A Randomized Phase III Trial of Melphalan and Dexamethasone (MDex) Versus Bortezomib, Melphalan and Dexamethasone (BMDex) for Untreated Patients With Systemic Light-Chain (AL) Amyloidosis Ineligible for Autologous Stem-Cell Transplantation
PRIMARY OBJECTIVES:
I. To compare hematologic overall response (partial response [PR], very good PR, amyloid
complete hematologic response [ACR], and stringent complete response [sCR]) after 3 courses
of therapy in patients with previously untreated systemic light-chain amyloidosis treated
with melphalan and dexamethasone with vs without bortezomib.
SECONDARY OBJECTIVES:
I. To evaluate the ACR rate after 3 courses of therapy and at completion of therapy.
II. To evaluate organ response rates after 3 courses of therapy and at 6, 9, and 12 months.
III. To evaluate treatment-related mortality. IV. To evaluate toxicity. V. To evaluate
progression-free and overall survival. VI. To evaluate PR or better at completion of
therapy. VII. To evaluate time to hematologic and organ response. VIII. To evaluate the
duration of hematologic and organ response. IX. To assess quality of life (QOL) at baseline,
at 3, 6, and 9 months during the therapy, at completion of therapy, and 3 and 6 months after
therapy.
TERTIARY OBJECTIVES:
I. To determine the prognostic impact of t(11;14) translocation and cyclin D1 overexpression
on response and overall survival.
II. (Correlative) To compare sCR rates and to determine the impact of sCR on the outcomes.
III. (Correlative) To perform a descriptive analysis of amyloid typing and proteomic
composition of amyloid tissues.
OUTLINE: This is a multicenter study. Patients are stratified according to cardiac stage (I
vs II) and are randomized to 1 of 2 treatment arms.
ARM I: Patients receive melphalan orally (PO) and dexamethasone PO on days 1-4. Treatment
repeats every 28 days for up to 9 courses in the absence of disease progression or
unacceptable toxicity.
ARM II: Patients receive melphalan PO and dexamethasone PO on days 1-4 and bortezomib
intravenously (IV) on days 1, 4, 8, and 11. Treatment repeats every 28 days for 2 courses.
Patients then receive melphalan PO and dexamethasone PO on days 1-4 and bortezomib IV on
days 1, 8, 15, and 22. Treatment repeats every 35 days for up to 6 courses in the absence of
disease progression or unacceptable toxicity.
Blood, urine, bone marrow, and fat samples may be collected periodically for laboratory
analysis. Health-related quality of life is assessed periodically before, during, and after
therapy. After completion of study treatment, patients are followed up periodically for 5
years.
Interventional
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Hematologic overall response (PR+VGPR+ACR+sCR)
Will be performed using Mantel-Haenszel test stratified on cardiac stage with an overall one-side type I error of 2.5%. The Mantel-Haenszel estimator is used to estimate the common odds ratio (BMDex/MDex), and a two-sided 95% confidence interval is also calculated.
84 days (3 courses)
No
Angela Dispenzieri
Principal Investigator
Eastern Cooperative Oncology Group
United States: Food and Drug Administration
NCI-2011-02010
NCT01078454
November 2010
Name | Location |
---|---|
Mayo Clinic | Rochester, Minnesota 55905 |
University of Iowa Hospitals and Clinics | Iowa City, Iowa 52242 |
University of Mississippi Medical Center | Jackson, Mississippi 39216-4505 |
Washington University School of Medicine | Saint Louis, Missouri 63110 |
Fox Chase Cancer Center | Philadelphia, Pennsylvania 19111 |
University of Washington Medical Center | Seattle, Washington 98195-6043 |
Boulder Community Hospital | Boulder, Colorado 80301-9019 |
Porter Adventist Hospital | Denver, Colorado 80210 |
Rose Medical Center | Denver, Colorado 80220 |
Swedish Medical Center | Englewood, Colorado 80110 |
Sky Ridge Medical Center | Lone Tree, Colorado 80124 |
