NCT03170882

Brief Summary

The main aim of this study is to learn if ixazomib, given with dexamethasone, stops the cancer from getting worse in people with relapsed or refractory multiple myeloma. It will be compared to another medicine called pomalidomide, given with dexamethasone with people with the same condition. Relapsed means the previous cancer treatment stopped working, over time. Refractory means they did not respond to previous cancer treatment. Another aim is to check for side effects from the study medicines. At the first visit, the study doctor will check who can take part. Participants who can take part will be picked for 1 of 2 treatments by chance.

  • Ixazomib capsules, given with dexamethasone tablets
  • Pomalidomide capsules, given with dexamethasone tablets All participants will take their study medicine on specific days during a 28-day cycle. The 1st dose of study medicines in each 28-day cycle will take place in the clinic, The other doses of the study medicines will be taken at home. This will happen for 6 cycles. After this, all study medicines will be taken at home. After treatment, participants will visit the clinic every 12 weeks for a check-up. If participants cannot attend their clinic for an important reason (for example, due to the COVID-19 pandemic), the clinic will make alternative arrangements using their local procedures.

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
122

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Aug 2017

Typical duration for phase_2

Geographic Reach
18 countries

111 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 22, 2017

Completed
9 days until next milestone

First Posted

Study publicly available on registry

May 31, 2017

Completed
2 months until next milestone

Study Start

First participant enrolled

August 1, 2017

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2020

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

October 27, 2021

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

November 26, 2021

Completed
Last Updated

December 20, 2022

Status Verified

November 1, 2022

Enrollment Period

3 years

First QC Date

May 22, 2017

Results QC Date

July 30, 2021

Last Update Submit

November 21, 2022

Conditions

Keywords

Drug therapy

Outcome Measures

Primary Outcomes (1)

  • Progression Free Survival (PFS)

    PFS: Time from randomization to first occurrence of confirmed progressive disease (PD) as assessed by investigator by International Myeloma Working Group(IMWG) response criteria/death from any cause, whichever occurs first. PD requires following: Increase of \>=25 % from nadir in: Serum M component (increase must be \>=0.5 gram per deciliter \[g/dl\]); Urine M-component (increase must be \>=200 milligram \[mg\]/24-hour); In participants without measurable serum and urine M-protein levels difference between involved and uninvolved free light chain (FLC) increase of \>10 mg/dl; In participants without measurable serum and urine M protein levels and without measurable disease by FLC level: bone marrow plasma cell percentage must be \>=10%; Development of new/increase in size of existing bone lesions/soft tissue plasmacytomas; development of hypercalcemia (\>11.5mg/dL corrected serum calcium) attributed solely to plasma cell proliferative disease.

    From date of randomization until first occurrence of confirmed disease progression or death due to any cause, whichever occurs first (Up to approximately 3 years)

Secondary Outcomes (12)

  • Overall Survival (OS)

    From date of randomization to death due to any cause (Up to approximately 3 years)

  • Percentage of Participants With Overall Response

    From date of randomization until first documentation of CR, VGPR or PR (Up to approximately 3 years)

  • Duration of Response (DOR)

    From date of first documentation of CR, VGPR or PR until first occurrence of confirmed disease progression or death due to any cause, whichever occurs first (Up to approximately 3 years)

  • Time to Response

    From date of randomization until first documentation of CR, VGPR or PR (Up to approximately 3 years)

  • Time to Progression (TTP)

    From date of randomization until first occurrence of confirmed disease progression or death due to any cause, whichever occurs first (Up to approximately 3 years)

  • +7 more secondary outcomes

Study Arms (2)

Pomalidomide 4 mg + Dexamethasone 40 mg

ACTIVE COMPARATOR

Pomalidomide 4 mg, capsules, orally, once daily on Days 1 to 21 of each 28-day cycle, plus dexamethasone 40 mg, (or 20 mg if participant is aged \>=75 years), tablets, orally, once daily on Days 1, 8, 15, and 22 of each 28-day cycle until disease progression, unacceptable toxicity, withdrawal of consent, or sponsor termination of study up to 2 years.

