Pomalidomide + Dexamethasone +/- Ixazomib for Multiple Myeloma

Not currently recruiting at 339 trial locations
Age: 18+
Sex: Any
Trial Phase: Phase 1 & 2
Sponsor: Alliance for Clinical Trials in Oncology
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how a combination of pomalidomide and dexamethasone (a corticosteroid), with or without ixazomib, can treat multiple myeloma, a cancer affecting the bone marrow that has returned after treatment. The researchers aim to determine which drug combination is most effective and identify the safest doses. Individuals with multiple myeloma that has recurred after lenalidomide treatment and who have not yet tried pomalidomide may be suitable for this study. As a Phase 1, Phase 2 trial, the study focuses on understanding the treatment's effects in people and measuring its effectiveness in an initial, smaller group.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot take strong inducers or inhibitors of certain liver enzymes (CYP3A4 or CYP1A2) within 14 days before starting the trial. It's best to discuss your current medications with the trial team to see if any adjustments are needed.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that using pomalidomide with low-dose dexamethasone is generally safe for patients whose multiple myeloma has returned or hasn't responded to treatment. This combination has proven effective, though it can cause serious side effects, such as a low white blood cell count (neutropenia). However, most side effects can be predicted and managed with proper care.

Adding ixazomib to this treatment has also been studied. Research indicates it may benefit patients whose multiple myeloma has returned. The safety of adding ixazomib is considered acceptable. Some side effects may occur, but patients have generally tolerated the treatment well in clinical settings. While there are risks, studies show that these treatments can be safely managed.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for multiple myeloma because they introduce a novel combination approach. Unlike standard treatments like bortezomib, lenalidomide, and carfilzomib, this trial examines the addition of ixazomib, an oral proteasome inhibitor, to the existing regimen of pomalidomide and dexamethasone. Ixazomib offers the convenience of oral administration and potentially enhances the effectiveness of the treatment by targeting cancer cells in a new way. This combination could offer improved outcomes for patients, especially those who have not responded to current therapies.

What evidence suggests that this trial's treatments could be effective for multiple myeloma?

Research has shown that using pomalidomide and dexamethasone together is a well-established treatment for multiple myeloma that has returned or not responded to other treatments. Studies indicate that many patients respond well to this treatment, often experiencing longer periods without disease progression. In this trial, one group of participants will receive pomalidomide and dexamethasone alone, while another group will receive pomalidomide, dexamethasone, and ixazomib. Adding ixazomib to this combination might enhance its effectiveness. Specifically, one study found that the response rate increased to 63.2% with ixazomib, compared to 43.6% without it. This suggests that including ixazomib could improve treatment outcomes for those whose myeloma has returned or resisted other treatments.678910

Who Is on the Research Team?

PV

Peter Voorhees, MD

Principal Investigator

University of North Carolina, Chapel Hill

Are You a Good Fit for This Trial?

This trial is for patients with relapsed multiple myeloma who have previously been treated and are lenalidomide-refractory. They should not have had major surgery, chemotherapy, or radiation within specific time frames before joining the trial. Participants must practice safe contraception if applicable, have no active hepatitis B/C or hypersensitivity to study drugs, meet certain blood count criteria, and cannot be HIV positive with certain conditions.

Inclusion Criteria

I have not had any major surgery in the last 28 days.
I can take care of myself and am up and about more than half of my waking hours.
I have not been treated with, or my disease responds to, proteasome inhibitors.
See 23 more

Exclusion Criteria

I have never had AIDS or any serious HIV-related illnesses.
RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2) must be met for patients opting to switch to the 3-drug regimen following disease progression

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Phase I Treatment

Dose-escalation study of pomalidomide and ixazomib to establish the maximum tolerated dose

28 days
4 visits (in-person)

Phase II Treatment

Randomized study to assess progression-free survival with pomalidomide/dexamethasone/ixazomib versus pomalidomide/dexamethasone

