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Multiple MyelomaPhase 4US MM-7NCT05183139

A Multicenter In-class Transition Study of Ixazomib Combined With Pomalidomide and Dexamethasone or With Lenalidomide and Dexamethasone in Adults With Relapsed/Refractory Multiple Myeloma

A Phase 4 study testing Ixazomib, Pomalidomide and Lenalidomide in people with Multiple Myeloma, run by Takeda.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The main aim is to show that long-term use of ixazomib can improve symptoms of multiple myeloma and provide an effective long-term alternative treatment. Participants will take ixazomib orally (by mouth) with pomalidomide and dexamethasone or lenalidomide and dexamethasone in 28-day treatment cycles. 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?
Ixazomib, Pomalidomide and Lenalidomide
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
30 Jun 2022to 31 Dec 2026
Phase
Phase 4
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

  • Has a diagnosis of multiple myeloma (MM) using current IMWG diagnostic criteria, and are relapsed or refractory to 1 to 3 prior lines of therapy*.
  • Has completed 3 or 4 cycles of a parenteral proteasome inhibitor (PI), and lenalidomide- or pomalidomide-based regimen and achieved a response of ≥ partial response (PR) with no evidence of disease progression as defined by IMWG criteria. This lead-in therapy to in-class transition (iCT) is not included as part of the 1 to 3 prior lines and should be completed no more than 28 days prior to initiation of IRd or IPd in this study.
  • Those with light chain myeloma and free light chain (FLC) only may be enrolled if they previously met or currently meet the criteria for a diagnosis of MM.
  • A line of therapy is defined as one or more cycles of a planned treatment program. This may consist of one or more planned cycles of single-agent therapy or combination therapy, as well as a sequence of treatments administered in a planned manner. For example, a planned treatment approach of induction therapy followed by autologous stem-cell transplantation, followed by maintenance is considered one line of therapy. Autologous and allogenic transplants are permitted.
  • Has a diagnosis of non-secretory disease as long as the participant has a marker of disease that can be followed serially and assessed for response.
  • Has an Eastern Cooperative Oncology Group (ECOG) performance status and/or other performance status of 0, 1, or 2 at the time of enrollment.

Who cannot join

  • Has Grade >2 peripheral neuropathy (PN), or Grade 2 PN with pain on clinical examination.
  • Has not adequately recovered from other non-neuropathy AEs related to prior therapy in the opinion of the investigator at the time of enrollment.
  • Is pomalidomide refractory.
  • Has primary light chain amyloidosis (AL). Those with MM and concurrent AL are allowed.
  • Has known central nervous system involvement by MM.
  • Has infection requiring systemic antibiotic therapy or other serious infection within 14 days before enrollment.
Show all 9Show fewer
  • Has ongoing or active systemic infection, active hepatitis B or C virus infection, or known positive status for human immunodeficiency virus.
  • Has been diagnosed or treated for another malignancy within 2 years before enrollment or has previously been diagnosed with another malignancy and has any evidence of residual disease. Participants with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
  • Has previously been treated with ixazomib or participated in a study with ixazomib whether treated with ixazomib or not.

About this study

Official title: An Open-Label, Non-Comparative, Two-Cohort, Multicenter Study to Evaluate the Effectiveness and Safety of Ixazomib (NINLARO®) in Combination With Pomalidomide and Dexamethasone (IPd, Cohort A) or With Lenalidomide and Dexamethasone (IRd, Cohort B) in Patients With Relapsed/Refractory Multiple Myeloma Previously Receiving a Parenteral Proteasome Inhibitor-based Treatment Regimen (US MM-7)

The main aim is to show that long-term use of ixazomib can improve symptoms of multiple myeloma and provide an effective long-term alternative treatment.

Participants will take ixazomib orally (by mouth) with pomalidomide and dexamethasone or lenalidomide and dexamethasone in 28-day treatment cycles. Participants will be treated for a maximum of 39 cycles but may continue to receive ixazomib beyond 39 cycles if they are benefiting from it. A follow-up study visit will occur 30 days after the last dose of ixazomib. Participants will be monitored for up to 3 years.

