Multiple Myeloma Clinical Trial
A Study of Oral Ixazomib Citrate (MLN9708) Maintenance Therapy in Participants With Multiple Myeloma Following Autologous Stem Cell Transplant
Summary
The purpose of this study is to determine the effect of ixazomib citrate maintenance therapy on progression-free survival (PFS), compared to placebo, in participants with newly diagnosed multiple myeloma (NDMM) who have had a response (complete response [CR], very good partial response [VGPR], or partial response [PR]) to treatment-for-multiple-myeloma-induction-therapy/" >induction therapy followed by high-dose therapy (HDT) and autologous stem cell transplant (ASCT).
Full Description
The investigational drug being tested in this study is called ixazomib citrate. Ixazomib citrate is being tested to slow disease progression and improve overall survival in people who have NDMM and who have had any type of positive response to induction therapy followed by HDT and ASCT. This study will look at the effect ixazomib citrate has on the length of time that participants are free of progressive disease (PD) and their overall survival (OS).
The study enrolled 656 participants. Participants were randomly assigned (by chance, like flipping a coin) to one of the two treatment groups-which will remain undisclosed to the participant and study doctor during the study (unless there is an urgent medical need, or if the disease has progressed and the information is required for planning the next treatment):
Ixazomib citrate 3 mg for the first 4 cycles, then 4 mg for the remaining 22 cycles
Placebo (dummy inactive pill) - this is a capsule that looks like the study drug but has no active ingredient.
All participants will be asked to take one capsule on Days 1, 8 and 15 of each 28-day cycle, for up to 26 cycles (approximately 24 months).
This multi-center trial will be conducted globally. The overall time to participate in this study is up to 107 months. Participants will make 28 visits to the clinic during the treatment period and will continue to make visits after treatment has ended. During this initial follow up period, participants will be assessed for disease status with follow up every 12 weeks. After the next line of therapy begins, follow-up will occur every 12 weeks until death or termination of the study.
Eligibility Criteria
Inclusion Criteria:
Adult male or female participants 18 years or older with a confirmed diagnosis of symptomatic multiple myeloma according to standard criteria.
Documented results of cytogenetics/ fluorescence in situ hybridization (FISH) obtained at any time before transplant, and International Staging System (ISS) staging at the time of diagnosis available.
Underwent standard of care (SOC) induction therapy (induction therapy must include proteasome inhibitor (PI) and/or immunomodulating drugs (IMiD)-based regimens as primary therapy for multiple myeloma), followed by a single autologous stem cell transplant (ASCT) with a high-dose melphalan (200 mg/m^2) conditioning regimen, within 12 months of diagnosis. Vincristine, Adriamycin [doxorubicin], and dexamethasone (VAD) is not an acceptable induction therapy for this trial.
Started screening no earlier than 75 days after transplant, completed screening within 15 days, and randomized no later than 115 days after transplant.
Must have not received post-ASCT consolidation therapy.
Documented response to ASCT (PR, VGPR, CR/stringent complete response [sCR]) according to IMWG criteria.
ECOG performance status of 0 to 2.
Female participants who:
If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 90 days after the last dose of study drug, AND
Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR
Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods for the female partner] and withdrawal are not acceptable methods of contraception.) Male participants, even if surgically sterilized (ie, status postvasectomy), who:
Agree to practice effective barrier contraception during the entire study treatment period and through 90 days after the last dose of study drug, AND
Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR
Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods for the female partner] and withdrawal are not acceptable methods of contraception.)
Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the participant at any time without prejudice to future medical care.
Suitable venous access for the study-required blood sampling.
Is willing and able to adhere to the study visit schedule and other protocol requirements.
Must meet the following clinical laboratory criteria at study entry:
Absolute neutrophil count (ANC) ≥ 1,000 per cubic milliliter (/mm^3) and platelet count ≥ 75,000/mm^3. Platelet transfusions to help participants meet eligibility criteria are not allowed within 3 days before randomization.
Total bilirubin ≤ 1.5 * the upper limit of the normal range (ULN).
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3 * ULN.