Drug: PomalidomideDrug: Dexamethasone

Ixazomib 4 mg + Dexamethasone 20 mg

EXPERIMENTAL

Ixazomib 4 mg as starting dose, capsules, orally, once daily on Days 1, 8, and 15 of each 28-day cycle, with escalation to 5.5 mg at the start of Cycle 2 for participants who tolerated the 4 mg dose in Cycle 1, plus dexamethasone 20 mg (or 10 mg if participant is aged \>=75 years), tablets, orally, once daily on Days 1, 2, 8, 9, 15, 16, 22, and 23 of every 28-day cycle until disease progression, unacceptable toxicity, withdrawal of consent, or sponsor termination of study up to 2 years.

Drug: IxazomibDrug: Dexamethasone

Interventions

Ixazomib capsules

Also known as: NINLARO, MLN9708
Ixazomib 4 mg + Dexamethasone 20 mg

Pomalidomide capsules

Pomalidomide 4 mg + Dexamethasone 40 mg

Dexamethasone tablets

Ixazomib 4 mg + Dexamethasone 20 mgPomalidomide 4 mg + Dexamethasone 40 mg

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Must have a confirmed diagnosis of multiple myeloma (MM) requiring therapy according to International Myeloma Working Group (IMWG) criteria.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
  • Must have had a relapse or progressive disease (PD) after having received 2 or more prior lines of systemic therapy. Note: A line of therapy is defined as 1 or more cycles of a planned treatment program; this may consist of 1 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 (SCT), followed by maintenance is considered 1 line of therapy. Typically each line of therapy is separated by PD. Discussion with the medical monitor may help clarify the number of lines of therapy that a prospective study participant had.
  • Must be refractory to lenalidomide, defined as having received at least 2 consecutive cycles of lenalidomide as a single agent or within a lenalidomide-containing regimen and having had PD during treatment with or within 60 days after the last dose of lenalidomide. The starting dose of lenalidomide should have been 25 mg (or as low as 10 mg in the case of renal function impairment or other safety concern), and the final dose should have been a minimum of 10 mg.
  • Must have received at least 2 consecutive cycles of a bortezomib- or carfilzomib-containing regimen, and either:
  • Achieved at least a partial response (PR) and did not have PD during treatment with or within 60 days after the last dose of bortezomib or carfilzomib, OR
  • Had bortezomib and/or carfilzomib intolerance (defined as discontinuation because of drug-related adverse events \[AEs\] before completion of the planned treatment course) without PD before the start of the next regimen.
  • Must have measurable disease defined by:
  • Serum M-protein \>=1 g/dL (\>=10 g/L), OR
  • Urine M-protein \>=200 mg/24 hours and must have documented MM isotype by immunofixation (central laboratory).
  • Suitable venous access for the study-required blood sampling, including pharmacokinetic (PK) sampling.
  • Recovered (that is, less than or equal to \[\<=\] Grade 1 nonhematologic toxicity) from the reversible effects of prior anticancer therapy.
  • Must be willing and able to adhere to pomalidomide-related risk mitigation activities if randomized to the pom+dex arm (example, Risk Evaluation and Mitigation Strategies \[REMS\], pregnancy prevention programs).

You may not qualify if:

  • Prior allogenic bone marrow transplantation in any prior line of therapy or prior autologous SCT in the last prior line of therapy- unless the autologous SCT was performed a year or more before disease progression.
  • Diagnosed with or treated for another malignancy within 2 years before randomization, or previously diagnosed with another malignancy and have any evidence of residual, persistent, or recurrent disease. Participants with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
  • Diagnosis of smoldering MM, Waldenström's macroglobulinemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, plasma cell leukemia, primary amyloidosis, myelodysplastic syndrome, or myeloproliferative syndrome.
  • Peripheral neuropathy Grade 1 with pain or Grade 2 or higher peripheral neuropathy of any cause on clinical examination during the Screening period.
  • Treatment with any investigational products or with chimeric or fully human monoclonal antibodies within 30 days before randomization, systemic anticancer therapy or radiotherapy within 14 days before randomization (Note: "spot" radiation for areas of pain is permitted), and major surgery within 14 days before randomization.
  • Known gastrointestinal disease or gastrointestinal procedure that could interfere with the oral absorption or tolerance of study therapy, including difficulty swallowing.
  • Serious infection requiring parenteral antibiotic therapy or any other serious infection within 14 days before randomization.
  • Central nervous system involvement with MM (by clinical symptoms and signs).
  • Ongoing or active systemic infection, known human immunodeficiency virus-ribonucleic acid (RNA) positive, known hepatitis B surface antigen seropositive, or known hepatitis C virus-RNA positive.
  • Systemic treatment with strong cytochrome P-450 3A inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital) or use of St. John's wort within 14 days before randomization.
  • Admission or evidence of illicit drug use, drug abuse, or alcohol abuse.
  • History of severe cutaneous reactions, including hypersensitivity reactions such as Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), in the context of treatment with lenalidomide or thalidomide.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (111)

