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WithdrawnNCT03591744Updated Dec 19, 2018

Daratumumab, Bortezomib, Dexamethasone, Pegylated Liposomal Doxorubicin Hydrochloride, and Lenalidomide in Treating Participants With Plasma Cell Leukemia

A Phase 1 interventional study of Bortezomib and Daratumumab in Plasma Cell Leukemia, sponsored by City of Hope Medical Center. Withdrawn at 5 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-12-19.

Sponsored by City of Hope Medical Center · Phase 1, Interventional, and Treatment

Why this study was withdrawn
Budgetary constraints
Phase
Phase 1
Study type
Interventional
Enrollment
0
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase I trial studies side effects of daratumumab, bortezomib, dexamethasone, pegylated liposomal doxorubicin hydrochloride, and lenalidomide in treating participants with plasma cell leukemia. Monoclonal antibodies, such as daratumumab, may interfere with the ability of cancer cells to grow and spread. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as, dexamethasone, pegylated liposomal doxorubicin hydrochloride, and lenalidomide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving daratumumab, bortezomib, dexamethasone, pegylated liposomal doxorubicin hydrochloride, and lenalidomide in treating participants with plasma cell leukemia.

Read the detailed description

PRIMARY OBJECTIVES:

I. To determine the maximum tolerated dose(s) (MTD)/recommended phase 2 dose(s) (RP2D) of, bortezomib and pegylated liposomal doxorubicin hydrochloride (doxil) when given in combination with fixed dose daratumumab, lenalidomide, and dexamethasone.

SECONDARY OBJECTIVES:

I. To assess the tolerability and safety of the planned regimen, by evaluation of toxicities including: type, frequency, severity, attribution, time course and duration.

II. To estimate and assess overall response rate, response duration, and survival probabilities (overall and progression-free).

EXPLORATORY OBJECTIVES:

I. Quantify CD38+ cells from the peripheral blood mononuclear cells (PBMC) fraction, including T, natural killer (NK), and monocytic subsets.

II. Assess possible changes in CD38 expression, as well as the co-receptor marker CD31, overall and by response status (responder/non-responder).

III. Assess cytokine levels in peripheral blood plasma. IV. Quantify CD38+ cells from the bone marrow CD-138 negative fractions and acellular fractions, including T, NK, and monocytic subsets.

V. Assess possible changes in CD38 expression, as well as the co-receptor marker CD31, overall and by response status (responder/non-responder).

VI. Assess cytokine levels in the bone marrow acellular fraction. VII. Investigate CD38 cellular localization in plasma cells and extracellular vesicles from blood plasma.

VIII. Assess messenger ribonucleic acid (mRNA) expression in the peripheral blood mononuclear cell (PBMC), the bone marrow CD138-negative fraction, the T cell fraction, and plasma cells.

IX. Investigate epigenetic changes in CD38 mRNA expression.

OUTLINE:

Participants receive daratumumab intravenously (IV) on days 1, 8, 15, and 22, dexamethasone IV/orally (PO) on days 1, 2, 8, 9, 15, 16, 22, and 23, pegylated liposomal doxorubicin hydrochloride IV on day 8, lenalidomide PO daily on days 1-14, and bortezomib subcutaneously (SC) on days 1, 4, 8, and 11 of courses 1 and 2. Participants then receive daratumumab IV on days 1, and 15, dexamethasone IV/PO on days 1, 2, 8, 9, 15, 16, 22, and 23, pegylated liposomal doxorubicin hydrochloride IV on day 8, lenalidomide PO daily on days 1-14, and bortezomib SC on days 1, 4, 8, and 11 of courses 3 and 4. Courses repeat every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Participants may receive up to 8 courses at the discretion of treating physician.

After completion of study treatment, participants are followed up at 30 days and then every 3 months for 18 months.

02

Conditions studied

  • Plasma Cell Leukemia
03

In context

Leukemia

5,442 studies on the registry are indexed under Leukemia; 637 are open to participants now.

Browse Leukemia studies →

Lead sponsor

City of Hope Medical Center is the lead sponsor of 670 studies on the registry; 181 are open to participants now.