Calculated creatinine clearance ≥ 30 milliliter per minute (mL/min).
Exclusion Criteria:
Multiple myeloma that has relapsed following primary therapy or is not responsive to primary therapy. For this study, stable disease following ASCT will be considered nonresponsive to primary therapy.
Double (tandem) ASCT.
Radiotherapy within 14 days before the first dose of study drug.
Diagnosed or treated for another malignancy within 5 years before randomization or previously diagnosed with another malignancy with 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.
Female participants who are lactating and breastfeeding or have a positive serum pregnancy test during the Screening period.
Major surgery within 14 days before randomization.
Central nervous system involvement.
Infection requiring intravenous (IV) antibiotic therapy or other serious infection within 14 days before randomization.
Diagnosis of Waldenstrom's macroglobulinemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, plasma cell leukemia, primary amyloidosis, myelodysplastic syndrome, or myeloproliferative syndrome.
Evidence of current uncontrolled cardiovascular conditions, including uncontrolled hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure, unstable angina, or myocardial infarction within the past 6 months.
Systemic treatment with strong cytochrome P450 3A (CYP3A) inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of Ginkgo biloba or St. John's wort within 14 days before randomization in the study.
Active hepatitis B or C virus infection, or known human immunodeficiency virus (HIV) positive.
Comorbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the participant inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens (eg, peripheral neuropathy that is Grade 1 with pain or Grade 2 or higher of any cause).
Psychiatric illness/social situation that would limit compliance with study requirements.
Known allergy to any of the study medications, their analogues, or excipients in the various formulations of any agent.
Inability to swallow oral medication, inability or unwillingness to comply with the drug administration requirements, or gastrointestinal (GI) procedure that could interfere with the oral absorption or tolerance of treatment.
Treatment with any investigational products within 60 days before the first dose of the study drug regimen.
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There are 215 Locations for this study
Little Rock Arkansas, 72205, United States
Rochester Minnesota, 55905, United States
Bronx New York, 10467, United States
Hershey Pennsylvania, 17033, United States
Dallas Texas, 75246, United States
Morgantown West Virginia, 26506, United States
La Plata Buenos Aires, B1900, Argentina
Rosario Santa Fe, 2000, Argentina
Rosario Santa Fe, S2000, Argentina
Rosario Santa Fe, S2000, Argentina
Ciudad Autonoma de Buenos Aires , C1181, Argentina
Santa Fe , S3006, Argentina
Kogarah New South Wales, 2217, Australia
Waratah New South Wales, 2298, Australia
Westmead New South Wales, 2145, Australia
South Brisbane Queensland, 4101, Australia
Southport Queensland, 4215, Australia
Adelaide South Australia, 5000, Australia
