A Phase 2 interventional study of Bortezomib and Lenalidomide in Multiple Myeloma, sponsored by Dana-Farber Cancer Institute. Completed at 8 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-13.
Sponsored by Dana-Farber Cancer Institute · Phase 2, Interventional, and Treatment
This research study is evaluating a combination of three drugs called lenalidomide, subcutaneous (injection under the skin) bortezomib, and dexamethasone (RVD) as a possible treatment for multiple myeloma.
This research study is a Phase II clinical trial, which tests the safety and effectiveness of an investigational combination of drugs to learn whether the combination of drugs works in treating a specific cancer. "Investigational" means that the combination of drugs is being studied. It also means that the FDA (the U.S. Food and Drug Administration) has not yet approved the combination of drugs for your type of cancer.
Each of the individual drugs, lenalidomide , subcutaneous bortezomib, and dexamethasone, are approved by the U.S. Food and Drug Administration (FDA). The combination has not been approved yet for multiple myeloma or any other type of cancer. Subcutaneous bortezomib is currently approved by the U.S. FDA for the treatment of patients with relapsed/refractory multiple myeloma. Lenalidomide is currently approved for use with dexamethasone for patients with multiple myeloma who have received at least one prior therapy and for the treatment of certain types of myelodysplastic syndrome (another form of cancer affecting the blood). Both Bortezomib and Lenalidomide kill tumor cells and help the body cells to fight cancer. Dexamethasone is commonly used, either alone, or in combination with other drugs, to treat multiple myeloma. Dexamethasone heps to reduce irritation and cell injury (inflammation).
In this research study, the investigators are looking to explore the drug combination of lenalidomide, subcutaneous bortezomib and dexamethasone to see what side effects it may have and how well it works for treatment of newly diagnosed multiple myeloma. This 3 drug regimen showed promising results in previous studies, however administration of intravenous bortezomib caused high levels of nerve injury (a condition involving the nerves of the upper and lower extremities associated with numbness, tingling and burning). In this study, the investigators are testing the hypothesis that subcutaneous administration of bortezomib will result in less nerve toxicity. Therefore, the combination of lenalidomide, dexamethasone and subcutaneous bortezomib may be better tolerated and may allow for a longer duration of therapy.
3,632 studies on the registry are indexed under Multiple Myeloma; 745 are open to participants now.
This study's enrollment of 46 is above the median of 41 across 2,907 interventional studies indexed under Multiple Myeloma.
Browse Multiple Myeloma studies →Dana-Farber Cancer Institute is the lead sponsor of 813 studies on the registry; 124 are open to participants now.
Of its 113 completed or terminated interventional studies of FDA-regulated products, 77 (68%) have results posted.
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Diagnosis of symptomatic MM, according to International Myeloma Foundation 2003 Diagnostic Criteria:
Myeloma-related organ dysfunction (1 or more) of the following (evidence of end-organ damage felt related to the plasma cell disorder related organ or tissue impairment (ROTI), commonly referred to by the acronym "CRAB"):
Has received no prior treatment with any systemic therapy for the treatment of multiple myeloma
Subject must be able to adhere to the study visit schedule and other protocol requirements.
Exclusion Criteria:
Known seropositive for or active HIV infection or hepatitis B or C viral infection.
Lenalidomide (R): 25 mg on days 1-14 orally Subcutaneous Bortezomib (sqV): 1.3 mg/m\^2 on days 1, 4, 8 and 11 Dexamethasone (d): 20 mg on days 1, 2, 4, 5, 8, 9, 11 and 12 Stem cell mobilization occurs at the end of Cycle 4. Participants may elect to stop treatment at the end of Induction Cycle 4 and proceed to autologous stem cell transplant (ASCT) with melphalan 200 mg/m\^2 conditioning, or receive a full 8 cycles of RsqVd induction therapy. RsqVd cycle duration is 21-days. Maintenance follows with the specific regimen determined by risk category. High-risk participants defined as those with International Staging System (ISS) stage II or stage III disease and/or high-risk cytogenetics including t(4;14), t(4; 16), del(17p) receive sqV of 1.3 mg/m\^2 on days 1 and 15 in addition to R 10mg (15mg after cycle 3 if tolerated) on days 1-21 of 28-day cycle. Standard-risk participants receive R monotherapy.
