ClinicalTrials.gg
CompletedNCT00305812Updated Aug 4, 2023

Lenalidomide and Melphalan in Treating Patients With Previously Untreated Multiple Myeloma

A Phase 2 interventional study of dexamethasone and lenalidomide in Multiple Myeloma and Plasma Cell Neoplasm, sponsored by NCIC Clinical Trials Group. Completed at 14 sites in Canada. Open to participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2023-08-04.

Sponsored by NCIC Clinical Trials Group · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
51
Allocation
Randomized
Ages
18 Years to 120 Years
Sex
All
01

Study summary

RATIONALE: Lenalidomide may stop the growth of multiple myeloma by blocking blood flow to the cancer. It may also stimulate the immune system in different ways and stop cancer cells from growing. Drugs used in chemotherapy, such as melphalan, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving lenalidomide together with melphalan may kill more cancer cells.

PURPOSE: This randomized phase II trial is studying the side effects and best dose of lenalidomide when given together with melphalan and to see how well they work in treating patients with multiple myeloma.

Read the detailed description

OBJECTIVES:

Primary

  • Evaluate the tolerability of 2 different doses of lenalidomide when administered with melphalan in patients with previously untreated multiple myeloma who are not planning to undergo future autologous stem cell transplantation.

Secondary

  • Characterize the toxicity profile of lenalidomide in combination with melphalan.
  • Determine tumor response in these patients after 2 and 12 courses of induction therapy with lenalidomide and melphalan and after 6 months of maintenance therapy with dexamethasone.
  • Determine progression-free and overall survival of these patients.
  • Determine time to dose modification and time to dose discontinuation in these patients.

Tertiary

  • Examine wnt pathway inhibition in response to lenalidomide on pre- and post-treatment bone marrow and blood samples using enzyme-linked immunosorbent assay (ELISA), gene expression profiling, drosophila-based chemical genetics, and surface-enhanced laser desorption/ionization mass spectrometry (SELDI MS) proteomics.

OUTLINE: This is a multicenter, randomized, open-label, dose-finding study of lenalidomide.

Prior to randomization, 6 patients receive oral lenalidomide at a lower dose (same dose to be used in arm I) once daily on days 1-21 and oral melphalan once daily on days 1-4. Treatment repeats every 28 days for 3 courses. If no unacceptable toxicity occurs, the trial will proceed and randomization will occur.

  • Induction therapy: Patients are randomized to 1 of 2 dose levels of lenalidomide.

    • Arm I: Patients receive oral lenalidomide once daily on days 1-21 and oral melphalan once daily on days 1-4.
    • Arm II: Patients receive oral lenalidomide as in arm I, but at a lower dose, and melphalan as in arm I, but at a higher dose.

Treatment in both arms repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity. After 12 courses of induction therapy, patients in both arms without progressive disease proceed to maintenance therapy.

  • Maintenance therapy: Patients receive oral dexamethasone once daily on days 1-4. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 4 weeks and then every 2 months thereafter.

PROJECTED ACCRUAL: A total of 92 patients will be accrued for this study.

02

Conditions studied

  • Multiple Myeloma and Plasma Cell Neoplasm

Keywords

  • stage I multiple myeloma
  • stage II multiple myeloma
  • stage III multiple myeloma
03

In context

Multiple Myeloma

3,760 studies on the registry are indexed under Multiple Myeloma; 769 are open to participants now.

This study's enrollment of 51 is above the median of 41 across 3,005 interventional studies indexed under Multiple Myeloma.

Browse Multiple Myeloma studies →

Lead sponsor

NCIC Clinical Trials Group is the lead sponsor of 116 studies on the registry; none are open to participants now.

Of its 28 completed or terminated interventional studies of FDA-regulated products, 8 (29%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • confirmed multiple myeloma by one of the following:

    • of an osteolytic lesion or soft tissue tumor composed of plasma cells
    • Bone marrow aspirate and/or biopsy demonstrating ≥ 10% plasmacytosis
    • Bone marrow \< 10% plasma cells but with ≥ 1 bony lesion AND meets the M-protein criteria
  • Ineligible for stem cell transplantation due to any of the following:

    • Advanced age
    • Comorbid illness
    • Patient preference
  • Previously untreated disease
  • Measurable (i.e., quantifiable) serum M-component of IgG, IgA, IgD, or IgE at initial diagnosis OR, if only light-chain disease is present (urine M-protein only), urinary excretion of light-chain protein (Bence Jones) ≥ 1.0 g/24 hours at initial diagnosis

    • No nonsecretory myeloma

PATIENT CHARACTERISTICS:

  • performance status 0-2
  • ≥ 12 months
  • ≥ 1,500/mm\^3
  • count ≥ 150,000/mm\^3
  • Creatinine ≤ 3 times (ULN)
  • ≤ 1.5 times ULN
  • and/or ALT ≤ 1.5 times ULN
  • Alkaline phosphatase ≤ 1.5 times ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use 2 methods of effective during and for 4 weeks after completion of study treatment
  • No other within the past 5 years, except adequately treated nonmelanoma skin cancer or curatively treated in situ cancer of the cervix
  • No to thalidomide or its components, including the development of a desquamating rash
  • No other serious illness or medical condition that would preclude study participation
  • No history of significant neurologic or psychiatric disorder that would preclude
  • No known positivity
  • No pre-existing cardiovascular conditions and/or symptomatic cardiac dysfunction, including any of the following:

