Myeloma XI

Trial overview

Myeloma IX is intended to be a unifying trial addressing issues in patients of all ages and providing

a strategy within which to introduce new treatments as they become available. There are, however,

two distinct treatment pathways.

i) Intensive pathway:

 

For younger/fitter patients where intensive HDT with stem cell support

ii) Non-intensive pathway:

considered appropriate.

Although the previous MRC Myeloma VII trial, in which there was randomisation to HDT, was

restricted to patients under the age of 65, it is recognised that fit patients over this age may wish to

receive the more intensive treatment, and the decision with regard to which pathway to follow will

be a matter for discussion between the treating clinician and the patient.

For older/less fit patients where standard dose chemotherapy is

is considered appropriate.

Inclusion criteria

Aged 18 years or greater

Newly diagnosed as having symptomatic multiple myeloma or non-secretory multiple

Provided written informed consent

- Women of childbearing potential (WCBP) (see Appendix J) must agree to use TWO

methods of contraception beginning 4 weeks prior to the start of thalidomide, while on

thalidomide and 4 weeks after the last dose of thalidomide. The two methods of

contraception must include one highly effective method and one additional effective

(barrier) method, as outlined in the Pharmion Risk Management Programme.

- Male patients (including those who have had a vasectomy) must use condoms when

engaging in heterosexual activity with WCBP while on thalidomide and 4 weeks after the

last dose of thalidomide, as outlined in the Pharmion Risk Management Programme.

Prepared to use contraception

- WCBP must have a negative blood pregnancy test performed by a healthcare

professional:

- within 24 hours before starting thalidomide

- every 4 weeks in women with regular menstrual cycles OR every 2 weeks in women

with irregular menstrual cycles while on thalidomide

- 4 weeks after the last dose of thalidomide.

Negative pregnancy test

myeloma (see Appendix A for definitions), based on:

- Paraprotein (M-protein) in serum and/or urine

- Bone marrow clonal plasma cells or plasmacytoma

- Related organ or tissue impairment and/or symptoms considered by the clinician to be

myeloma related

Exclusion criteria

Patients with the following characteristics are ineligible for this trial (see Appendix A for

definitions):

Asymptomatic myeloma

Solitary plasmacytoma of bone

Extramedullary plasmacytoma (without evidence of myeloma)

of the skin or other in situ carcinomas

Previous or concurrent active malignancies, except surgically-removed basal cell carcinoma

16

Previous treatment for myeloma, except the following:

local radiotherapy to relieve bone pain or spinal cord compression

prior bisphosphonate treatment

14 days)

low-dose corticosteroids (up to 12mg/day dexamethasone or 80mg/day prednisolone, for

dexamethasone, or 1.25g prednisolone).

up to 4 single doses of corticosteroids (total dose 1g methylprednisolone, 200mg

disorders, but exclusion is essentially to be at the discretion of the treating clinician

Caution is advised in patients with a past history of ischaemic heart disease or psychiatric

creatinine >500mol/l or urine output <400ml/day or requirement for dialysis). These

patients are not eligible for this study but may be eligible for inclusion in MERIT (MyEloma

Renal Impairment Trial). NB. Patients with serum creatinine 2 x upper limit of normal (or

creatinine clearance <30ml/min) are eligible for Myeloma IX, but bisphosphonates should

not be administered until serum creatinine has decreased to <2 x upper limit of normal (or

creatinine clearance >30ml/min).

Acute renal failure (unresponsive to up to 72 hours of rehydration, characterised by



Other trials currently active for Multiple Myeloma

Celgene PASS

A non-interventional observational post authorisation safety study of subjects treated with lenalidomide

Merck Vorinostat 095

Study of Vorinostat (MK0683), an HDAC Inhibitor, in Combination With Bortezomib in Patients With Relapsed or Refractory Multiple Myeloma after at least 2 prior treatment regimens

Merck Vorinostat 088

Study of Vorinostat (MK0683) an HDAC Inhibitor, or Placebo in Combination With Bortezomib in Patients With relapsed or refractory  Multiple Myeloma

 


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hdt intensive non intensive