A Phase 3 interventional study of Lenalidomide in Multiple Myeloma, sponsored by National Heart, Lung, and Blood Institute (NHLBI). Completed at 42 sites in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2020-05-11.
Sponsored by National Heart, Lung, and Blood Institute (NHLBI) · Phase 3, Interventional, and Treatment
This study is designed to compare long-term outcomes among patients randomized on the BMT CTN 0702 protocol (NCT01109004), "A Trial of Single Autologous Transplant with or without Consolidation Therapy versus Tandem Autologous Transplant with Lenalidomide Maintenance for Patients with Multiple Myeloma". It is hypothesized that use of novel anti-myeloma agents will improve long-term progression-free survival (PFS) after high-dose melphalan followed by autologous hematopoietic cell transplantation (HCT) as compared to a second autologous transplantation.
This study is designed to compare long-term outcomes among patients randomized on the BMT CTN 0702 protocol (NCT01109004). All patients who consent will be followed for death, progression, Second Primary Malignancies (SPMs), and Quality of Life (QOL). Patients who do not consent to the long-term follow-up mechanism or who have experienced progression on the BMT CTN 0702 study will be followed through the standard Center for International Blood and Marrow Transplant Research (CIBMTR) long-term follow-up mechanism. Additionally, patients who are eligible and are willing to continue with lenalidomide as maintenance therapy will be provided lenalidomide free of charge. These patients will continue to receive lenalidomide as maintenance therapy until disease progression or discontinuation due to toxicity, death, or withdrawal from the study. The endpoints assessed will include progression-free survival (PFS), overall survival (OS), event-free survival (EFS), incidence of second primary malignancies (SPM) and health quality of life (QOL).
3,632 studies on the registry are indexed under Multiple Myeloma; 745 are open to participants now.
This study's enrollment of 273 is above the median of 41 across 2,907 interventional studies indexed under Multiple Myeloma.
Browse Multiple Myeloma studies →National Heart, Lung, and Blood Institute (NHLBI) is the lead sponsor of 1,117 studies on the registry; 71 are open to participants now.
Of its 57 completed or terminated interventional studies of FDA-regulated products, 49 (86%) have results posted.
Counted across the registry records on this site, refreshed daily.
Patients fulfilling the following criteria will be eligible to provide continued long-term follow-up data as part of this study:
Inclusion Criteria for Optional Long-term Lenalidomide Maintenance Therapy:
Patients fulfilling the following criteria will be eligible to provide continued long-term follow-up data AND receive long-term lenalidomide maintenance therapy as part of this study:
Exclusion Criteria:
Patients who meet any of the following criteria will be ineligible to receive long-term lenalidomide maintenance therapy as part of this study:
Initial autologous transplant followed by a second autologous transplant and lenalidomide maintenance
Drug: Lenalidomide
Initial autologous transplant followed by lenalidomide, bortezomib and dexamethasone (RVD) consolidation and lenalidomide maintenance
Drug: Lenalidomide
Initial autologous transplant followed by lenalidomide maintenance
Drug: Lenalidomide
In BMT CTN 0702, maintenance therapy with lenalidomide started at 10 mg daily for three months and increased to 15 mg daily. The duration of maintenance was three years in all treatment arms. Lenalidomide will be administered initially at the patient's last documented dose prior to discontinuation of BMT CTN 0702 lenalidomide maintenance therapy. Cycle duration is 28 days. Patients will continue lenalidomide until disease progression, or discontinuation due to toxicity, death, or withdrawal from the study.
Also known as: Revlimid™
Percentage of Participants With Progression-free Survival (PFS)
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). Progression-free survival is defined as survival without disease progression or initiation of non-protocol anti-myeloma therapy. To account for loss to follow-up, the Kaplan-Meier estimator was used to estimate progression-free survival during the 5 year post-randomization follow-up period.
Time frame: 5 years post-randomization in BMT CTN 0702
Percentage of Participants With Overall Survival (OS)
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). Overall survival is defined as survival of death from any cause. To account for loss to follow-up, the Kaplan-Meier estimator was used to estimate overall survival during the 5 year post-randomization follow-up period.