Woodville South South Australia, 5011, Australia
Heidelberg Victoria, 3084, Australia
Melbourne Victoria, 3004, Australia
Linz , 4020, Austria
Salzburg , 5020, Austria
Wien , 1090, Austria
Wien , 1160, Austria
La Louviere Hainaut, 7100, Belgium
Mons Hainaut, 7000, Belgium
Gent Oost-Vlaanderen, 9000, Belgium
Brugge West-Vlaanderen, 8000, Belgium
Antwerpen , 2020, Belgium
Antwerpen , 2060, Belgium
Belo Horizonte Minas Gerais, 30130, Brazil
Curitiba Parana, 80530, Brazil
Curitiba Parana, 81520, Brazil
Passo Fundo Rio Grande Do Sul, 99010, Brazil
Porto Alegre Rio Grande Do Sul, 90035, Brazil
Porto Alegre Rio Grande Do Sul, 90470, Brazil
Florianopolis Santa Catarina, 88034, Brazil
Joinville Santa Catarina, 89201, Brazil
Jau Sao Paulo, 17210, Brazil
Sao Jose Do Rio Preto Sao Paulo, 15090, Brazil
Rio De Janeiro , 20231, Brazil
Rio de Janeiro , 21941, Brazil
Sao Paulo , 01223, Brazil
Sao Paulo , 05651, Brazil
Sao Paulo , 54030, Brazil
Toronto Ontario, M5G 2, Canada
Montreal Quebec, H4A 3, Canada
Bogota Cundinamarca, , Colombia
Cali Valle Del Cauca, , Colombia
Medellin , , Colombia
Hradec Kralove Kralovehradeck Kraj, 500 0, Czechia
Brno , 625 0, Czechia
Olomouc , 779 0, Czechia
Ostrava , 708 5, Czechia
Praha 2 , 128 0, Czechia
Praha , 100 3, Czechia
Herlev Capital, 2730, Denmark
Aalborg Nordjylland, DK-90, Denmark
Aarhus N , DK-82, Denmark
Copenhagen , 2100, Denmark
Odense , 5000, Denmark
Roskilde , DK-40, Denmark
Vejle , DK-71, Denmark
Clamart Hauts-de-Seine, 92140, France
Nantes Loire-Atlantique, 44093, France
Lille Nord, 59037, France
Limoges , 87042, France
Paris , 75015, France
Heidelberg Baden-Wurttemberg, 69120, Germany
Mannheim Baden-Wurttemberg, 68167, Germany
Ulm Baden-Wurttemberg, 89081, Germany
Munchen Bayern, 81377, Germany
Wurzburg Bayern, 97080, Germany
Darmstadt Hessen, 64283, Germany
Frankfurt am Main Hessen, 65929, Germany
Oldenburg Niedersachsen, 26121, Germany
Bonn Nordrhein-Westfalen, 53105, Germany
Essen Nordrhein-Westfalen, 45122, Germany
Essen Nordrhein-Westfalen, 45239, Germany
Hagen Nordrhein-Westfalen, 58095, Germany
Koln Nordrhein-Westfalen, 50937, Germany
Mainz Rheinland-Pfalz, 55131, Germany
Dresden Sachsen, 1307, Germany
Berlin , 13125, Germany
Berlin , 13353, Germany
Hamburg , 20099, Germany
Hamburg , 20246, Germany
Hamburg , 22763, Germany
Hannover , 30459, Germany
Ludwigshafen , 67063, Germany
Tubingen , 72076, Germany
Athens Attiki, 10676, Greece
Athens Attiki, 11527, Greece
Athens , 11528, Greece
Thessaloniki , 57010, Greece
Budapest , 1083, Hungary
Budapest , 1097, Hungary
Debrecen , 4032, Hungary
Kaposvar , 7400, Hungary
Szeged , 6725, Hungary
Ashkelon , 78278, Israel
Be'er Sheva , 84101, Israel
Haifa , 31048, Israel
Haifa , 31096, Israel
Haifa , 34362, Israel
Jerusalem , 91031, Israel
Jerusalem , 91120, Israel
Nahariya , 22100, Israel
Petach Tikva , 49100, Israel
Ramat-Gan , 52621, Israel
Rehovot , 76100, Israel
Safed , 13100, Israel
Tel Aviv , 64239, Israel
Tzrifin , 70300, Israel
Pescara Abruzzo, 65100, Italy
Roma Lazio, 152, Italy
Pavia Lombardia, 27100, Italy
Ancona Marche, 60020, Italy
Torino Piemonte, 10126, Italy
Rionero In Vulture Potenza, 85028, Italy
Terni Umbria, 5100, Italy
Bologna , 40138, Italy
Brescia , 25123, Italy
