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An Open-Label Study to Determine the Maximum Tolerated Dose and Evaluate the Safety and Efficacy of CEP-18770 in Combination With Lenalidomide and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma


Phase 1/Phase 2
18 Years
N/A
Open (Enrolling)
Both
Multiple Myeloma

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Trial Information

An Open-Label Study to Determine the Maximum Tolerated Dose and Evaluate the Safety and Efficacy of CEP-18770 in Combination With Lenalidomide and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma


After cycle 1, the start of treatment in each cycle may occur within a 3-day window. In
addition, after cycle 2, the start of treatment in cycle 3 may be delayed by 1 week if, in
the opinion of the investigator, the delay is warranted. If a patient cannot receive 75% of
the planned dose for any of the 3 agents (missing more than 1 dose of CEP-18770, or more
than 5 doses of lenalidomide [either consecutively or separately], or more than 1 dose of
dexamethasone [either consecutively or separately]), due to a drug-related adverse event,
the event will be considered a dose limiting toxicity (DLT), even if the grade of toxicity
is lower than specified DLT determination. Patients will receive intravenous (IV) CEP-18770
on days 1, 8, and 15, oral lenalidomide on days 1 through 21, and oral dexamethasone on days
1, 8, 15, and 22 of each 28-day cycle. Treatment with all 3 drugs will continue for up to 12
cycles (approximately 11 months), or until disease progression or intolerable toxicities.
Patients experiencing clinical benefit may continue to receive additional treatment at the
investigator's discretion and following sponsor notification. In part 2 of the study,
patients will receive CEP-18770 as a slow IV bolus (approximately 1 milliliter per minute)
at the maximum tolerated dose on days 1, 8, and 15 of every 28-day cycle. Patients who
complete or discontinue study drug treatment and whose disease has not progressed will have
study visits every 7-9 weeks during follow-up until disease progression, death, or until
they have been monitored for 1 year after the first administration of study drug, whichever
occurs first.


Inclusion Criteria:



- The patient is a man or woman at least 18 years of age with documented multiple
myeloma.

- The patient has relapsed or progressive disease after receiving at least 1 previous
chemotherapy treatment but no more than 5 previous therapies.

- The patient has measurable disease defined as 1 of the following:

- serum M-protein 0.5 g/dL or greater

- urine M-protein 200 mg/24 hours or greater

- The patient has a life expectancy of more than 3 months.

- Written informed consent is obtained.

- The patient has an ECOG performance status of 0, 1, or 2.

- The patient has adequate hepatic and renal function and hematologic assessments as
specified by the study protocol

- The patient has been independent of support with granulocyte-colony stimulating
factor (G-CSF) or granulocyte macrophage-colony stimulating factor (GM-CSF) for more
than 1 week at the time of screening.

- The patient has been independent of platelet transfusions for 1 week at the time of
screening.

- The patient may have received an allogeneic and/or autologous transplant.

- The patient must agree to register into the mandatory risk evaluation and mitigation
program for receiving lenalidomide if required by local regulations.

- Agreement by women of childbearing potential (not surgically sterile or 24 months
postmenopausal) to use 2 medically accepted methods of contraception and must agree
to continue use of these methods from 4 weeks prior to treatment to 4 weeks after
treatment. Acceptable methods of contraception include at least one highly effective
method (e.g., intrauterine device [IUD], non-combination hormonal contraception,
tubal ligation, or partner's vasectomy) and one additional method (e.g., latex
condom, diaphragm, or cervical cap).

- Agreement by men who are sexually active with a woman of childbearing potential (as
defined in the criterion above), to use a condom during any sexual contact for the
duration of the study and for 4 weeks after the last administration of study drug.
This requirement applies even if the man has had a vasectomy.

- The patient may not donate blood, semen or sperm while taking lenalidomide or for 4
weeks after the last administration of lenalidomide.

- The patient may not breastfeed while taking lenalidomide or for 4 weeks after the
last administration of lenalidomide.

Exclusion Criteria:

- The patient has nonmeasurable multiple myeloma, defined as less than 0.5 g/dL
M-protein in the serum, and less than 200 mg/24 hours M-protein in the urine.

- The patient could not tolerate previous lenalidomide or low-dose dexamethasone
treatment.

- The patient had previous treatment with CEP-18770.

- The patient has POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy,
monoclonal gammopathy or monoclonal proliferative disorder, and skin changes
[increased skin pigment, increased body hair, thickening of the skin, whitening of
the nails, etc]).

- The patient has plasma cell leukemia or primary amyloidosis.

- The patient received chemotherapy with approved or investigative anticancer
therapeutics within 3 weeks before the first dose of study drug.

- The patient received radiation therapy or immunotherapy within 4 weeks or localized
radiation therapy within 1 week prior to the first dose of study drug.

- The patient had major surgery within 3 weeks before the first dose of study drug.

- The patient has congestive heart failure (New York Heart Association Class III to IV)
or had symptomatic ischemia, conduction abnormalities uncontrolled by conventional
intervention, or myocardial infarction within the last 6 months.

- The patient had an acute infection requiring systemic antibiotics, antiviral agents,
or antifungal agents within 2 weeks before the first dose of study drug.

- The patient has a known or suspected human immunodeficiency virus (HIV) infection,
acute or chronic hepatitis B virus or hepatitis C virus on the basis of their medical
history.

- The patient has myelodysplastic or myeloproliferative syndrome.

- The patient has significant neuropathy (at least grade 2, or grade 1 with pain).

- The patient is a pregnant or lactating woman.

- The patient has known hypersensitivity to CEP-18770, lenalidomide, thalidomide,
dexamethasone, mannitol, or hydroxypropyl betadex.

- The patient received glucocorticoid therapy (prednisone >10 mg/day orally or
equivalent) within the last 2 weeks prior to the first dose of study drug.

- The patient has a history of malignancy, other than multiple myeloma, within the last
5 years excluding adequately treated curable disease or indolent disease that is not
likely to require therapy during the conduct of the study.

- The patient has known central nervous system (CNS) involvement.

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

The patient's best response to treatment with CEP-18770 in combination with lenalidomide and dexamethasone

Outcome Description:

The primary efficacy variable is the overall response rate (ORR) defined as the number of patients in the full analysis set achieving a best response of stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) during the study divided by the total number of patients in the full analysis set.

Outcome Time Frame:

Baseline to endpoint (defined as a maximum of 1 year after first administration of CEP-18770 or until disease progression)

Safety Issue:

No

Principal Investigator

Sponsor's Medical Expert, Medical Director - Clinical Research Oncology

Investigator Role:

Study Director

Investigator Affiliation:

Cephalon

Authority:

United States: Food and Drug Administration

Study ID:

C18770/2049

NCT ID:

NCT01348919

Start Date:

August 2011

Completion Date:

December 2013

Related Keywords:

  • Multiple Myeloma
  • Cancer
  • Multiple myeloma
  • CEP-18770
  • Lenalidomide
  • Dexamethasone
  • Multiple Myeloma
  • Neoplasms, Plasma Cell

Name

Location

Teva Investigational Site 1 Augusta, Georgia  
Teva Investigational Site 3 Lexington, Kentucky  
Teva Investigational Site 2 Houston, Texas