Highlands Oncology Group

Fayetteville, Arkansas, 72703, United States

Location

St Joseph Heritage Healthcare

Santa Rosa, California, 95403, United States

Location

Lynn Cancer Institute

Boca Raton, Florida, 33486, United States

Location

University of Florida

Gainesville, Florida, 32610, United States

Location

University of Maryland

Baltimore, Maryland, 21201, United States

Location

Henry Ford Health System

Detroit, Michigan, 48202, United States

Location

Michigan State University

Lansing, Michigan, 48910, United States

Location

Mayo Clinic

Rochester, Minnesota, 55905, United States

Location

San Juan Oncology Associates

Farmington, New Mexico, 87401, United States

Location

University of Toledo Medical Center

Toledo, Ohio, 43614, United States

Location

Icon Cancer Care South Brisbane

South Brisbane, Queensland, 4101, Australia

Location

The Queen Elizabeth Hospital

Woodville South, South Australia, 5011, Australia

Location

Box Hill Hospital

Box Hill, Victoria, 3128, Australia

Location

St Vincents Hospital Melbourne

Fitzroy, Victoria, 3065, Australia

Location

Royal Adelaide Hospital

Adelaide, Australia

Location

GasthuisZusters Antwerpen

Wilrijk, Antwerpen, 2610, Belgium

Location

AZ St Jan Brugge Oostende AV

Bruges, 8000, Belgium

Location

Royal Victoria Regional Health Centre

Barrie, Ontario, L4M 6M2, Canada

Location

Lakeridge Health Center

Ottawa, Ontario, L1G 2B9, Canada

Location

Fakultni nemocnice Hradec Kralove

Hradec Králové, Kralovehradeck Kraj, 500 05, Czechia

Location

University Hospital Olomouc

Olomouc, Olomouck Kraj, 775 20, Czechia

Location

Fakultni nemocnice Kralovske Vinohrady

Prague, Praha, Hlavni Mesto, 100 34, Czechia

Location

Vseobecna fakultni nemocnice v Praze

Prague, Praha, Hlavni Mesto, 128 08, Czechia

Location

Fakultni nemocnice Brno

Brno, 625 00, Czechia

Location

Fakultni nemocnice Ostrava

Ostrava, Czechia

Location

Fakultni nemocnice Plzen

Plzen Lochotin, 304 60, Czechia

Location

Aalborg Universitetshospital

Aalborg, North Denmark, 9100, Denmark

Location

Regionshospitalet Holstebro

Holstebro, 7500, Denmark

Location

Centre Antoine Lacassagne Centre Regional de Lutte Contre Le Cancer

Nice, Alpes-Maritimes, 06189, France

Location

CHRU Dijon Complexe Du Bocage

Dijon, Cote-d'Or, 21034, France

Location

CHRU de Brest - Hopital Morvan

Brest, Finistere, 29609, France

Location

CHRU Nancy

Vandœuvre-lès-Nancy, Meurthe-et-Moselle, 54511, France

Location

Centre Hospitalier Bretagne Atlantique Vannes

Vannes, Morbihan, 56017, France

Location

Centre Hospitalier Le Mans

Le Mans, Sarthe, 72037, France

Location

Groupe Hospitalier du Havre

Montivilliers, Seine-Maritime, 76290, France

Location

CHU Amiens Hopital Sud

Amiens, 80054, France

Location

Centre Hospitalier Fleyriat

Bourg-en-Bresse, 01012, France

Location

Centre Hospitalier (CH) William Morey

Chalon-sur-Saône, 71100, France

Location

Hospital d Instructions des Armees Percy

Clamart, 92140, France

Location

Centre Hospitalier de Dunkerque

Dunkirk, 59240, France

Location

Centre Jean Bernard Clinique Victor Hugo

Le Mans, 72015, France

Location

Centre Hospitalier Regional d'Orleans

Orléans, 45100, France

Location

Centre Hospitalier de Perigueux

Périgueux, 24000, France

Location

CHRU de Poitiers La Miletrie

Poitiers, 86021, France

Location

CHRU Rennes

Rennes, 35033, France

Location

Centre Henri Becquerel

Rouen, 76038, France

Location

Uberortliche Gemeinschaftspraxis Pasing und Furstenfeldbruck

München, Bavaria, 81241, Germany

Location

Universitatsklinikum Dusseldorf

Düsseldorf, 40225, Germany

Location

Asklepios Klinik Altona

Hamburg, 22763, Germany

Location

Universitatsklinikum Tubingen

Tübingen, 72076, Germany

Location

University General Hospital of Patras

Pátrai, Achaia, 26500, Greece

Location

University Hospital of Alexandroupolis

Alexandroupoli, 68100, Greece

Location

Evangelismos General Hospital of Athens

Athens, 10676, Greece

Location

Alexandra Hospital

Athens, 11528, Greece

Location

University General Hospital of Ioannina

Ioannina, 45500, Greece

Location

Theageneio Anticancer Oncology Hospital of Thessaloniki

Thessaloniki, 54007, Greece

Location

Soroka University Medical Centre

Beersheba, 84001, Israel

Location

Bnai Zion Medical Center

Haifa, 31048, Israel

Location

Rambam Health Corporation

Haifa, 31096, Israel

Location

Lady Davis Carmel Medical Center

Haifa, 34362, Israel

Location

Hadassah Medical Center

Jerusalem, 91120, Israel

Location

Azienda Ospedaliero Universitaria Di Bologna - Policlinico S Orsola Malpighi

Bologna, Emilia-Romagna, 40138, Italy

Location

Ospedale Santa Maria Delle Croci

Ravenna, Emilia-Romagna, 48100, Italy

Location

Arcispedale Santa Maria Nuova

Reggio Emilia, Emilia-Romagna, 42123, Italy

Location

Ospedale Infermi di Rimini

Rimini, Emilia-Romagna, 47900, Italy

Location

Fondazione del Piemonte per lOncologia (IRCCS)

