prior pomalidomide therapy is permitted.
  • Patients who have had chemotherapy or radiotherapy within 2 weeks (6 weeks for nitrosoureas or mitomycin C) prior to the first dose or those who have not recovered from adverse events due to agents administered more than 2 weeks earlier. Patients may have received dexamethasone within 2 weeks prior to entering study.
  • Patients who are receiving any other investigational agents.
  • Concomitant high dose corticosteroids except participants may be on chronic steroids (maximum dose 10 mg/day prednisone equivalent) if they are being given for disorders other than myeloma, e.g. adrenal insufficiency, rheumatoid arthritis, etc.
  • Pregnant or lactating females
  • Prior history of malignancies, other than MM, unless the patient has been free of the disease for ≥ 3 years. Exceptions include the following:
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  • Basal or squamous cell carcinoma of the skin
  • Carcinoma in situ of the cervix
  • Ductal carcinoma in situ of the breast
  • Incidental histologic finding of prostate cancer (T1a or T1b)
  • Patients undergoing active treatment for another malignancy with the exception of non-melanoma skin cancer or in situ cervical cancer.
  • Patients with plasma cell leukemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) syndrome, or amyloidosis are excluded from this trial.
  • HIV infection
  • Active hepatitis B infection or active hepatitis C infection, per treating investigator. Patients who have prior hepatitis C infection but who have received an antiviral treatment and show no detectable viral RNA for 6 months are eligible
  • Peripheral neuropathy ≥ grade 2 despite supportive therapy
  • Hypersensitivity to thalidomide, lenalidomide, pomalidomide, bortezomib, or dexamethasone (such as Stevens-Johnson syndrome). Rash to immunomodulatory drug that can be medically managed is allowed
  • Patients who had allogeneic stem cell transplant fewer than 12 months prior to initiation of study treatment and who have not discontinued immunosuppressive treatment for at least four weeks prior to initiation of study treatment and are currently dependent on such treatment.
  • Patients with active graft v. host disease.
  • History of significant cardiovascular, neurological, endocrine, gastrointestinal, respiratory, or inflammatory illness that could preclude study participation, pose an undue medical hazard, or interfere with the interpretation of the study results, including, but not limited to, patients with congestive heart failure (New York Heart Association [NYHA] Class 3 or 4); unstable angina; cardiac arrhythmia; recent (within the preceding 6 months) myocardial infarction or stroke; hypertension requiring > 2 medications for adequate control; diabetes mellitus with > 2 episodes of ketoacidosis in the preceding 12 months; or chronic obstructive pulmonary disease (COPD) requiring > 2 hospitalizations in the preceding 12 months.
  • Patient has any other medical, psychiatric, or social condition that would preclude participation in the study, pose an undue medical hazard, interfere with the conduct of the study, or interfere with interpretation of the study results.
  • History of interstitial lung disease and/or pneumonitis, or pulmonary hypertension.
  • Use of strong inhibitors and inducers of CYP3A4 within the 14 days prior to receiving the first dose of ABI-009. Additionally, use of any known CYP3A4 substrates with narrow therapeutic window (such as fentanyl, alfentanil, astemizole, cisapride, dihydroergotamine, pimozide, quinidine, terfanidine) within the 14 days prior to receiving the first dose of ABI-009.

Trial locations and contacts

1 site in 1 country.

United States1 site

  • Massachusetts General Hospital Cancer Center

    Boston, Massachusetts, 02114

Other trials in United States

About this study

Official title: A Phase Ib Investigation of the Safety and Efficacy of ABI-009 (Nab-rapamycin) in Combination With Pomalidomide and Dexamethasone for Relapsed and Refractory Multiple Myeloma

This research study is studying a combination of drugs as a possible treatment for multiple myeloma.

The drugs that will be administered are:

  • ABI-009 (nab-rapamycin)
  • Pomalidomide
  • Dexamethasone
Read the detailed description

This research study is a Phase I clinical trial, which tests the safety of an investigational drug and also tries to define the appropriate dose of the investigational drug to use for further studies. "Investigational" means that the drug is being studied.

The FDA (the U.S. Food and Drug Administration) has not approved ABI-009 as a treatment for any disease.

The FDA has approved pomalidomide and dexamethasone as treatment options for multiple myeloma.

The purpose of this study is to determine whether ABI-009 (study drug) will be safe and slow the progress of the disease when used in combination with pomalidomide and dexamethasone, depending on what type of cancer.

ABI-009 is an inhibitor of an overactive biological pathway in the cancer cells. Pomalidomide is an immunomodulatory agent and believed to work by affecting the growth signals that keep cancer cells alive. Dexamethasone is a steroid which is believed to kill cancer cells. The investigators hope that the combination of ABI-009 with pomalidomide and dexamethasone will help stop the growth of the cancer.

Being tested
ABI-009, Pomalidomide, Dexamethasone
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.

  • ABI-009Drug

    Also called nab-rapamycin

    ABI-009 is an mTOR inhibitor. This pathway is believed to be overactive in multiple myeloma.

  • PomalidomideDrug

    Also called Pomalyst

    Pomalidomide is an immunomodulatory agent and believed to work by affecting the growth signals that keep cancer cells alive.

  • DexamethasoneDrug

    Also called Decadron

    Dexamethasone is a steroid which is believed to kill cancer cells

Study groups in NCT03657420
Study groupRoleWhat they receive
ABI-009 + Pomalidomide + DexamethasoneExperimental* Pomalidomide is given orally daily on days 1-21, 7 days off * ABI-009 is given intravenously on days 1, 8, and 15 * Dexamethasone is given orally weekly on days 1, 8, 15, 22
Receives: Drug: ABI-009; Drug: Pomalidomide; Drug: Dexamethasone

What is being measured

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

  1. Maximum tolerated dose.

    The maximum Tolerated Dose (MTD) is the highest dose of ABI-009 (nab-rapamycin) when administered in combination with pomalidomide and dexamethasone that dose not cause unacceptable side effects. The maximum tolerated dose is determined in clinical trials by testing increasing doses on different groups of people until the highest dose with acceptable side effects is found. A standard 3+3 dose escalation design will be used to assess the MTD.

    Measured: 1 Cycle (28-Days)

Secondary outcomes (3)

  1. Overall response rate.

    The number of participants that achieve a partial response or better. This is assessed using International Myeloma Working Group criteria.

    Measured: 2 years

  2. Progression free survival.

    Progression free survival is defined as the time to disease progression or death from any cause, censored at date last known progression free for those who have not progressed or died. Progression is assessed using International Myeloma Working Group Criteria.

    Measured: 2 years

  3. Treatment-emergent adverse events.

    Adverse events will be assessed using CTCAE criteria.

    Measured: 2 years

Timeline

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

  1. First posted5 Sep 2018
  2. Study start30 May 2019 (estimated)
  3. Primary completion30 Sep 2021 (estimated)
  4. Study completion30 Sep 2024 (estimated)

Why it stopped: Funding withdrawn by sponsor

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 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03657420
Sponsor's protocol ID
18-252
Status last verified
Aug 2019
First submitted
30 Aug 2018
Last updated
14 Aug 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing ABI-009, Pomalidomide and Dexamethasone in people with Multiple Myeloma, run by Massachusetts General Hospital 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 22 inclusion and 22 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: withdrawn, as of the sponsor's last update on 14 Aug 2019. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 was withdrawn before enrolling participants, so there are no results.

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?

Maximum tolerated dose. (time frame: 1 Cycle (28-Days)). 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 NCT03657420.

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 14 Aug 2019.

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