Time frame: 5 years post-randomization in BMT CTN 0702
Percentage of Participants With Event-free Survival (EFS)
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). Event-free survival is defined as survival without disease progression, second primary malignancy, and death. To account for loss to follow-up, the Kaplan-Meier estimator was used to estimate event-free survival during the 5 year post-randomization follow-up period.
Time frame: 5 years post-randomization in BMT CTN 0702
Percentage of Participants With Secondary Primary Malignancies (SPM)
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). SPM is defined as development of any second malignancy, excluding non-melanoma skin cancers. To account for loss to follow-up, the Aalen-Johansen estimator was used to estimate the cumulative incidence of SPM during the 5 year post-randomization follow-up period. The development of any SPMs excludes non-melanoma skin cancers. Death without SPMs will be considered a competing risk for this event. The cumulative incidence of SPMs will be compared between treatment arms.
Time frame: 5 years post-randomization in BMT CTN 0702
Percentage of Participants With Disease Progression
This analysis includes all randomized subjects from BMT CTN 0702, classified by their treatment assignment (intention-to-treat). Disease progression is defined as progression of multiple myeloma, including one or more of the following: * Reappearance of serum monoclonal paraprotein at a level \>= 0.5 g/dL * 24-hour urine protein electrophoresis of at least 200mg paraprotein/24 hours * Abnormal free light chain levels of \>10 mg/dl, only in patients without measurable paraprotein in serum and urine * At least 10% plasma cells in a bone marrow aspirate or trephine biopsy * Definite increase in the size of existing bone lesions or soft tissue plasmacytomas * Development of new bone lesions or soft tissue plasmacytomas * Development of hypercalcemia (corrected serum Ca \>11.5 mg/dL or \>2.8 mmol/L) not attributable to other causes To account for loss to follow-up, the Aalen-Johansen estimator was used to estimate the cumulative incidence of progression during the follow-up period.
Time frame: 5 years post-randomization in BMT CTN 0702
| Milestone | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Started | 98 | 86 | 89 |
| Completed | 98 | 86 | 89 |
| Not completed | 0 | 0 | 0 |
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). Progression-free survival is defined as survival without disease progression or initiation of non-protocol anti-myeloma therapy. To account for loss to follow-up, the Kaplan-Meier estimator was used to estimate progression-free survival during the 5 year post-randomization follow-up period.
| percentage of participants | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Percentage of Participants With Progression-free Survival (PFS) | 47.7 (41.1 to 53.8) | 44.1 (38.0 to 50.3) | 45.0 (38.8 to 51.2) |
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). Overall survival is defined as survival of death from any cause. To account for loss to follow-up, the Kaplan-Meier estimator was used to estimate overall survival during the 5 year post-randomization follow-up period.
| percentage of participants | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Percentage of Participants With Overall Survival (OS) | 74.7 (69.1 to 80.0) | 75.4 (70.0 to 80.6) | 76.4 (71.0 to 81.5) |
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). Event-free survival is defined as survival without disease progression, second primary malignancy, and death. To account for loss to follow-up, the Kaplan-Meier estimator was used to estimate event-free survival during the 5 year post-randomization follow-up period.
| percentage of participants | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Percentage of Participants With Event-free Survival (EFS) | 44.2 (38.0 to 50.5) | 42.1 (36.1 to 48.3) | 42.4 (36.4 to 48.6) |
This analysis includes all randomized subjects from the BMT CTN 0702 protocol classified according to their randomized treatment assignment (intention-to-treat). SPM is defined as development of any second malignancy, excluding non-melanoma skin cancers. To account for loss to follow-up, the Aalen-Johansen estimator was used to estimate the cumulative incidence of SPM during the 5 year post-randomization follow-up period. The development of any SPMs excludes non-melanoma skin cancers. Death without SPMs will be considered a competing risk for this event. The cumulative incidence of SPMs will be compared between treatment arms.