Candiolo, Piedmont, 10060, Italy

Location

Azienda Sanitaria Ospedaliera S Luigi Gonzaga

Orbassano, Piedmont, 10043, Italy

Location

Azienda Ospedaliera Citta della Salute e della Scienza di Torino

Turin, Piedmont, 10126, Italy

Location

Centro Di Riferimento Oncologico Della Basilicata

Rionero in Vulture, PZ, Italy

Location

Azienda Ospedaliera Ospedali Riuniti Marche Nord

Pesaro, The Marches, 61122, Italy

Location

Centro Di Riferimento Oncologico

Aviano, 33081, Italy

Location

ASST degli Spedali Civili di Brescia - Spedali Civili di Brescia

Brescia, 25123, Italy

Location

Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori IRST

Meldola, 47014, Italy

Location

Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico

Milan, 20122, Italy

Location

Azienda Ospedaliero Universitaria Di Modena Policlinico

Modena, 41100, Italy

Location

Azienda Ospedaliero Universitaria di Parma

Parma, 43100, Italy

Location

Ospedale Santa Maria Della Misericordia

Udine, 33100, Italy

Location

Azienda ULSS 6 Vicenza

Vicenza, 36100, Italy

Location

Albert Schweitzer Ziekenhuis

Dordrecht, South Holland, 3318 AT, Netherlands

Location

Zuyderland Medisch Centrum

Sittard, 6162 BG, Netherlands

Location

Oslo Universitetssykehus HF Rikshospitalet

Oslo, Oppland, N-1346, Norway

Location

Haukeland Universitetssykehus

Bergen, N-5021, Norway

Location

Forde Sentralsjukehus

Førde, 6812, Norway

Location

Stavanger Universitetssykehus

Stavanger, N-4011, Norway

Location

St Olavs Hospital

Trondheim, N-7006, Norway

Location

Kirov Research Institute of Haematology and Blood Transfusion

Kirov, 610027, Russia

Location

Moscow Clinical Scientific Center

Moscow, 111123, Russia

Location

City Clinical Hospital n a S P Botkin

Moscow, 125284, Russia

Location

City Clinical Hospital # 40

Moscow, 129301, Russia

Location

Samara State Medical University

Samara, 433021, Russia

Location

Hospital Universitario Infanta Leonor

Madrid, Madrid, Communidad Delaware, 28031, Spain

Location

Hospital Universitari de Girona Dr Josep Trueta

Girona, 17007, Spain

Location

Hospital Clinico Universitario de Valencia

Valencia, 46010, Spain

Location

Helsingborg Lasarett

Helsingborg, Skåne County, SE-25187, Sweden

Location

Sodra Alvsborgs Sjukhus Boras

Borås, SE-50182, Sweden

Location

Norrlands Universitetssjukhus

Umeå, 901 85, Sweden

Location

Dr. Abdurrahman Yurtaslan Ankara Onkoloji Egitim ve Arastirma Hastanesi

Ankara, 06200, Turkey (Türkiye)

Location

Gazi University Medical Faculty Gazi Hospital

Ankara, 06500, Turkey (Türkiye)

Location

Ankara University Medical Faculty Cebeci Hospital

Ankara, 06590, Turkey (Türkiye)

Location

