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Multiple MyelomaPhase 1/2BuMelCarAutoNCT03795597

Busulfan, Melphalan, Escalating Carfilzomib Conditioning Auto Stem Cell Transplantation for Multiple Myeloma (MM)

A Phase 1/2 study testing Carfilzomib, Busulfan IV and Melphalan IV in people with Multiple Myeloma, run by Loyola University at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In this protocol, the investigators hypothesize that the combination of intravenous busulfan and melphalan with carfilzomib will be an effective preparative regimen with acceptable toxicity for participants with multiple myeloma who are candidates for autologous stem cell transplantation. 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?
Carfilzomib, Busulfan IV and Melphalan IV
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
1 siteUnited States
Study dates
22 May 2019to 1 Nov 2023
Phase
Phase 1/2
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

  • Participants must be greater than or equal to 18 years of age.
  • Participants must have been diagnosed with multiple myeloma in a first or subsequent remission and have undergone a successful pre-transplant work up and are otherwise eligible for an autotransplant with a busulfan/melphalan preparative regimen at Loyola University Medical Center.
  • Participants may receive this preparative regimen if in first or subsequent remission. Participants may enter if they have received a prior autologous stem cell transplant and this therapy produced a remission that lasted greater than 18 months before progression of disease. Participants who have undergone prior allogeneic transplantation are excluded.
  • All participants must have responsive disease as defined by a Partial Response or greater to most recent conventional regimen.
  • Participants receiving prior carfilzomib will be eligible for inclusion provided they demonstrated responsive disease to this agent and either had a remission that lasted greater than 6 months after its discontinuance, or if in remission after a carfilzomib containing regimen administered to qualify for transplant.
  • Participants must have an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) less than or equal to 2.
  • Acceptable heart function test.

Who cannot join

  • Participants must not have below normal kidney function.
  • Participants must not have below normal liver function.
  • Participants must not have active bacterial, fungal, or viral infection.
  • Participants must not have severe lung function.
  • Participants must not have Grade 2 or greater peripheral neuropathy.
  • Participants must not have uncontrolled hypertension.

Trial locations and contacts

1 site in 1 country.

Patrick Stiff, MD contact

708-327-3148

mailto:pstiff@lumc.edu

United States1 site, 1 recruiting
  • Loyola University Medical Center

    Maywood, Illinois, 60153

    Patrick Stiff, MD, 708-327-3148, pstiff@lumc.edu

    Mary Lee, RN, 708-327-2241, mlee@luc.edu

    Recruiting

Other trials in United States

About this study

Official title: Phase I/II Study Utilizing High Dose Busulfan and Melphalan With Escalating Carfilzomib as Conditioning in Autologous Peripheral Blood Stem Cell Transplantation for Patients With Multiple Myeloma

In this protocol, the investigators hypothesize that the combination of intravenous busulfan and melphalan with carfilzomib will be an effective preparative regimen with acceptable toxicity for participants with multiple myeloma who are candidates for autologous stem cell transplantation. To test this hypothesis, the investigators designed a phase I/II trial combining IV busulfan 130 mg/m2 plus melphalan 140 mg combined with escalating doses of carfilzomib ranging from 20 mg/m2 to 45 mg/m2. These results will be compared with the center's historical controls of participants treated with melphalan, busulfan and bortezomib.

Read the detailed description

Participants enrolled in this study protocol will receive daily intravenous (IV) infusions of carfilzomib for a total of 4 days (Day-9, -8 and Days -2, -1). The first two daily infusions will be given at a fixed dose of 20 mg/m2 and the final two doses will be escalated from the standard dose of 27 mg/m2 to 56 mg/m2 in a Phase I design, based on toxicity. The busulfan will be administered for 2 days over 3 hours from D-7, -6, at 130 mg/m2 . This dose was found to be safe and equivalent to the standard daily dose of 3.2 mg/kg. The 3rd and 4th daily doses of IV Busulfan will be adjusted in order to yield a systemic plasma drug exposure represented by a daily area under the plasma concentration versus time curve (AUC) of approximately 5,000 millimoles-minute per dose (mM-min). These targeted plasma concentration of IV busulfan will be based on pharmacokinetics studies performed during the first day of IV busulfan. Melphalan will be given at a dose of 140 mg/m2 on Day -3. Each cohort will start with a goal of accruing three patients to determine the dose limiting toxicity.