Drug: Bortezomib · Drug: Lenalidomide · Drug: Dexamethasone · Procedure: Stem Cell Mobilization · Procedure: Autologous Stem Cell Transplant
Also known as: Velcade®
Also known as: Revlimid®
Also known as: Decadron, Dexasone, Diodex, Hexadrol, Maxidex
Also known as: ASCT
4-Cycle Induction Overall Response Rate (ORR)
4-cycle ORR was defined as the percentage of participants who achieved partial response or better based on the International Myeloma Working Group Response (IMWG) criteria during the first 4 cycles of induction therapy.
Time frame: Participants were followed up to 12 weeks.
Induction Overall Response Rate (ORR)
Induction ORR was defined as the percentage of participants who achieved partial response or better based on the International Myeloma Working Group Response (IMWG) criteria during induction therapy either 4 cycles or 8 cycles of combination therapy. Response on ASCT is not included.
Time frame: Participants were followed up to 24 weeks.
Four-cycle Induction Peripheral Neuropathy (PN) Rate
Four-cycle induction PN rate was defined as the proportion of participants who experienced peripheral neuropathy includes any attribution and any grades based on the Common Toxicity Criteria for Adverse Events Version 4.0 (CTCAEv4) during the first 4 cycles of induction therapy.
Time frame: Participants were followed up to 12 weeks.
Grade 3-4 Induction Peripheral Neuropathy Rate
Grade 3-4 induction peripheral neuropathy rate was defined as the proportion of participants who experienced grade 3 or 4 peripheral neuropathy based on the Common Toxicity Criteria for Adverse Events Version 4.0 (CTCAEv4) as reported on case report forms during induction therapy (4 cycles RsqVd for ASCT patients and 8 cycles for non-ASCT patients).
Time frame: Participants were followed up to 24 weeks.
Median Time to Progression (TTP)
Median TTP based on KM method is defined as the time from first dose of treatment to the first progression event or censored at date last disease assessment. PD, based on IMWG criteria, requires 1+ of the following: \>25% increase in the level of serum monoclonal paraprotein, which must also be an absolute increase of at least 5 g/L and confirmed on a repeat investigation. \>25% increase in 24h urinary light chain excretion, which must also be an absolute increase of at least 200 mg/24 h and confirmed on a repeat investigation. \>25% increase in plasma cells in a bone marrow aspirate or on trephine biopsy, which must also be an absolute increase of at least 10%. Definite increase in the size of existing lytic bone lesions or soft tissue plasmacytomas. Development of new bone lesions or soft tissue plasmacytomas. Development of hypercalcemia.
Time frame: Disease was assessed up to 41.2 months.
1-Year Progression Free Survival (PFS) Probability
1-year PFS is the probability estimate at 1 year based on the Kaplan-Meier method. PFS is defined as the duration of time from study entry to documented disease progression or death from any cause, censored at the date last known progression-free for those who have not progressed or died. PD, based on IMWG criteria, requires 1+ of the following: \>25% increase in the level of serum monoclonal paraprotein, which must also be an absolute increase of at least 5 g/L and confirmed on a repeat investigation. \>25% increase in 24h urinary light chain excretion, which must also be an absolute increase of at least 200 mg/24 h and confirmed on a repeat investigation. \>25% increase in plasma cells in a bone marrow aspirate or on trephine biopsy, which must also be an absolute increase of at least 10%. Definite increase in the size of existing lytic bone lesions or soft tissue plasmacytomas. Development of new bone lesions or soft tissue plasmacytomas. Development of hypercalcemia.
Time frame: Median follow up for PFS is 13.4 months with the relevant observation timepoint equal to 1 year.
Median Duration of Response (DOR)
DOR was defined at the time from the first assessment indicating PR or better response to the first progression (PD) event based on IMWG criteria.