North Suburban Medical Center | Thornton, Colorado 80229 |
Bronson Methodist Hospital | Kalamazoo, Michigan 49007 |
West Michigan Cancer Center | Kalamazoo, Michigan 49007-3731 |
Borgess Medical Center | Kalamazooaa, Michigan 49001 |
Fairview Ridges Hospital | Burnsville, Minnesota 55337 |
Hutchinson Area Health Care | Hutchinson, Minnesota 55350 |
United Hospital | St. Paul, Minnesota 55102 |
Ridgeview Medical Center | Waconia, Minnesota 55387 |
Geisinger Medical Center | Danville, Pennsylvania 17822-0001 |
Marshfield Clinic | Marshfield, Wisconsin 54449 |
Methodist Medical Center of Illinois | Peoria, Illinois 61636 |
University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
Boston Medical Center | Boston, Massachusetts 02118 |
Group Health Cooperative | Seattle, Washington 98112 |
Great Falls Clinic | Great Falls, Montana 59405 |
MetroHealth Medical Center | Cleveland, Ohio 44109 |
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Seattle, Washington 98109 |
North Colorado Medical Center | Greeley, Colorado 80631 |
McKee Medical Center | Loveland, Colorado 80539 |
Bozeman Deaconess Hospital | Bozeman, Montana 59715 |
Kalispell Medical Oncology | Kalispell, Montana 59901 |
Kalispell Regional Medical Center | Kalispell, Montana 59901 |
Harborview Medical Center | Seattle, Washington 98104 |
Cancer Care Northwest - Spokane South | Spokane, Washington 99202 |
Welch Cancer Center | Sheridan, Wyoming 82801 |
Beebe Medical Center | Lewes, Delaware 19958 |
Memorial Hospital | Carthage, Illinois 62321 |
Galesburg Clinic | Galesburg, Illinois 61401 |
Mason District Hospital | Havana, Illinois 62644 |
McDonough District Hospital | Macomb, Illinois 61455 |
BroMenn Regional Medical Center | Normal, Illinois 61761 |
Proctor Hospital | Peoria, Illinois 61614 |
Perry Memorial Hospital | Princeton, Illinois 61356 |
Grandview Hospital | Dayton, Ohio 45405 |
Providence Milwaukie Hospital | Milwaukie, Oregon 97222 |
Exempla Lutheran Medical Center | Wheat Ridge, Colorado 80033 |
Eureka Hospital | Eureka, Illinois 61530 |
Mercy Hospital | Coon Rapids, Minnesota 55433 |
Graham Hospital Association | Canton, Illinois 61520 |
Holy Family Medical Center | Des Plaines, Illinois 60016 |
Saint Joseph Medical Center | Joliet, Illinois 60435 |
Fairview-Southdale Hospital | Edina, Minnesota 55435 |
Abbott-Northwestern Hospital | Minneapolis, Minnesota 55407 |
Regions Hospital | Saint Paul, Minnesota 55101 |
Saint Francis Regional Medical Center | Shakopee, Minnesota 55379 |
Rice Memorial Hospital | Willmar, Minnesota 56201 |
Geisinger Medical Group | State College, Pennsylvania 16801 |
Miami Valley Hospital | Dayton, Ohio 45409 |
Eastern Connecticut Hematology and Oncology Associates | Norwich, Connecticut 06360 |
Bozeman Deaconess Cancer Center | Bozeman, Montana 59715 |
Northern Montana Hospital | Havre, Montana 59501 |
Wayne Hospital | Greenville, Ohio 45331 |
Clinton Memorial Hospital | Wilmington, Ohio 45177 |
Wenatchee Valley Medical Center | Wenatchee, Washington 98801-2028 |
Marshfield Clinic Cancer Care at Regional Cancer Center | Eau Claire, Wisconsin 54701 |
Marshfield Clinic - Weston Center | Weston, Wisconsin 54476 |
Diagnostic and Treatment Center | Weston, Wisconsin 54476 |
Marshfield Clinic - Wisconsin Rapids Center | Wisconsin Rapids, Wisconsin 54494 |
Rocky Mountain Oncology | Casper, Wyoming 82609 |
Longmont United Hospital | Longmont, Colorado 80501 |
Greene Memorial Hospital | Xenia, Ohio 45385 |
Union Hospital of Cecil County | Elkton MD, Maryland 21921 |
Mayo Clinic in Arizona | Scottsdale, Arizona 85259-5404 |
Mayo Clinic in Florida | Jacksonville, Florida 32224 |
Memorial Medical Center | Springfield, Illinois 62781 |
Queen's Medical Center | Honolulu, Hawaii 96813 |
Northwest Cancer Specialists | Vancouver, Washington 98664 |
Kapiolani Medical Center at Pali Momi | Aiea, Hawaii 96701 |