    • Significant cardiac event (including symptomatic heart failure or angina) within 3 months prior to randomization
    • Any cardiac disease that increases risk for ventricular arrhythmia
    • History of ventricular arrhythmia that was symptomatic or required treatment, including any of the following:

      • Multifocal premature ventricular contractions
      • Bigeminy
      • Trigeminy
      • Ventricular tachycardia/fibrillation/flutter/arrhythmia NOS

PRIOR CONCURRENT THERAPY:

  • No prior chemotherapy or for the treatment of multiple myeloma

    • Prior corticosteroids for the treatment of hypercalcemia or spinal cord compression allowed provided maximum levels have not been reached (i.e.,\< 120 mg for dexamethasone or \< 792 mg for prednisone)
  • Prior radiotherapy to single sites for pain control or local plasmacytoma allowed
  • Prior or concurrent bisphosphonates allowed
  • At least 28 days since prior anticancer agents or therapy
  • No concurrent corticosteroids above physiologic replacement doses
  • Concurrent radiotherapy to sites of active myeloma with pain or neurologic compromise allowed
  • No concurrent filgrastim (G-CSF) on day 1 of course 1
  • No other concurrent anticancer therapy
  • No other concurrent investigational therapy
Terms in these criteria, in plain language(16)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
51 participants (actual)

Interventions

06

What researchers measure

Primary outcomes

  1. Incidence of dose-limiting toxicity within first 3 courses of treatment

Secondary outcomes

  1. Toxicity

  2. Disease response after 2 courses, 6 courses, 12 courses, and 6 months of maintenance therapy

  3. Time to progression

  4. Overall survival

  5. Duration of disease-free interval

  6. Time to dose modification

  7. Time to dose discontinuation

07

Study locations

14 sites
  • Tom Baker Cancer Centre - Calgary
    Calgary, Alberta T2N 4N2, Canada
  • Cross Cancer Institute at University of Alberta
    Edmonton, Alberta T6G 1Z2, Canada
  • British Columbia Cancer Agency - Centre for the Southern Interior
    Kelowna, British Columbia V1Y 5L3, Canada
  • Moncton Hospital
    Moncton, New Brunswick E1C 6Z8, Canada
  • Nova Scotia Cancer Centre
    Halifax, Nova Scotia B3H 1V7, Canada
  • Margaret and Charles Juravinski Cancer Centre
    Hamilton, Ontario L8V 5C2, Canada
  • London Regional Cancer Program at London Health Sciences Centre
    London, Ontario N6A 4L6, Canada
  • Algoma District Cancer Program at Sault Area Hospital
    Sault Ste. Marie, Ontario P6A 2C4, Canada
  • Princess Margaret Hospital
    Toronto, Ontario M5G 2M9, Canada
  • Humber River Regional Hospital - Weston
    Toronto, Ontario M9N 1N8, Canada
  • Hopital Charles Lemoyne
    Greenfield Park, Quebec J4V 2H1, Canada
  • Hopital Notre-Dame du CHUM
    Montreal, Quebec H2L 4M1, Canada
  • McGill Cancer Centre at McGill University
    Montreal, Quebec H2W 1S6, Canada
  • Allan Blair Cancer Centre at Pasqua Hospital
    Regina, Saskatchewan S4T 7T1, Canada
08

References and documents

Publications

  • White DJ, Paul N, Macdonald DA, Meyer RM, Shepherd LE. Addition of lenalidomide to melphalan in the treatment of newly diagnosed multiple myeloma: the National Cancer Institute of Canada Clinical Trials Group MY.11 trial. Curr Oncol. 2007 Apr;14(2):61-5. doi: 10.3747/co.2007.107. PubMed 17576467 ↗
  • White DJ, Bahlis NJ, Marcellus DC, et al.: Phase II testing of lenalidomide plus melphalan for previously untreated older patients with multiple myeloma: the NCIC CTG MY.11 trial. [Abstract] Blood 112 (11): A-2767, 2008.
  • White DJ, Kovacs MJ, Belch A, et al.: Phase II testing of lenalidomide plus melphalan for previously untreated older patients with multiple myeloma: toxicity data from the NCIC CTG MY.11 trial. [Abstract] Blood 110 (11): A-189, 2007.
  • White DJ, Bahlis NJ, Marcellus DC, Belch A, Stewart AK, Chen C, Kovacs MJ, Macdonald DA, Reece DE, Reiman T, Harnett E, Meyer RM, Chapman JA, Couban S. Lenalidomide plus melphalan without prednisone for previously untreated older patients with multiple myeloma: a phase II trial. Clin Lymphoma Myeloma Leuk. 2013 Feb;13(1):19-24. doi: 10.1016/j.clml.2012.08.009. Epub 2012 Nov 7. PubMed 23141150 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 4, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00305812
Responsible party
Sponsor
First posted
Mar 22, 2006
Start date
Mar 9, 2006
Primary completion
Jun 30, 2008
Completion
Jun 30, 2008
Last update
Aug 4, 2023

Study contacts

Darrell White, MD
study chair · Nova Scotia Cancer Centre

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2020. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Lenalidomide · Melphalan

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