Time frame: Disease was assessed up to 41.2 months.
1-year Overall Survival (OS) Rate
1-year OS rate was defined as the percentage of participants alive at 1 year.
Time frame: Survival was assessed up to 1 year.
Participants were enrolled from December 2015 to June 2017.
| Milestone | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Started | 46 |
| Safety | 42 |
| Progression-free survival evaluable | 41 |
| Evaluable for induction response | 40 |
| Received autologous stem cell transplant (asct) | 15 |
| Completed | 38 |
| Not completed | 8 |
| Withdrew: Adverse event | 4 |
| Withdrew: Complicating disease | 1 |
| Withdrew: Physician decision | 1 |
| Withdrew: Withdrawal by subject | 1 |
| Withdrew: Did not receive treatment | 1 |
| Milestone | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Started | 38 |
| Safety | 35 |
| Completed | 0 |
| Not completed | 38 |
| Withdrew: Remaining on treatment | 23 |
| Withdrew: Physician decision | 1 |
| Withdrew: Adverse event | 3 |
| Withdrew: Progressive disease | 10 |
| Withdrew: Withdrawal by subject | 1 |
4-cycle ORR was defined as the percentage of participants who achieved partial response or better based on the International Myeloma Working Group Response (IMWG) criteria during the first 4 cycles of induction therapy.
| percentage of participants | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| 4-Cycle Induction Overall Response Rate (ORR) | 95 (85 to 99) |
Induction ORR was defined as the percentage of participants who achieved partial response or better based on the International Myeloma Working Group Response (IMWG) criteria during induction therapy either 4 cycles or 8 cycles of combination therapy. Response on ASCT is not included.
| percentage of participants | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Induction Overall Response Rate (ORR) | 97.5 (89 to 99) |
Four-cycle induction PN rate was defined as the proportion of participants who experienced peripheral neuropathy includes any attribution and any grades based on the Common Toxicity Criteria for Adverse Events Version 4.0 (CTCAEv4) during the first 4 cycles of induction therapy.
| proportion of participants | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Four-cycle Induction Peripheral Neuropathy (PN) Rate | 0.71 (0.58 to 0.83) |
Grade 3-4 induction peripheral neuropathy rate was defined as the proportion of participants who experienced grade 3 or 4 peripheral neuropathy based on the Common Toxicity Criteria for Adverse Events Version 4.0 (CTCAEv4) as reported on case report forms during induction therapy (4 cycles RsqVd for ASCT patients and 8 cycles for non-ASCT patients).
| proportion of participants | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Grade 3-4 Induction Peripheral Neuropathy Rate | 0.07 (0.02 to 0.17) |
Median TTP based on KM method is defined as the time from first dose of treatment to the first progression event or censored at date last disease assessment. PD, based on IMWG criteria, requires 1+ of the following: \>25% increase in the level of serum monoclonal paraprotein, which must also be an absolute increase of at least 5 g/L and confirmed on a repeat investigation. \>25% increase in 24h urinary light chain excretion, which must also be an absolute increase of at least 200 mg/24 h and confirmed on a repeat investigation. \>25% increase in plasma cells in a bone marrow aspirate or on trephine biopsy, which must also be an absolute increase of at least 10%. Definite increase in the size of existing lytic bone lesions or soft tissue plasmacytomas. Development of new bone lesions or soft tissue plasmacytomas. Development of hypercalcemia.
| Months | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Median Time to Progression (TTP) | NA (29.7 to NA) |
1-year PFS is the probability estimate at 1 year based on the Kaplan-Meier method. PFS is defined as the duration of time from study entry to documented disease progression or death from any cause, censored at the date last known progression-free for those who have not progressed or died. PD, based on IMWG criteria, requires 1+ of the following: \>25% increase in the level of serum monoclonal paraprotein, which must also be an absolute increase of at least 5 g/L and confirmed on a repeat investigation. \>25% increase in 24h urinary light chain excretion, which must also be an absolute increase of at least 200 mg/24 h and confirmed on a repeat investigation. \>25% increase in plasma cells in a bone marrow aspirate or on trephine biopsy, which must also be an absolute increase of at least 10%. Definite increase in the size of existing lytic bone lesions or soft tissue plasmacytomas. Development of new bone lesions or soft tissue plasmacytomas. Development of hypercalcemia.