Read the detailed description

The main objective is to determine whether an in-class transition (iCT) from a parenteral proteasome inhibitor (PI) regimen to an all-oral ixazomib(NINLARO) regimen can improve outcomes and provide an effective long-term alternative treatment for participants with relapsed and/or refractory multiple myeloma.

The drug being tested in this study is called ixazomib (NINLARO). Ixazomib is being tested to treat people who have relapsed and/or refractory multiple myeloma (R/R MM). This study will look at the efficacy and safety of ixazomib in participants with R/R MM who were previously receiving parenteral proteasome inhibitor (PI)-based therapy in combination with pomalidomide or with lenalidomide, and who undergo in-class transition to an oral ixazomib-based combination containing either pomalidomide (cohort A) or lenalidomide (cohort B).

The study will enroll approximately 140 patients. Participants will be enrolled to one of the two treatment groups, depending on whether they are transitioning from a pomalidomide- or lenalidomide- based regimen:

  • Cohort A: Ixazomib 4 mg + Pomalidomide 4 mg + Dexamethasone 40 mg
  • Cohort B: Ixazomib 4 mg + Lenalidomide 25 mg + Dexamethasone 40 mg

Participants who are >75 years of age at time of enrollment will be instructed to take 20 mg dexamethasone. For participants with moderate or severe hepatic impairment, severe renal impairment, or end-stage renal disease requiring dialysis, the recommended starting dose of ixazomib is 3 mg which can be further reduced to 2.3 mg at investigator's discretion.

This multi-center trial will be conducted at approximately 30 study centers across the United States. The overall duration of this study is approximately 5 years or until all participants have died, have been lost to follow-up, or completion of the study by the sponsor, whichever occurs first.

Being tested
Ixazomib, Pomalidomide, Lenalidomide, Dexamethasone
Keywords
Drug Therapy
Medical subject headings
Multiple Myeloma

What participants receive

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

  • IxazomibDrug

    Also called NINLARO

    Ixazomib capsules

  • PomalidomideDrug

    Also called POMALYST

    Pomalidomide capsules

  • LenalidomideDrug

    Also called REVLIMID

    Lenalidomide capsules

  • DexamethasoneDrug

    Dexamethasone tablets

Study groups in NCT05183139
Study groupRoleWhat they receive
Cohort A: Ixazomib 4 mg + Pomalidomide 4 mg + Dexamethasone 40 mgExperimentalIxazomib 4 mg (3 mg for participants with moderate or severe hepatic impairment, severe renal impairment, or end-stage renal disease requiring dialysis), capsules, orally, on Days 1, 8, and 15, along with pomalidomide 4 mg, capsules, orally from Days 1 to 21 and dexamethasone 40 mg (20 mg if the participant is over 75 years of age), tablets, orally on Days 1, 8, 15, and 22 of each 28-day cycle, for a maximum of 39 cycles or until disease progression or unacceptable toxicity leading to discontinuation of ixazomib or to a change in regimen. Participants who were taking modified doses of pomalidomide or dexamethasone can start at that dose level in the study.
Receives: Drug: Ixazomib; Drug: Pomalidomide; Drug: Dexamethasone
Cohort B: Ixazomib 4 mg + Lenalidomide 25 mg + Dexamethasone 40 mgExperimentalIxazomib 4 mg (3 mg for participants with moderate or severe hepatic impairment, severe renal impairment, or end-stage renal disease requiring dialysis), capsules, orally, on Days 1, 8, and 15, along with lenalidomide 25 mg capsules, orally, from Days 1 to 21 and dexamethasone 40 mg (20 mg if the participant is over 75 years of age), tablets, orally, on Days 1, 8, 15, and 22 of each 28-day cycle, for a maximum of 39 cycles or until disease progression or unacceptable toxicity leading to discontinuation of ixazomib or to a change in regimen. Participants who were taking modified doses of lenalidomide or dexamethasone can start at that dose level in the study.
Receives: Drug: Ixazomib; Drug: Lenalidomide; Drug: Dexamethasone

What is being measured

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

  1. Progression Free Survival (PFS)

    PFS is defined as the time from the date of the first administration of the study drug regimen ixazomib with pomalidomide and dexamethasone or ixazomib with lenalidomide and dexamethasone (IPd/IRd) to the date of the first documentation of disease progression before the start of next line of therapy based on local laboratory results and the investigator's assessment using modified International Myeloma Working Group (IMWG) response criteria or death due to any cause, whichever occurs first.