Being tested
Carfilzomib, Busulfan IV, Melphalan IV
Keywords
Multiple Myeloma, Autologous, Stem Cell Transplantation, Bone Marrow Transplant, Carfilzomib
Medical subject headings
Multiple Myeloma

What participants receive

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

  • CarfilzomibDrug

    Also called Kyprolis

    Carfilzomib is an anti-cancer drug acting as a selective proteasome inhibitor that is used to treat Multiple Myeloma.

  • Busulfan IVDrug

    Also called Busulfex

    Busulfan is an anti-cancer drug acting as a bifunctional alkylating agent that is used to treat Multiple Myeloma.

  • Melphalan IVDrug

    Also called Alkeran

    Melphalan is an anti-cancer drug acting as alkylating agent that is used to treat Multiple Myeloma.

Study groups in NCT03795597
Study groupRoleWhat they receive
Carfilzomib IV at dose: 20 mg/m2ExperimentalThe participants will receive Carfilzomib IV at dose: 20 mg/m2 on days -9 and -8 over 30 minutes. The participant will receive Busulfan IV over 3 hours every 24 hours for a total of 4 doses from Day -6 to Day -3 and Melphalan IV over 15-30 minutes for one dose on day -3.The participants will receive stem cell infusion on Day 0 and Granulocyte-Colony stimulating factor (G-CSF) given daily until engraftment occurs.
Receives: Drug: Carfilzomib; Drug: Busulfan IV; Drug: Melphalan IV
Carfilzomib IV at dose: 27 mg/m2ExperimentalThe participants will receive Carfilzomib IV at dose: 27 mg/m2 on days -9 and -8 over 30 minutes. The participant will receive Busulfan IV over 3 hours every 24 hours for a total of 4 doses from Day -6 to Day -3 and Melphalan IV over 15-30 minutes for one dose on day -3.The participants will receive stem cell infusion on Day 0 and G-CSF given daily until engraftment occurs.
Receives: Drug: Carfilzomib; Drug: Busulfan IV; Drug: Melphalan IV
Carfilzomib IV at dose: 36 mg/m2ExperimentalThe participants will receive Carfilzomib IV at dose: 36 mg/m2 on days -9 and -8 over 30 minutes. The participant will receive Busulfan IV over 3 hours every 24 hours for a total of 4 doses from Day -6 to Day -3 and Melphalan IV over 15-30 minutes for one dose on day -3.The participants will receive stem cell infusion on Day 0 and G-CSF given daily until engraftment occurs.
Receives: Drug: Carfilzomib; Drug: Busulfan IV; Drug: Melphalan IV
Carfilzomib IV at dose: 45 mg/m2ExperimentalThe participants will receive Carfilzomib IV at dose: 45 mg/m2 on days -9 and -8 over 30 minutes. The participant will receive Busulfan IV over 3 hours every 24 hours for a total of 4 doses from Day -6 to Day -3 and Melphalan IV over 15-30 minutes for one dose on day -3.The participants will receive stem cell infusion on Day 0 and G-CSF given daily until engraftment occurs.
Receives: Drug: Carfilzomib; Drug: Busulfan IV; Drug: Melphalan IV
Carfilzomib IV at dose: 56 mg/m2ExperimentalThe participants will receive Carfilzomib IV at dose: 56 mg/m2 on days -9 and -8 over 30 minutes. The participant will receive Busulfan IV over 3 hours every 24 hours for a total of 4 doses from Day -6 to Day -3 and Melphalan IV over 15-30 minutes for one dose on day -3.The participants will receive stem cell infusion on Day 0 and G-CSF given daily until engraftment occurs.
Receives: Drug: Carfilzomib; Drug: Busulfan IV; Drug: Melphalan IV

What is being measured

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

  1. 36 participants evaluated for safety with treatment-related adverse events and grading by using CTCAE v4.0.

