Lenalidomide +/- Ixazomib + Dexamethasone for Multiple Myeloma

Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: University of Chicago
Must be taking: Lenalidomide
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effectiveness of different drug combinations for people with multiple myeloma that persists after a stem cell transplant. Researchers compare lenalidomide alone to a combination of lenalidomide, ixazomib citrate (a proteasome inhibitor), and dexamethasone (a corticosteroid). Lenalidomide helps the immune system fight cancer, while ixazomib citrate and dexamethasone aim to stop cancer cells from growing. Individuals who have undergone a stem cell transplant, are on lenalidomide maintenance, and have some remaining myeloma might be suitable for this study. As a Phase 2 trial, this research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to early findings.

Do I need to stop my current medications to join the trial?

The trial does not specify if you need to stop taking your current medications, but it does mention that you should not have taken certain strong inhibitors or inducers of specific enzymes within 14 days before starting the trial. It's best to discuss your current medications with the trial team to ensure they don't interfere with the study.

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

Research shows that the combination of ixazomib, lenalidomide, and dexamethasone is generally well-tolerated by patients with multiple myeloma. Studies have found that adding ixazomib to lenalidomide and dexamethasone can help patients live longer without their cancer worsening.

Regarding safety, researchers have tested this treatment combination in both controlled trials and real-world settings. These studies indicate that while some side effects occur, they are usually manageable. For example, patients might feel tired, have diarrhea, or experience low blood counts, but these are common with many cancer treatments.

Lenalidomide alone has also been extensively studied. It is already approved for other conditions, so its safety profile is well-known. Patients often handle it well, though it can cause side effects like low blood counts or a rash.

Overall, evidence suggests these treatments are fairly safe, with side effects typical of cancer therapies.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. Ixazomib citrate, part of the experimental arm, is an oral proteasome inhibitor that works by interfering with cancer cell proteins, leading to cell death—offering a convenient oral option compared to the more traditional, intravenous proteasome inhibitors. Additionally, when combined with lenalidomide and dexamethasone, ixazomib citrate may enhance the treatment's effectiveness by targeting the cancer cells through different mechanisms. This combination could potentially lead to better outcomes and improved quality of life for patients by providing an all-oral regimen.

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

Research has shown that adding ixazomib to lenalidomide and dexamethasone, which participants in this trial may receive, can benefit people with multiple myeloma. Studies have found that this combination allows patients to live longer without their cancer worsening, with an average of about 20.6 months before disease progression. In contrast, another group in this trial will receive lenalidomide alone, which has a response rate of about 55%, but the cancer typically worsens after about 10 months. This evidence suggests that the combination treatment might be more effective for those with remaining multiple myeloma after a transplant.12467

Who Is on the Research Team?

Andrzej Jakubowiak, MD, PhD - UChicago ...

Andrzej Jakubowiak, MD, PhD

Principal Investigator

University of Chicago

Are You a Good Fit for This Trial?

This trial is for multiple myeloma patients with residual disease after a donor stem cell transplant. They must have been on lenalidomide maintenance for 3-4 months, have measurable residual disease, and proper organ function. Women of childbearing potential and men must agree to effective contraception methods. Exclusions include uncontrolled conditions like heart issues or diabetes, recent infections or surgeries, other cancer treatments within 30 days, certain drug allergies, severe neuropathy, CNS involvement, and QTc >470 msec.

Inclusion Criteria

I am currently taking lenalidomide and can handle a higher dose.
My condition has not worsened while on lenalidomide.
Your bilirubin levels must be within a certain range.
See 14 more

Exclusion Criteria

I haven't had radiotherapy in the last 14 days, or if it was a small area, in the last 7 days.
I do not have any serious health or mental conditions that could stop me from completing the treatment.
I haven't taken any antibiotics, antivirals, or antifungals in the last two weeks.
See 17 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either lenalidomide alone or in combination with ixazomib citrate and dexamethasone for 12 courses, each lasting 28 days

12 months
Monthly visits for 12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment completion

2 years
Every 3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Dexamethasone
  • Ixazomib Citrate
  • Lenalidomide
Trial Overview The study compares the effectiveness of lenalidomide alone versus in combination with ixazomib citrate and dexamethasone in treating remaining multiple myeloma post-transplant. Lenalidomide may boost the immune system's ability to kill cancer cells; ixazomib could interfere with cancer cell growth; dexamethasone aims to stop cancer spread.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm I (ixazomib citrate, lenalidomide, dexamethasone)Experimental Treatment3 Interventions
Group II: Arm II (lenalidomide)Active Control1 Intervention

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?

University of Chicago

Lead Sponsor

Trials
1,086
Recruited
844,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Multiple Myeloma Research Foundation

Collaborator

Trials
11
Recruited
3,600+

Citations

Real-world effectiveness of ixazomib combined with ...Real-world effectiveness of ixazomib combined with lenalidomide and dexamethasone in relapsed/refractory multiple myeloma: the REMIX study. M ...
A comparison of the efficacy and safety of ixazomib ...Conclusion: Compared with the combination of lenalidomide and DXMS, ixazomib combined with DXMS can achieve higher complete remission rate and more improved PFS ...
NCT03173092 | A Study of Ixazomib (NINLARO®) in ...This study will look at the effectiveness and safety in participants who take the all-oral combination of ixazomib added to lenalidomide and dexamethasone.
Oral Ixazomib, Lenalidomide, and Dexamethasone for ...The addition of ixazomib to a regimen of lenalidomide and dexamethasone was associated with significantly longer progression-free survival.
Results with NINLARO® (ixazomib)In the clinical study, people taking the NINLARO treatment combination went more than a year and a half (20.6 months) without their multiple myeloma getting ...
Real-World Evidence for the NINLARO® (ixazomib) RegimenThe NINLARO® regimen has been investigated in patients with relapsed multiple myeloma in both randomized controlled trials and real-world studies.
7.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/34992070/
Safety and Efficacy of Combination Maintenance Therapy with ...The addition of ixazomib to lenalidomide maintenance demonstrated a better than expected PFS compared with historical data using lenalidomide alone and was ...
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