Kapiolani Medical Center for Women and Children | Honolulu, Hawaii 96826 |
Hennepin County Medical Center | Minneapolis, Minnesota |
Cleveland Clinic Florida - Weston | Weston, Florida 33331 |
Case Western Reserve University | Cleveland, Ohio 44106 |
Emory University | Atlanta, Georgia 30322 |
Wayne State University | Detroit, Michigan 48202 |
Straub Clinic and Hospital | Honolulu, Hawaii 96813 |
Providence Portland Medical Center | Portland, Oregon 97213-3635 |
Indiana University Medical Center | Indianapolis, Indiana 46202 |
Presbyterian - Saint Lukes Medical Center - Health One | Denver, Colorado 80218 |
Montana Cancer Consortium CCOP | Billings, Montana 59101 |
Metro-Minnesota CCOP | St. Louis Park, Minnesota |
Providence Hospital | Southfield, Michigan 48075 |
Tufts Medical Center | Boston, Massachusetts 02111 |
Lakeview Hospital | Stillwater, Minnesota 55082 |
Decatur Memorial Hospital | Decatur, Illinois 62526 |
Montana Cancer Specialists | Missoula, Montana 59807-7877 |
Castle Medical Center | Kailua, Hawaii 96734 |
Clackamas Radiation Oncology Center | Clackamas, Oregon 97015 |
Providence Newberg Medical Center | Newberg, Oregon 97132 |
Littleton Adventist Hospital | Littleton, Colorado 80122 |
Parker Adventist Hospital | Parker, Colorado 80138 |
New Ulm Medical Center | New Ulm, Minnesota 56073 |
OSF Saint Francis Medical Center | Peoria, Illinois 61637 |
The Medical Center of Aurora | Aurora, Colorado 80012 |
Penrose-Saint Francis Healthcare | Colorado Springs, Colorado 80907 |
Saint Anthony Central Hospital | Denver, Colorado 80204 |
Exempla Saint Joseph Hospital | Denver, Colorado 80218 |
Colorado Cancer Research Program CCOP | Denver, Colorado 80224-2522 |
Saint Mary's Hospital and Regional Medical Center | Grand Junction, Colorado 81502 |
Saint Mary Corwin Medical Center | Pueblo, Colorado 81004 |
Oncare Hawaii Inc-POB II | Honolulu, Hawaii 96813 |
Oncare Hawaii Inc-Kuakini | Honolulu, Hawaii 96817 |
University of Hawaii | Honolulu, Hawaii 96813 |
Community Cancer Center Foundation | Normal, Illinois 61761 |
Illinois CancerCare-Ottawa Clinic | Ottawa, Illinois 61350 |
Ottawa Regional Hospital and Healthcare Center | Ottawa, Illinois 61350 |
Pekin Cancer Treatment Center | Pekin, Illinois 61554 |
Illinois Oncology Research Association CCOP | Peoria, Illinois 61615 |
Illinois CancerCare-Peoria | Peoria, Illinois 61615 |
Illinois Valley Hospital | Peru, Illinois 61354 |
Saint Francis Hospital and Health Centers | Beech Grove, Indiana 46107 |
Reid Hospital and Health Care Services | Richmond, Indiana 47374 |
McFarland Clinic | Ames, Iowa 50010 |
Mercy Medical Center-Sioux City | Sioux City, Iowa 51104 |
Saint Luke's Regional Medical Center | Sioux City, Iowa 51104 |
Green Bay Oncology - Escanaba | Escanaba, Michigan 49431 |
Green Bay Oncology - Iron Mountain | Iron Mountain, Michigan 49801 |
Unity Hospital | Fridley, Minnesota 55432 |
Saint John's Hospital - Healtheast | Maplewood, Minnesota 55109 |
Minnesota Oncology Hematology PA-Maplewood | Maplewood, Minnesota 55109 |
North Memorial Medical Health Center | Robbinsdale, Minnesota 55422 |
Park Nicollet Clinic - Saint Louis Park | Saint Louis Park, Minnesota 55416 |
Minnesota Oncology and Hematology PA-Woodbury | Woodbury, Minnesota 55125 |
Hematology-Oncology Centers of the Northern Rockies PC | Billings, Montana 59101 |
Saint Vincent Healthcare | Billings, Montana 59101 |
Billings Clinic | Billings, Montana 59107-7000 |
Saint James Community Hospital and Cancer Treatment Center | Butte, Montana 59701 |
Benefis Healthcare- Sletten Cancer Institute | Great Falls, Montana 59405 |
Saint Peter's Community Hospital | Helena, Montana 59601 |
Glacier Oncology PLLC | Kalispell, Montana 59901 |
Saint Patrick Hospital - Community Hospital | Missoula, Montana 59802 |
Cooper Hospital University Medical Center | Camden, New Jersey 08103 |
Good Samaritan Hospital - Dayton | Dayton, Ohio 45406 |