| percentage of participants | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Percentage of Participants With Secondary Primary Malignancies (SPM) | 10.8 (7.2 to 15.1) | 7.9 (4.9 to 11.6) | 7.2 (4.3 to 10.8) |
This analysis includes all randomized subjects from BMT CTN 0702, classified by their treatment assignment (intention-to-treat). Disease progression is defined as progression of multiple myeloma, including one or more of the following: * Reappearance of serum monoclonal paraprotein at a level \>= 0.5 g/dL * 24-hour urine protein electrophoresis of at least 200mg paraprotein/24 hours * Abnormal free light chain levels of \>10 mg/dl, only in patients without measurable paraprotein in serum and urine * At least 10% plasma cells in a bone marrow aspirate or trephine biopsy * Definite increase in the size of existing bone lesions or soft tissue plasmacytomas * Development of new bone lesions or soft tissue plasmacytomas * Development of hypercalcemia (corrected serum Ca \>11.5 mg/dL or \>2.8 mmol/L) not attributable to other causes To account for loss to follow-up, the Aalen-Johansen estimator was used to estimate the cumulative incidence of progression during the follow-up period.
| percentage of participants | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Percentage of Participants With Disease Progression | 48.8 (42.5 to 55.2) | 54.3 (48.1 to 60.4) | 54.2 (48.0 to 60.4) |
Collected over 22 months post-enrollment to BMT CTN 07LT. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Tandem Auto Transplant | 4/98 (4.1%) | 6/98 (6.1%) | 0/98 (0%) |
| RVD Consolidation | 4/86 (4.7%) | 10/86 (11.6%) | 0/86 (0%) |
| Lenalidomide Maintenance | 2/89 (2.2%) | 6/89 (6.7%) | 0/89 (0%) |
| Event | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance |
|---|---|---|---|
| Cervical vertebral fractureInjury, poisoning and procedural complications | 0/98 | 1/86 | 0/89 |
| Subdural haematomaInjury, poisoning and procedural complications | 0/98 | 1/86 | 1/89 |
| Liver function test increasedInvestigations | 0/98 | 1/86 | 0/89 |
| Acute lymphocytic leukaemiaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/98 | 1/86 | 0/89 |
| Breast cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/98 | 1/86 | 0/89 |
| Colon cancer metastaticNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/98 | 1/86 | 0/89 |
| Hodgkin's diseaseNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/98 | 1/86 | 1/89 |
| Malignant melanomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/98 | 1/86 | 0/89 |
| Myelodysplastic syndromeNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/98 | 1/86 | 0/89 |
| Renal cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/98 | 1/86 | 0/89 |
| Age, Continuous(years) | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance | Total |
|---|---|---|---|---|
| Median | 55 (28 to 70) | 56 (28 to 69) | 57 (31 to 66) | 56 (28 to 70) |
| Sex: Female, Male(Participants) | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance | Total |
|---|---|---|---|---|
| Female | 40 | 31 | 34 | 105 |
| Male | 58 | 55 | 55 | 168 |
| Ethnicity (NIH/OMB)(Participants) | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance | Total |
|---|---|---|---|---|
| Hispanic or Latino | 11 | 5 | 2 | 18 |
| Not Hispanic or Latino | 81 | 77 | 84 | 242 |
| Unknown or Not Reported | 6 | 4 | 3 | 13 |
| Race/Ethnicity, Customized(Participants) | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance | Total |
|---|---|---|---|---|
| Asian | 2 | 5 | 4 | 11 |
| Black or African American | 22 | 10 | 16 | 48 |
| White | 68 | 69 | 68 | 205 |
| Multiracial | 2 | 0 | 1 | 3 |
| Other | 1 | 0 | 0 | 1 |
| Unknown or Not Reported | 3 | 2 | 0 | 5 |
| Karnofsky Performance Score (KPS)(Participants) | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance | Total |
|---|---|---|---|---|
| 90-100 | 78 | 60 | 63 | 201 |
| 70-80 | 20 | 26 | 26 | 72 |
| Diseae Risk at BMT CTN 0702 Enrollment(Participants) | Tandem Auto Transplant | RVD Consolidation | Lenalidomide Maintenance | Total |
|---|---|---|---|---|
| Standard | 73 | 65 | 72 | 210 |
| High | 25 | 21 | 17 | 63 |
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — Results will be published in a manuscript and supporting information submitted to NIH BioLINCC (including data dictionaries, case report forms, data submission documentation, documentation for outcomes dataset, etc where indicated).
Supporting information: Study protocol, Icf
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National Heart, Lung, and Blood Institute (NHLBI)