3 years
Monthly visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 years
Every 4 weeks until disease progression, then every 3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Dexamethasone
  • Ixazomib
  • Pomalidomide
Trial Overview The study is testing how well a combination of pomalidomide and dexamethasone works with or without ixazomib in treating relapsed multiple myeloma. It aims to determine the best dose and side effects of these drugs together while assessing their effectiveness in stimulating the immune system to stop cancer growth.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Arm II (pomalidomide, dexamethasone, ixazomib)Experimental Treatment3 Interventions
Group II: Arm I (pomalidomide, dexamethasone)Experimental Treatment2 Interventions

Dexamethasone is already approved in European Union, United States, Canada, Japan for the following indications:

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Approved in European Union as Dexamethasone for:
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Approved in United States as Dexamethasone for:
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Approved in Canada as Dexamethasone for:
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Approved in Japan as Dexamethasone for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Alliance for Clinical Trials in Oncology

Lead Sponsor

Trials
521
Recruited
224,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Celgene Corporation

Industry Sponsor

Trials
446
Recruited
58,500+
Mark Alles profile image

Mark Alles

Celgene Corporation

Chief Executive Officer since 2016

Bachelor's degree from Lock Haven University of Pennsylvania

Sol J. Barer profile image

Sol J. Barer

Celgene Corporation

Chief Medical Officer since 2006

PhD in Organic and Physical Chemistry from Rutgers University

Millennium Pharmaceuticals, Inc.

Industry Sponsor

Trials
406
Recruited
46,900+

Dr. Christophe Bianchi

Millennium Pharmaceuticals, Inc.

Chief Medical Officer since 2006

MD from University of Geneva

Dr. Deborah Dunsire profile image

Dr. Deborah Dunsire

Millennium Pharmaceuticals, Inc.

Chief Executive Officer since 2005

MD from University of Witwatersrand

Citations

The real‐world use and efficacy of pomalidomide for ...Pomalidomide‐dexamethasone (Pd) has been a standard care treatment for relapsed and refractory multiple myeloma since 2013.
A Meta-Analysis of the Efficacy of Pomalidomide-Based ...Pomalidomide-based combination regimens were effective in patients with RRMM previously treated with lenalidomide and tended to be associated with better ...
Pomalidomide plus low-dose dexamethasone in myeloma ...Pomalidomide at doses of 2 or 4 mg/d has demonstrated excellent activity in patients with multiple myeloma (MM). We opened 2 sequential phase 2 trials using ...
Final Overall Survival From MM-014At a median follow-up of 28.4 months, overall response rate was 77.7% and median progression-free survival was 30.8 months (95% confidence ...
an Asian Myeloma Network study (AMN003)Pomalidomide has been shown to improve survival in patients with relapsed/refractory myeloma (RRMM). However, the optimal pomalidomide-based ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/35778685/
a multicenter, prospective, single-arm, phase 2 trialConclusions: Pomalidomide in combination with low-dose dexamethasone is effective and safe in Chinese RRMM patients. Trial registration: The ...
Pomalyst (Pomalidomide) for Multiple Myeloma | The IMFMost of the side effects associated with Pomalyst are manageable and predictable. However, certain potential side effects are serious enough to require a “Boxed ...
Safety and efficacy of pomalidomide plus low-dose ...The STRATUS study assessed safety and efficacy of pomalidomide plus low-dose dexamethasone in the largest cohort to date of patients with RRMM. Patients who ...
POMALYST®(pomalidomide) capsules, for oral useMultiple Myeloma. In trials 1 and 2 in patients who received POMALYST + Low-dose Dex, neutropenia was the most frequently reported Grade 3 or 4 adverse reaction ...
Efficacy and Safety of Daratumumab Plus Pomalidomide and ...This retrospective study examines the real-world efficacy and safety of Daratumumab (Dara) combined with pomalidomide (P) and dexamethasone (d) ...
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