Dayton CCOP | Dayton, Ohio 45429 |
Samaritan North Health Center | Dayton, Ohio 45415 |
Blanchard Valley Hospital | Findlay, Ohio 45840 |
Atrium Medical Center-Middletown Regional Hospital | Franklin, Ohio 45005-1066 |
Kettering Medical Center | Kettering, Ohio 45429 |
Upper Valley Medical Center | Troy, Ohio 45373 |
Providence Saint Vincent Medical Center | Portland, Oregon 97225 |
Columbia River Oncology Program | Portland, Oregon 97225 |
Geisinger Wyoming Valley | Wilkes-Barre, Pennsylvania 18711 |
Harrison Bremerton Hematology and Oncology | Bremerton, Washington 98310 |
Columbia Basin Hematology and Oncology PLLC | Kennewick, Washington 99336 |
Minor and James Medical PLLC | Seattle, Washington 98104 |
The Polyclinic | Seattle, Washington 98122 |
Swedish Medical Center-First Hill | Seattle, Washington 98122-4307 |
Saint Vincent Hospital | Green Bay, Wisconsin 54301 |
Green Bay Oncology Limited at Saint Mary's Hospital | Green Bay, Wisconsin 54303 |
Saint Mary's Hospital | Green Bay, Wisconsin 54303 |
Green Bay Oncology at Saint Vincent Hospital | Green Bay, Wisconsin 54301-3526 |
Bay Area Medical Center | Marinette, Wisconsin 54143 |
Marshfield Clinic-Minocqua Center | Minocqua, Wisconsin 54548 |
Green Bay Oncology - Oconto Falls | Oconto Falls, Wisconsin 54154 |
Marshfield Clinic at James Beck Cancer Center | Rhinelander, Wisconsin 54501 |
Marshfield Clinic-Rice Lake Center | Rice Lake, Wisconsin 54868 |
Green Bay Oncology - Sturgeon Bay | Sturgeon Bay, Wisconsin 54235 |
Illinois CancerCare-Bloomington | Bloomington%, Illinois 61701 |
Illinois CancerCare-Canton | Canton, Illinois 61520 |
Illinois CancerCare-Carthage | Carthage, Illinois 62321 |
Illinois CancerCare-Eureka | Eureka, Illinois 61530 |
Illinois CancerCare-Havana | Havana, Illinois 62644 |
Illinois CancerCare-Kewanee Clinic | Kewanee, Illinois 61443 |
Illinois CancerCare-Macomb | Macomb, Illinois 61455 |
Illinois CancerCare-Monmouth | Monmouth, Illinois 61462 |
Illinois CancerCare-Community Cancer Center | Normal, Illinois 61761 |
Illinois CancerCare-Pekin | Pekin, Illinois 61603 |
Illinois CancerCare-Peru | Peru, Illinois 61354 |
Illinois CancerCare-Princeton | Princeton, Illinois 61356 |
Illinois CancerCare-Spring Valley | Spring Valley, Illinois 61362 |
University of Michigan University Hospital | Ann Arbor, Michigan 48109 |
Skagit Valley Hospital | Mt. Vernon, Washington 98273 |
Evergreen Hematology and Oncology PS | Spokane, Washington 99218 |
Marshfield Clinic-Chippewa Center | Chippewa Falls, Wisconsin 54729 |
Holy Family Memorial Hospital | Manitowoc, Wisconsin 54221 |
Marshfield Clinic Cancer Care at Saint Michael's Hospital | Stevens Point, Wisconsin 54481 |
Kuakini Medical Center | Honolulu, Hawaii 96817 |
Wilcox Memorial Hospital and Kauai Medical Clinic | Lihue, Hawaii 96766-1099 |
Cancer Care Center at Island Hospital | Anacortes, Washington 98221 |
Highline Medical Center-Main Campus | Burien, Washington 98166 |
United General Hospital | Sedro-Woolley, Washington 98284 |
Gundersen Lutheran | La Crosse, Wisconsin 54601 |
Saint Nicholas Hospital | Madison, Wisconsin 53715 |
The Jewish Hospital | Cincinnati, Ohio 45236 |
Siouxland Hematology Oncology Associates | Sioux City, Iowa 51101 |
Swedish Cancer Institute-Issaquah | Issaquah, Washington 98029 |
Geisinger Medical Center-Cancer Center Hazelton | Hazleton, Pennsylvania 18201 |
PeaceHealth Saint Joseph Medical Center | Bellingham, Washington 98225 |
Christiana Care Health System-Christiana Hospital | Newark, Delaware 19718 |
Harrison Poulsbo Hematology and Oncology | Poulsbo, Washington 98370 |
PeaceHealth Southwest Medical Center | Vancouver, Washington 98664 |
OnCare Hawaii-Liliha | Honolulu, Hawaii 96817-3169 |
Providence Willamette Falls Medical Center | Oregon City, Oregon 97045 |
Oncare Hawaii Inc - Kapiolani Medical Center at Pali Momi | Aiea, Hawaii 96701 |