Of its 30 completed or terminated interventional studies of FDA-regulated products, 12 (40%) have results posted.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Documented informed consent of the participant and/or legally authorized representative. Assent, when appropriate, will be obtained per institutional guidelines.
  • Willingness to provide bone marrow and peripheral blood samples for research purposes. If unavailable, exceptions may be granted with study principal investigator (PI) approval.
  • All study participants must be registered into the mandatory Revlimid Risk Evaluation and Mitigation Strategies (REMS) program and be willing to comply with its requirements.
  • Karnofsky performance status (KPS) > 60.
  • Plasma cell leukemia; either newly diagnosed or relapsed: defined as the presence of > 2 x 10\^9/L peripheral blood plasma cells or plasmacytosis accounting for > 20% of the differential white cell count.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Absolute neutrophil count (ANC) >= 500/mm\^3

    • NOTE: Growth factor is not permitted within 14 days of ANC assessment unless cytopenia is secondary ot disease involvement.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Total bilirubin =\< 2.0 x ULN (unless has Gilbert's disease).
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Aspartate aminotransferase (AST) =\< 3.0 x ULN.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Alanine aminotransferase (ALT) =\< 3.0 x ULN.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Creatinine clearance of >= 30 mL/min per 24 hour urine test or the Cockcroft-Gault formula.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Left ventricular ejection fraction (LVEF) > 45%
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Hemoglobin >= 8.0 g/dL

    • Note: Transfusion support is allowed.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Seronegative for human immunodeficiency virus (HIV) antigen-antibody (Ag/Ab) combo, hepatitis C virus (HCV), active hepatitis B virus (HBV) (surface antigen negative), and syphilis (RPR).

    • If positive, hepatitis C RNA quantitation must be performed.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Meets other institutional and federal requirements for infectious disease titer requirements.

    • Note: Infectious disease testing to be performed within 28 days prior to day 1 of protocol therapy.
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Women of childbearing potential (WOCBP): negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
  • Agreement by females and males of childbearing potential* to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 6 months after the last dose of protocol therapy.

    • Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for > 1 year (women only).
  • Women of childbearing potential must follow pregnancy testing requirements as outline in REMS program material.

Exclusion criteria

Exclusion Criteria:

  • Progression or intolerance to daratumumab, bortezomib, or lenalidomide.
  • Prior stem cell transplant.
  • Participant is receiving concurrent chemotherapy or biologic or hormonal therapy for cancer treatment.

    • Note: Concurrent use of hormones for noncancer-related conditions (e.g., insulin for diabetes) is acceptable.
  • Vaccination with live attenuated vaccines within 4 weeks of first study agent administration.
  • Participant is currently using or has used immunosuppressive medication within 14 days prior to the first study dose of study treatment. The following are exceptions:

    • Intranasal, topical, inhaled, or local steroid injections (e.g., intra-articular injection)
    • Chronic systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or equivalent
    • Steroids as premedication for hypersensitivity reactions (e.g., infusion-related reactions, computed tomography [CT] scan premedication).
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to study agent.
  • Has known chronic obstructive pulmonary disease with a forced expiratory volume in 1 second (FEV1) \< 50% of predicted normal.
  • Has known moderate or severe persistent asthma within the past 2 years, or currently has uncontrolled asthma of any classification.
  • Clinically significant uncontrolled illness.
  • Active infection requiring intravenous antibiotics or antifungals within 14 days prior to start of study treatment.
  • Known history of immunodeficiency virus (HIV) or hepatitis B or hepatitis C infection.
  • Grade >= 3 peripheral neuropathy, or grade >= 2 with pain on clinical examination during the screening period.
  • Evidence of current uncontrolled cardiovascular conditions, including cardiac arrhythmias, congestive heart failure, angina, or myocardial infarction within the past 6 months. Note: Prior to study entry, any electrocardiogram (ECG) abnormality at screening must be documented by the investigator as not medically relevant.
  • Other active malignancy. Exceptions: Non-melanoma skin cancer, ductal breast carcinoma in situ (DCIS) or carcinoma-in-situ of the cervix. Note: If there is a history or prior malignancy, they must not be receiving other specific treatment for their cancer. Prior malignancy treated with curative intent is not an exclusion.
  • Females only: Pregnant or breastfeeding.
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures.
  • Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics).
05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    Treatment (daratumumab, bortezomib, chemotherapy)

    Participants receive daratumumab IV on days 1, 8, 15, and 22, dexamethasone IV/PO on days 1, 2, 8, 9, 15, 16, 22, and 23, pegylated liposomal doxorubicin hydrochloride IV on day 8, lenalidomide PO daily on days 1-14, and bortezomib SC on days 1, 4, 8, and 11 of courses 1 and 2. Participants then receive daratumumab IV on days 1, and 15, dexamethasone IV/PO on days 1, 2, 8, 9, 15, 16, 22, and 23, pegylated liposomal doxorubicin hydrochloride IV on day 8, lenalidomide PO daily on days 1-14, and bortezomib SC on days 1, 4, 8, and 11 of courses 3 and 4. Courses repeat every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Participants may receive up to 8 courses at the discretion of treating physician.