Firenze , 50134, Italy
Genova , 16132, Italy
Meldola , 47014, Italy
Milano , 20162, Italy
Rimini , 47900, Italy
Kobe-City Hyogo, 650-0, Japan
Morioka-shi Iwate, 020-8, Japan
Sendai Miyagi, 98385, Japan
Niigata-shi Niigata, 951-8, Japan
Okayama-City Okayama, 701-1, Japan
Kawagoe-city Saitama, 350-8, Japan
Bunkyo Tokyo, 113-8, Japan
Chiba Tokyo, 26086, Japan
Shibuya-ku Tokyo, 150-8, Japan
Shinjuku-ku Tokyo, 160-8, Japan
Shinjuku Tokyo, 162-8, Japan
Fukuoka-City , 812-8, Japan
Nagoya-City , 467-8, Japan
Nagoya , 460-0, Japan
Shibukawa , 377-0, Japan
Tachikawa , 19000, Japan
Toyohashi-City , 441-8, Japan
Goyang Gyeonggido, 41076, Korea, Republic of
Daejeon , 301-7, Korea, Republic of
Incheon , 405-7, Korea, Republic of
Seoul , 11074, Korea, Republic of
Seoul , 120-7, Korea, Republic of
Seoul , 135-7, Korea, Republic of
Seoul , 137-7, Korea, Republic of
Seoul , 138-7, Korea, Republic of
Seoul , 15871, Korea, Republic of
Guadalajara Jalisco, 44160, Mexico
Monterrey Nuevo Leon, 64460, Mexico
Amsterdam Noord-Holland, 1081 , Netherlands
Dordrecht Zuid-Holland, 3318 , Netherlands
Groningen , 9713 , Netherlands
Rotterdam , 3015 , Netherlands
Utrecht , 3584 , Netherlands
Gjelta Oppland, N-134, Norway
Trondheim Sor-Trondelag, N-703, Norway
Oslo , 450, Norway
Stavanger , 4011, Norway
Wroclaw Dolnoslaskie, 50-36, Poland
Warszawa Mazowieckie, 04-14, Poland
Gdansk Pomorskie, 80-95, Poland
Chorzow Slaskie, 41-50, Poland
Brzozow , 36-20, Poland
Lodz , 93-51, Poland
Braga , 4710-, Portugal
Coimbra , 3000-, Portugal
Porto , 4200-, Portugal
Porto , 4200-, Portugal
Singapore , 11907, Singapore
Singapore , 16960, Singapore
Johannesburg Gauteng, 2196, South Africa
Pretoria Gauteng, 181, South Africa
Pretoria Gauteng, 44, South Africa
Badalona Barcelona, 8916, Spain
Madrid Madrid, Communidad Delaware, 28009, Spain
Pamplona Navarra, 31008, Spain
Barcelona , 8036, Spain
Cordoba , 14004, Spain
Girona , 17007, Spain
Madrid , 28006, Spain
Madrid , 28046, Spain
Madrid , 28050, Spain
Madrid , 28222, Spain
Murcia , 30008, Spain
Salamanca , 37007, Spain
Sevilla , 41013, Spain
Helsingborg Skane Lan, , Sweden
Lund Skane Lan, , Sweden
Goteborg Vastra Gotalands Lan, , Sweden
Stockholm , 14186, Sweden
Uppsala , SE-75, Sweden
Basel Basel-Stadt (de), 4031, Switzerland
Zurich Zurich (de), 8091, Switzerland
Kaohsiung , 807, Taiwan
Kaohsiung , , Taiwan
Taipei , 10002, Taiwan
Taipei , 613, Taiwan
Taoyuan City , 333, Taiwan
Bangkok Krung Thep Maha Nakhon-Bangkok, 10330, Thailand
Bangkok Krung Thep Maha Nakhon-Bangkok, 10400, Thailand
Ankara , 6100, Turkey
Ankara , 6200, Turkey
Ankara , , Turkey
Denizli , 20070, Turkey
Istanbul , 34093, Turkey
Kayseri , 38039, Turkey
Trabzon , 61080, Turkey
Kyiv , 3115, Ukraine
Southampton Hampshire, SO16 , United Kingdom
London London, City Of, EC1A , United Kingdom
London London, City Of, SE5 9, United Kingdom
London London, City Of, W12 0, United Kingdom
Oxford Oxfordshire, OX3 7, United Kingdom
Sutton Surrey, SM2 5, United Kingdom
Leeds Yorkshire, LS9 7, United Kingdom
Sheffield Yorkshire, S10 2, United Kingdom
Leicester , LE1 5, United Kingdom
London , WC1E , United Kingdom
Swansea , , United Kingdom
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