Dokuz Eylul University Medical Faculty

Izmir, 35340, Turkey (Türkiye)

Location

Ege Universitesi Tip Fakultesi Hastanesi

Izmir, Turkey (Türkiye)

Location

Erciyes Universitesi Tip Fakultesi Hastanesi

Kayseri, 38039, Turkey (Türkiye)

Location

Royal Cornwall Hospital

Truro, Cornwall, TR1 3LJ, United Kingdom

Location

Betsi Cadwaladr University Health Board

Bodelwyddan, Denbighshire-SirDdinbych, LL18 5UJ, United Kingdom

Location

Royal Bournemouth Hospital

Bournemouth, Dorset, BH7 7DW, United Kingdom

Location

Kent and Canterbury Hospital

Canterbury, Kent, CT1 3NG, United Kingdom

Location

GenesisCare Oxford

Oxford, Oxfordshire, OX4 6LB, United Kingdom

Location

Royal Stoke University Hospital

Stoke-on-Trent, Staffordshire, ST4 6QG, United Kingdom

Location

Leicester Royal Infirmary

Leicester, LE1 5WW, United Kingdom

Location

Singleton Hospital

Swansea, SA2 8QA, United Kingdom

Location

New Cross Hospital

Wolverhampton, WV10 0QP, United Kingdom

Location

Related Publications (1)

  • Dimopoulos MA, Schjesvold F, Doronin V, Vinogradova O, Quach H, Leleu X, Montes YG, Ramasamy K, Pompa A, Levin MD, Lee C, Mellqvist UH, Fenk R, Demarquette H, Sati H, Vorog A, Labotka R, Du J, Darif M, Kumar S. Oral ixazomib-dexamethasone vs oral pomalidomide-dexamethasone for lenalidomide-refractory, proteasome inhibitor-exposed multiple myeloma: a randomized Phase 2 trial. Blood Cancer J. 2022 Jan 24;12(1):9. doi: 10.1038/s41408-021-00593-2.

Related Links

MeSH Terms

Interventions

ixazomibpomalidomideDexamethasone

Intervention Hierarchy (Ancestors)

PregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsSteroids, Fluorinated

Results Point of Contact

Title
Study Director
Organization
Takeda

Study Officials

  • Medical Director

    Takeda

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 22, 2017

First Posted

May 31, 2017

Study Start

August 1, 2017

Primary Completion

August 1, 2020

Study Completion

November 26, 2021

Last Updated

December 20, 2022

Results First Posted

October 27, 2021

Record last verified: 2022-11

Data Sharing

IPD Sharing
Will share

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.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR
Access Criteria
IPD from eligible studies will be shared with qualified researchers according to the criteria and process described on https://vivli.org/ourmember/takeda/. For approved requests, the researchers will be provided access to anonymized data (to respect patient privacy in line with applicable laws and regulations) and with information necessary to address the research objectives under the terms of a data sharing agreement.
More information

Locations