    Drug: Bortezomib · Biological: Daratumumab · Drug: Dexamethasone · Drug: Lenalidomide · Drug: Pegylated Liposomal Doxorubicin Hydrochloride

Interventions

  • DrugBortezomib

    Given SC

    Also known as: [(1R)-3-Methyl-1-[[(2S)-1-oxo-3-phenyl-2-[(pyrazinylcarbonyl)amino]propyl]amino]butyl]boronic Acid, LDP 341, MLN341, PS-341, PS341, Velcade

  • BiologicalDaratumumab

    Given IV

    Also known as: Anti-CD38 Monoclonal Antibody, Darzalex, HuMax-CD38, JNJ-54767414

  • DrugDexamethasone

    Given IV and PO

    Also known as: Aacidexam, Adexone, Aknichthol Dexa, Alba-Dex, Alin, Alin Depot, Alin Oftalmico, Amplidermis, Anemul mono, Auricularum, Auxiloson, Baycuten, Baycuten N, Cortidexason, Cortisumman, Decacort, Decadrol, Decadron, Decalix, Decameth, Decasone R.p., Dectancyl, Dekacort, Deltafluorene, Deronil, Desamethasone, Desameton, Dexa-Mamallet, Dexa-Rhinosan, Dexa-Scheroson, Dexa-sine, Dexacortal, Dexacortin, Dexafarma, Dexafluorene, Dexalocal, Dexamecortin, Dexameth, Dexamethasonum, Dexamonozon, Dexapos, Dexinoral, Dexone, Dinormon, Fluorodelta, Fortecortin, Gammacorten, Hexadecadrol, Hexadrol, Lokalison-F, Loverine, Methylfluorprednisolone, Millicorten, Mymethasone, Orgadrone, Spersadex, Visumetazone

  • DrugLenalidomide

    Given PO

    Also known as: CC-5013, CC5013, CDC 501, Revlimid

  • DrugPegylated Liposomal Doxorubicin Hydrochloride

    Given IV

    Also known as: ATI-0918, Caelyx, DOX-SL, Doxil, Doxilen, Doxorubicin HCl Liposome, doxorubicin hydrochloride liposome, Duomeisu, Evacet, LipoDox, Liposomal Adriamycin, liposomal doxorubicin hydrochloride, Liposomal-Encapsulated Doxorubicin, Pegylated Doxorubicin HCl Liposome, S-Liposomal Doxorubicin, Stealth Liposomal Doxorubicin, TLC D-99

06

What researchers measure

Primary outcomes

  1. Incidence of adverse events assessed by National Cancer Institute-Common Terminology Criteria for Adverse Events (CTCAE) version 5.0

    Observed toxicities will be tabulated using frequencies and percentages based on the CTCAE v5.0.

    Time frame: Up to 30 days

Secondary outcomes

  1. Overall response rate described by the International Myeloma Working Group (IMWG)

    Response rates will also be evaluated based on number and type of prior therapy(ies); the exact binomial confidence interval (CI) will be calculated for these estimates.

    Time frame: Up to 18 months

  2. Duration of response

    The overall response rate (ORR) will be estimated by the number of participants who achieve a confirmed response (stringent complete response \[sCR\]/complete response \[CR\]/very good partial response \[VGPR\] or partial response \[PR\]) divided by the total number of response evaluable participants. Response rates will also be evaluated based on number and type of prior therapy(ies); the exact binomial CI will be calculated for these estimates.

    Time frame: Up to 18 months

  3. Overall survival rate

    Will be estimated using the product-limit method of Kaplan and Meier; 95% confidence intervals will be calculated using Greenwood's formula.

    Time frame: From date of first dose of study drug to date of death from any cause, assessed up to 18 months

  4. Progression-free survival rate

    Will be estimated using the product-limit method of Kaplan and Meier; 95% confidence intervals will be calculated using Greenwood's formula.

    Time frame: From date of first dose of study drug to date of first documented disease relapse, progression or death from any cause, whichever occurs first, up to 18 months

07

Study locations

5 sites
  • City of Hope Medical Center
    Duarte, California 91010, United States
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Siteman Cancer Center at Washington University
    Saint Louis, Missouri 63110, United States
  • Carolinas Medical Center/Levine Cancer Institute
    Charlotte, North Carolina 28203, United States
  • Sarah Cannon Cancer Center
    Nashville, Tennessee 37203, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 19, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03591744
Lead sponsor
City of Hope Medical Center
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Jul 19, 2018
Start date
Oct 25, 2018 (estimated)
Primary completion
Oct 25, 2019 (estimated)
Completion
Oct 25, 2019 (estimated)
Last update
Dec 19, 2018

Study contacts

Amrita Krishnan
principal investigator · City of Hope Medical Center

Oversight

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

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This study is withdrawn, as verified in Dec 2018. You cannot join it, but the record below documents what was studied.

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