A Phase 1 Dose Escalating Trial of Bortezomib in Combination With Lenalidomide in Patients With Myelodysplasia
A Phase I Dose Escalating Study of Bortezomib and Lenalidomide in Patients With Untreated or Previously Treated, Primary and Secondary Non 5q- Del Myelodysplasia
This date has not been verified as actual or estimated.
Primary Completion
March 2012
Actual (reported)
Study Completion
March 2012
Actual (reported)
Brief Summary
This study proposes using bortezomib in cohorts of 3-6 patients at the doses of 0.7, 1, and 1.3 mg/m2 on days 1, 4, 8, and 11 to determine the MTD in combination with lenalidomide 10 mg a day, for 21 days of a 28 day treatment cycle for patients with myelodysplastic syndrome.
Registry Overview
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
Recruitment status
completed
Actual enrollment (reported)
23 participants
Study completion date
March 2012
Actual (reported)
Listed locations
1 countries · 2 sites
Trial Relationships
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Study Timeline
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
Study Start
November 2007
Date type not reported
This date has not been verified as actual or estimated.
Establish the maximally tolerated dose of bortezomib, up to 1.3 mg/m2/day, that can be administered in combination with lenalidomide in patients with primary and secondary non 5q del myelodysplasia who are untreated or previously treated.
3, 6 and 9 months
Secondary Outcomes (6)
Assess efficacy in terms of the number of patients experiencing a decrease in blast percentage
3, 6 and 9 months
Assess efficacy in terms of the number of patients experiencing a decrease in transfusion requirements
3, 6 and 9 months
Determine the toxicity profile of bortezomib when used in combination with lenalidomide for patients with myelodysplasia
3, 6 and 9 months
Determine the time (days) to transfusion independence
3, 6 and 9 months
Determine the duration of response
3, 6 and 9 months
+1 more secondary outcomes
Study Arms (1)
1
EXPERIMENTAL
This is a Phase I dose escalation trial with three cohorts of 3-6 patients each plus 10 additional patients (up to a maximum total of 28 patients) treated at the candidate maximum tolerated dose.Cohorts will receive increasing doses of bortezomib at 0.7, 1, and 1.3 mg/m2 on days 1, 4, 8, and 11 in combination with lenalidomide at 10 mg a day for Days 1-21. Each cycle will be 28 days. Patients will receive up to 9 cycles of treatment, with efficacy assessed after 3, 6, and 9 cycles.
Drug: BortezomibDrug: Lenalidomide
Interventions
BortezomibDrug
First cohort: Bortezomib 0.7mg/m2 IV on Days on Days 1, 4, 8, and 11. Patients may receive up to 9 cycles with each cycle lasting a total of 28 days
Also known as: Velcade
1
BortezomibDrug
Second cohort: Bortezomib 1mg/m2 IV on Days 1, 4, 8, and 11 Patients may receive up to 9 cycles with each cycle lasting a total of 28 days
Third Cohort: Bortezomib 1.3mg/m2 IV on Days 1, 4, 8, and 11 of each cycle Patients may receive up to 9 cycles with each cycle lasting a total of 28 days
Also known as: Velcade
1
LenalidomideDrug
Lenalidomide 10 mg PO QD on Days 1 -21 followed by a 7 day rest period
Also known as: Revlimid
1
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Able to adhere to study schedule and other protocol requirements
Unequivocal clinicopathologic diagnosis of myelodysplastic syndrome, non 5q- deletion.
Patients may have had prior chemotherapy or radiotherapy for another malignancy or myelodysplasia as long as it was completed at least 4 weeks (6 weeks for nitrosureas) prior to initiation of therapy.
ECOG performance status of 0-2 (Appendix 10.3)
Life expectancy greater than 3 months
Total bilirubin ≤ 2.0 mg/dl, ALT and AST ≤ 3 X the upper limit of normal (ULN), creatinine \< 2.0 mg/dl all within 28 days prior to enrollment.
Patients must give voluntary written informed consent and HIPAA authorization before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
Absolute neutrophil count \> 0.5 x 10 (9)/l
Platelet count \> 30 x 10 (9)/l
Prior treatment with 5-azacytidine is encouraged, but not required.
Patients may have had prior treatment for MDS, including single agent lenalidomide or bortezomib.
Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 50mIU/ml within 10-14 days prior to and within 24 hours of prescribing lenalidomide and must commit to abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control,at least 4 weeks before starting taking lenalidomide. FCBP must agree to ongoing pregnancy testing. Men must agree not to father a child and agree to use a latex condom during sexual contact with a female of child bearing potential even if they have had a successful vasectomy.
All study participants must be registered into the mandatory RevAssist Program®, and be willing and able to comply with the requirements of RevAssist®.
You may not qualify if:
Ejection fraction \< 40%
Patients who have had a myocardial infarction within 6 months of enrollment or has New York Heart Association (NYHA) Class III or IV heart failure, uncontrolled angina, uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening has to be documented by the investigator as not medically relevant.
Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the consent form.
Any condition, including laboratory abnormalities, that in the opinion of the investigator places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
Patients with major surgery within the 28 days prior to trial enrollment.
Patients with ≥ Grade 2 peripheral neuropathy or active herpes infection
Patients with an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, cirrhosis, chronic obstructive or restrictive pulmonary disease, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrythmia.
Patients with secondary MDS that require concurrent therapy for the primary cancer diagnosis.
The development of erythema nodosum as characterized by a desquamating rash while taking thalidomide or similar drugs.
Patient with hypersensitivity to bortezomib, boron or mannitol.
Female subject is pregnant or breast-feeding. . Lactating females must agree not to breast feed while taking lenalidomide.
Patient has received an investigational drug within 28 days of enrollment.
Known hypersensitivity to thalidomide or lenalidomide
Concurrent use of other anti-cancer agents or treatments.
Known positive for HIV
Contact the study team to confirm eligibility.
Othercollaborator
Boron Compounds
Organic Chemicals
Pyrazines
Heterocyclic Compounds, 1-Ring
Heterocyclic Compounds
Phthalimides
Phthalic Acids
Acids, Carbocyclic
Carboxylic Acids
Piperidones
Piperidines
Isoindoles
Heterocyclic Compounds, 2-Ring
Heterocyclic Compounds, Fused-Ring
Primary Completion
March 2012
Actual (reported)
Study Completion
March 2012
Actual (reported)
Last Updated
March 8, 2012
Record last verified: 2012-03
Source record
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Source: ClinicalTrials.gov.
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