| percentage probability | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| 1-Year Progression Free Survival (PFS) Probability | 89.2 (79.2 to 99.3) |
DOR was defined at the time from the first assessment indicating PR or better response to the first progression (PD) event based on IMWG criteria.
| Months | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Median Duration of Response (DOR) | NA (24.2 to NA) |
1-year OS rate was defined as the percentage of participants alive at 1 year.
| percentage of participants | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| 1-year Overall Survival (OS) Rate | 100 (93 to 100) |
Collected over AEs were assessed for a maximum of 274 days on induction +30 days, 1071 days on maintenance +30 days.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Lenalidomide, Subcutaneous Bortezomib, Dexamethasone - Induction Phase | 0/42 (0%) | 8/42 (19%) | 42/42 (100%) |
| Lenalidomide, [Subcutaneous Bortezomib] - Maintenance Phase | 0/35 (0%) | 8/35 (22.9%) | 30/35 (85.7%) |
| Event | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone - Induction Phase | Lenalidomide, [Subcutaneous Bortezomib] - Maintenance Phase |
|---|---|---|
| Neutrophil count decreasedInvestigations | 0/42 | 2/35 |
| Upper respiratory infectionInfections and infestations | 1/42 | 1/35 |
| ColitisGastrointestinal disorders | 0/42 | 1/35 |
| PneumoniaInfections and infestations | 0/42 | 1/35 |
| SinusitisInfections and infestations | 0/42 | 1/35 |
| FallInjury, poisoning and procedural complications | 0/42 | 1/35 |
| Acute kidney injuryRenal and urinary disorders | 0/42 | 1/35 |
| Renal impairmentRenal and urinary disorders | 0/42 | 1/35 |
| Pleural effusionRespiratory, thoracic and mediastinal disorders | 0/42 | 1/35 |
| PneumonitisRespiratory, thoracic and mediastinal disorders | 0/42 | 1/35 |
| Event | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone - Induction Phase | Lenalidomide, [Subcutaneous Bortezomib] - Maintenance Phase |
|---|---|---|
| Peripheral sensory neuropathyNervous system disorders | 33/42 | 11/35 |
| FatigueGeneral disorders | 24/42 | 9/35 |
| ConstipationGastrointestinal disorders | 23/42 | 6/35 |
| HypercholesterolaemiaInvestigations | 23/42 | 11/35 |
| Neutrophil count decreasedInvestigations | 16/42 | 18/35 |
| Rash maculo-papularSkin and subcutaneous tissue disorders | 17/42 | 3/35 |
| Upper respiratory infectionInfections and infestations | 16/42 | 14/35 |
| Edema limbsGeneral disorders | 16/42 | 7/35 |
| Pain in extremityMusculoskeletal and connective tissue disorders | 16/42 | 8/35 |
| DiarrheaGastrointestinal disorders | 11/42 | 12/35 |
The analysis population is all enrolled participants.
| Age, Continuous(years) | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Median | 61.5 (42 to 78) |
| Sex: Female, Male(Participants) | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Female | 19 |
| Male | 27 |
| Ethnicity (NIH/OMB)(Participants) | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| Hispanic or Latino | 2 |
| Not Hispanic or Latino | 41 |
| Unknown or Not Reported | 3 |
| Race (NIH/OMB)(Participants) | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 1 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 3 |
| White | 40 |
| More than one race | 0 |
| Unknown or Not Reported | 2 |
| ECOG Performance Score (PS)(participants) | Lenalidomide, Subcutaneous Bortezomib, Dexamethasone |
|---|---|
| ECOG PS 0 | 19 |
| ECOG PS 1 | 21 |
| ECOG PS 2 | 2 |
| Unknown | 4 |
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