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The Role of Ixazomib in Autologous Stem Cell Transplant in Relapsed Myeloma - Myeloma XII (ACCoRd)
Sponsor: University of Leeds
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
Conditions
Interventions
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
Conventional autologous stem cell transplant (ASCT-con)
Melphalan 200mg/m2 IV infusion on Day -1, followed by ASCT on Day 0.
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.
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