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RECRUITING
NCT03562169
PHASE3

The Role of Ixazomib in Autologous Stem Cell Transplant in Relapsed Myeloma - Myeloma XII (ACCoRd)

Sponsor: University of Leeds

View on ClinicalTrials.gov

Summary

Study design: Randomised, controlled, multi-centre, open-label, phase III trial (with a single intervention registration phase). Primary Objectives The primary objectives of this study are to determine: * The impact on Depth of Response (DoR: less than VGPR versus VGPR or better) when salvage ASCT conditioning is augmented by the addition of a proteasome inhibitor * The influence of a consolidation and maintenance strategy on the Durability of Response (DuR:PFS) Secondary objectives The secondary objectives of this study are to determine: * Overall survival * Time to disease progression * The overall response rate following ixazomib, thalidomide and dexamethasone (ITD) re-induction * Time to next treatment * Progression-free survival 2 (PFS2) * Duration of response * Minimal Residual Disease (MRD) negative rate post re-induction, post-ASCT and conversion after ITD consolidation * Engraftment kinetics * Toxicity and safety * Quality of life (QoL) Participant population (refer to protocol section 9 for a full list of eligibility criteria). * Relapsed MM (with measurable disease by IMWG criteria) previously treated with ASCT * First progressive disease (PD) at least 12 months since first ASCT, requiring therapy. * ECOG Performance Status 0-2 * Aged at least 18 years * Adequate full blood count and renal, hepatobiliary, pulmonary and cardiac function * Written informed consent Interventions: All participants will be registered at trial entry and will receive re-induction therapy with 4-6, 28-day cycles of ixazomib, thalidomide and dexamethasone (ITD), in order to reach maximum response. Participants who achieve at least stable disease (SD) will be randomised on a 1:1 basis to receive either conventional ASCT (ASCTCon), using melphalan, or augmented ASCT (ASCTAug), using melphalan with ixazomib. All participants achieving or maintaining a minimal response (MR) or better following trial ASCT will undergo a second randomisation to consolidation and maintenance or no further treatment. Participants randomised to consolidation and maintenance will receive treatment as follows: consolidation with 2 cycles of ITD and maintenance with ixazomib until disease progression. Number of participants: 406 participants will be registered into the trial to allow 284 participants to be randomised at the first randomisation (R1) and 248 participants to be randomised at the second randomisation (R2).

Official title: A Phase III Study to Determine the Role of Ixazomib as an Augmented Conditioning Therapy in Salvage Autologous Stem Cell Transplant (ASCT) and as a Post-ASCT Consolidation and Maintenance Strategy in Patients With Relapsed Multiple Myeloma

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

406

Start Date

2017-03-20

Completion Date

2027-03

Last Updated

2018-06-19

Healthy Volunteers

No

Interventions

DRUG

Ixazomib, thalidomide, & dexamethasone (ITD) re-induction

4 - 6 ITD 28-day cycles as follows: * Ixazomib 4mg capsule on days 1, 8 and 15 * Thalidomide 100mg capsule on days 1-28 * Dexamethasone 40mg tablets on days 1, 8, 15 and 22

DRUG

Conventional autologous stem cell transplant (ASCT-con)

Melphalan 200mg/m2 IV infusion on Day -1, followed by ASCT on Day 0.

DRUG

Augmented autologous stem cell transplant (ASCT-aug)

Melphalan 100mg/m2 IV infusion on Day -3 and Day -2 plus ixazomib 4mg capsules on Day -4 and Day -1. ASCT will then be given on Day 0.

DRUG

ITD consolidation and ixazomib maintenance vs. No further therapy

Participants will be randomised to either 'no further therapy' or 'ITD consolidation and ixazomib maintenance'. Participants randomised to 'no further treatment' will not receive any further treatment but will be followed up at 8 weeks post randomisation 2 and at 3-monthly clinic visits until disease progression. Participants randomised to ITD consolidation and ixazomib maintenance will receive: Two 28-day cycles of ITD consolidation (same doses as in ITD re-induction). This will be followed by ixazomib maintenance as follows: Ixazomib 4mg capsule on days 1, 8 and 15 of each 28-day cycle until disease progression.