    Measured: Up to approximately 5 years

Secondary outcomes (8)

  1. Percentage of Participants Maintaining or Achieving PR, Very Good Partial Response (VGPR), or Complete Response (CR)

    Percentage of participants with PR, VGPR, and CR will be determined based on local laboratory results and investigator's assessment using modified IMWG response criteria. CR: No immunofixation on serum/urine, disappearance of soft tissue plasmacytomas, <5% plasma cells in bone marrow. Participants with measurable disease only by serum free light chain (SFLC) level, normal FLC ratio of 0.26 to 1.65 in addition to CR criteria required. VGPR: Serum/urine M-protein detectable by immunofixation but not on electrophoresis or ≥90% decrease in serum M-protein with urine M-protein <100 milligram per 24 hours (mg/24 hrs). If disease measurable only by SFLC, ≥90% decrease in difference between involved and uninvolved free light chain (dFLC) levels in addition to VGPR criteria required. PR: ≥50% reduction of serum M-protein and ≥90% reduction in urine M-protein or to <200 mg/24 hrs, or a ≥50% decrease in dFLC. If present at Baseline, ≥50% reduction in size of soft tissue plasmacytomas required.

    Measured: Up to approximately 5 years

  2. Time to Progression (TTP)

    TTP is defined as the time from the date of the first administration of the study drug regimen (IPd/IRd) to the date of the first documentation of disease progression based on local laboratory results and the investigator's assessment using modified IMWG response criteria.

    Measured: Up to approximately 5 years

  3. Duration of Therapy (DoT 1)

    DoT 1 is defined as the date of the first administration of the parenteral PI-based regimen to the date of the last administration of any of the three drugs in the study drug regimen.

    Measured: Up to approximately 5 years

  4. Duration of Therapy (DoT 2)

    DoT 2 is defined as the time from the date of the first administration of the study drug regimen (IPd or IRd) to the date of the last administration of any of the three drugs in the study drug regimen.

    Measured: Up to approximately 5 years

  5. Duration of PI Therapy

    Duration of parenteral PI therapy is defined as the time from the date of the first administration of the parenteral PI therapy of the regimen preceding the study drug regimen (IPd or IRd) to the date of the last administration of ixazomib therapy

    Measured: Up to approximately 5 years

  6. Duration of Ixazomib Therapy

    Duration of ixazomib therapy is defined as the time from the date of the first administration of ixazomib to the date of the last administration of ixazomib therapy.

    Measured: Up to approximately 5 years

  7. Relative Dose Intensity (RDI) for Each Drug in the Treatment Regimen

    RDI for each drug in the study drug regimen (IPd/IRd) is defined as 100 × (Total amount of dose taken)/(Total prescribed dose of treated cycles), where total prescribed dose equals (dose prescribed at enrollment) × number of prescribed doses per cycle × the number of treated cycles.

    Measured: Up to approximately 5 years

  8. Percentage of Participants who Experience at Least One Treatment Emergent Adverse Event (TEAE)

    An adverse event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (e.g., a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug.

    Measured: Up to approximately 5 years

Timeline

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

  1. First posted10 Jan 2022
  2. Study start30 Jun 2022 (estimated)
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2026 (estimated)

Why it stopped: Business decision (no enrollment)

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 4
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05183139
Sponsor's protocol ID
C16063
Acronym
US MM-7
Status last verified
Apr 2022
First submitted
20 Dec 2021
Last updated
3 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ixazomib, Pomalidomide and Lenalidomide in people with Multiple Myeloma, run by Takeda.

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 6 inclusion and 9 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 3 May 2022. Status can change between updates, so confirm with the study contact before making plans.

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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

Progression Free Survival (PFS) (time frame: Up to approximately 5 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 NCT05183139.

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 3 May 2022.

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