    To determine the maximal tolerated dose of carfilzomib when added to busulfan and melphalan as a preparative regimen for high dose therapy with autologous hematopoietic transplantation for patients with multiply myeloma.

    Measured: 3 years

  2. 36 participants evaluated for tolerability with treatment-related adverse events and grading by using CTCAE v4.0.

    To determine the maximal tolerated dose of carfilzomib when added to busulfan and melphalan as a preparative regimen for high dose therapy with autologous hematopoietic transplantation for patients with multiply myeloma.

    Measured: 3 years

Secondary outcomes (10)
  1. 36 participants evaluated for response to treatment by testing blood for multiple myeloma levels.

    To evaluate complete, very good partial, partial and stable disease response rate for both clinical and biologic endpoints.

    Measured: 100 days

  2. 36 participants evaluated for progression by testing blood for multiple myeloma levels.

    Progression Free Survival

    Measured: 3 years

  3. 36 participants evaluated for overall survival by clinical visit or contact by phone.

    Overall Survival

    Measured: 3 years

  4. 36 participants evaluated for absolute neutrophil count by testing white blood cells levels.

    Days to neutrophil engraftment: Absolute neutrophil count > 500/microliter

    Measured: 100 days

  5. 36 participants evaluated for platelet engraftment by testing platelet count in blood cells.

    Days to platelet engraftment: platelet count > 20,000/microliter untransfused

    Measured: 100 days

  6. 36 participants evaluated by oral exam to assess mucositis events and grading levels by using CTCAE v4.0.

    Mucositis: CTCAE v 4.0 grade and severity

    Measured: 100 days

  7. 36 participants evaluated by the liver to assess Veno-occlusive disease and grading levels by using CTCAE v4.0.

    Veno-occlusive disease

    Measured: 100 days

  8. 36 participants evaluated by a physical exam to assess peripheral neuropathy and grading by using CTCAE v4.0.

    Peripheral neuropathy greater than or equal to CTCAE V 4.0 Grade 3

    Measured: 3 years

  9. 36 participants evaluated for response to treatment by testing urine for multiple myeloma levels.

    To evaluate complete, very good partial, partial no stable disease response rate for both clinical and biologic endpoints

    Measured: 100 days

  10. 36 participants evaluated for progression by testing urine for multiple myeloma levels.

    Progression Free Survival

    Measured: 3 years

Timeline

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

  1. First posted8 Jan 2019
  2. Study start22 May 2019
  3. Primary completion1 Nov 2022 (estimated)
  4. Study completion1 Nov 2023 (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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
Busulfan IV over 3 hours every 24 hours for a total of 4 doses from D-6 to D-3. First two daily infusions will be given at a fixed dose of 3.2 mg/kg over 3 hours from D-6 to D-5. The 3rd and 4th daily doses will be adjusted to an AUC of approximately 5,000 mMol-min per dose. Melphalan 140 mg/ m2 IV over 15-30 minutes for one dose on day -3. Carfilzomib administration will follow a Phase I dose escalation design. Each cohort will start with a goal of accruing three patients to determine the dose limiting toxicities. Once the Maximum Tolerated Dose is established an expansion cohort will be treated to include a total of 10 additional patients.
Masking
None (open label)
Enrolment
36 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03795597
Sponsor's protocol ID
209274
Acronym
BuMelCarAuto
Status last verified
Apr 2021
First submitted
17 Oct 2018
Last updated
26 Apr 2021
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 1/2 study testing Carfilzomib, Busulfan IV and Melphalan IV in people with Multiple Myeloma, run by Loyola University 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 7 inclusion and 6 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: status not confirmed, as of the sponsor's last update on 26 Apr 2021. 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 combined 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.

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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Patrick Stiff, MD (708-327-3148, mailto:pstiff@lumc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

36 participants evaluated for safety with treatment-related adverse events and grading by using CTCAE v4.0. (time frame: 3 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 26 Apr 2021.

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