Locations (91)

Aberdeen Royal Infirmary

Aberdeen, United Kingdom

Monklands Hospital

Airdrie, United Kingdom

University Hospital Ayr

Ayr, United Kingdom

Barnsley Hospital

Barnsley, United Kingdom

Basingstoke & North Hampshire Hospital

Basingstoke, United Kingdom

Royal United Hospital

Bath, United Kingdom

Good Hope Hospital

Birmingham, United Kingdom

Heartlands Hospital

Birmingham, United Kingdom

Queen Elizabeth Hospital

Birmingham, United Kingdom

Blackpool Victoria Hospital

Blackpool, United Kingdom

Pilgrim Hospital

Boston, United Kingdom

Royal Bournemouth Hospital

Bournemouth, United Kingdom

Bradford Royal Infirmary

Bradford, United Kingdom

Bristol Haematology & Oncology Centre

Bristol, United Kingdom

Southmead Hospital

Bristol, United Kingdom

Queen's Hospital

Burton-on-Trent, United Kingdom

Addenbrooke's Hospital

Cambridge, United Kingdom

St Helier Hospital

Carshalton, United Kingdom

Cheltenham General Hospial

Cheltenham, United Kingdom

Countess of Chester Hospital

Chester, United Kingdom

Chesterfield Royal Hospital

Chesterfield, United Kingdom

St Richards Hospital

Chichester, United Kingdom

University Hospital Coventry

Coventry, United Kingdom

Royal Derby Hospital

Derby, United Kingdom

Dewsbury Hospital

Dewsbury, United Kingdom

Russells Hall Hospital

Dudley, United Kingdom

Ninewells Hospital

Dundee, United Kingdom

Hairmyres Hospital

East Kilbride, United Kingdom

Western General Hospital

Edinburgh, United Kingdom

Beatson Cancer Centre

Glasgow, United Kingdom

New Victoria Hospital

Glasgow, United Kingdom

Gloucestershire Royal Hospital

Gloucester, United Kingdom

Grantham and District Hospital

Grantham, United Kingdom

Diana Princess of Wales Hospital

Grimsby, United Kingdom

Calderdale Royal Hospital

Halifax, United Kingdom

Harrogate District Hospital

Harrogate, United Kingdom

Huddersfield Royal Infirmary

Huddersfield, United Kingdom

Castle Hill Hospital

Hull, United Kingdom

Raigmore Hospital

Inverness, United Kingdom

Ipswich Hospital

Ipswich, United Kingdom

Kidderminster Hospital

Kidderminster, United Kingdom

University Hospital Crosshouse

Kilmarnock, United Kingdom

St James's University Hospital

Leeds, United Kingdom

Leicester Royal Infirmary

Leicester, United Kingdom

Lincoln County Hospital

Lincoln, United Kingdom

Royal Liverpool University Hospital

Liverpool, United Kingdom

University Hospital Aintree

Liverpool, United Kingdom

Guys and St Thomas's Hospital

London, United Kingdom

Kings College Hospital

London, United Kingdom

Royal Marsden Hospital

London, United Kingdom

St Barts Hospital

London, United Kingdom

University College London Hospital

London, United Kingdom

Maidstone Hospital

Maidstone, United Kingdom

Manchester Royal Infirmary

Manchester, United Kingdom

The Christie

Manchester, United Kingdom

Borders General Hospital

Melrose, United Kingdom

James Cook University Hospital

Middlesbrough, United Kingdom

Milton Keynes General Hospital

Milton Keynes, United Kingdom

Freeman Hospital

Newcastle, United Kingdom

North Tyneside General Hospital

North Shields, United Kingdom

Norfolk & Norwich University Hospital

Norwich, United Kingdom

Nottingham City Hospital

Nottingham, United Kingdom

Royal Oldham Hospital

Oldham, United Kingdom

Churchill Hospital

Oxford, United Kingdom

Royal Alexandra Hospital

Paisley, United Kingdom

Derriford Hospital

Plymouth, United Kingdom

Pontefract Hospital

Pontefract, United Kingdom

Whiston Hospital

Prescot, United Kingdom

Royal Berkshire Hospital

Reading, United Kingdom

Redditch Hospital

Redditch, United Kingdom

Tunbridge Wells Hospital

Royal Tunbridge Wells, United Kingdom

Salford Royal Hospital

Salford, United Kingdom

Salisbury Hospital

Salisbury, United Kingdom

Scunthorpe General Hospital

Scunthorpe, United Kingdom

Royal Hallamshire Hospital

Sheffield, United Kingdom

Southampton General Hospital

Southampton, United Kingdom

St Helens Hospital

St Helens, United Kingdom

Stafford County Hospital

Stafford, United Kingdom

Stepping Hill Hospital

Stockport, United Kingdom

Royal Stoke University Hospital

Stoke-on-Trent, United Kingdom

Sunderland Royal Hospital

Sunderland, United Kingdom

King's Mill Hospital

Sutton in Ashfield, United Kingdom

Singleton Hospital

Swansea, United Kingdom

Musgrove Park Hospital

Taunton, United Kingdom

St George's Hospital

Tooting, United Kingdom

Pinderfields General Hospital

Wakefield, United Kingdom

Royal Hampshire County Hospital

Winchester, United Kingdom

Wishaw Hospital

Wishaw, United Kingdom

New Cross Hospital

Wolverhampton, United Kingdom

Worcestershire Royal Hospital

Worcester, United Kingdom

Worthing Hospital

Worthing, United Kingdom