ClinicalTrials.gg
Enrolling by invitationNCT03815279iStopMMUpdated Aug 16, 2019

A Nationwide Phase 2 Trial of Patients With Smoldering and Active Multiple Myeloma (MM)

A Phase 2 interventional study of Carfilzomib and Lenalidomide in Multiple Myeloma and Smoldering Multiple Myeloma, sponsored by Landspitali University Hospital. Enrolling by invitation at 1 site in Iceland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-08-16.

Sponsored by Landspitali University Hospital · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jan 2024, 2 years 10 months ago, but the record still lists the study as enrolling by invitation.
Phase
Phase 2
Study type
Interventional
Enrollment
80
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to determine the efficacy of treating patients with intermediate risk smoldering multiple myeloma (SMM) with combinational therapy with dexamethasone and lenalidomide (Rd) and patients with high risk SMM with combinational therapy with Rd and carfilzomib.

Read the detailed description

This is an open label, single center, phase II study assessing the efficacy of treating patients with intermediate-risk smoldering myeloma (SMM) with combinational therapy with dexamethasone and lenalidomide and treating patients with high risk SMM and active multiple myeloma (MM) with combinational therapy with dexamethasone, lenalidomide and carfilzomib. Patients that are eligible for this study are participants in the IstopMM study (ClinicalTrials.gov number, NCT03327597) that are diagnosed with intermediate or high-risk SMM or active MM.

02

Conditions studied

  • Multiple Myeloma
  • Smoldering Multiple Myeloma

Keywords

  • Multiple Myeloma
  • Smoldering Multiple Myeloma
  • Carfilzomib
  • Lenalidomide
  • Screening
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 planned enrollment of 80 is above the median of 41 across 3,005 interventional studies indexed under Multiple Myeloma.

Browse Multiple Myeloma studies →

Lead sponsor

Landspitali University Hospital is the lead sponsor of 21 studies on the registry; 6 are open to participants now.

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Participants that are diagnosed with MM, high- or intermediate-risk SMM in the iStopMM study will be invited to participate in this study. Each patient must meet all the following inclusion criteria to be enrolled in the study:

  1. Age more than 18 years.
  2. Active MM or
  3. Smoldering myeloma, which is untreated, as defined by: Measurable M spike OR pathological FLC ratio AND bone marrow PC% > 10%
  4. The following laboratory values obtained ≤ 30 days prior to registration

    • Calculated ≥ 30mL/min (using equation)
    • (ANC) > 1000/mm3
    • count > 75000/mm3
    • ≥ 8.0 g/dL
    • Total ≤ 1.5 x
    • and AST ≤ 3 x ULN
  5. as defined by at least one of the following:

    • Serum monoclonal protein > 1.0g/L
    • > 200 mg of monoclonal protein in the urine on 24 hour electrophoresis
    • Serum immunoglobulin free light chain ≥ 10 mg/dL and abnormal serum immunoglobulin kappa to lambda free light chain ratio
  6. Prior therapy for the treatment of solitary plasmacytoma is permitted, but >7 days should have elapsed from the last day of radiation. NOTE: Prior therapy with clarithromycin, DHEA, anakinra, pamidronate or zoledronic acid is permitted. Any additional agents not listed must be approved by the Principal Investigator.
  7. performance status 0, 1 or 2
  8. Negative pregnancy test done ≤7 days prior to C1D1, for women of only.
  9. Willing to follow strict measures as outlined in the protocol.
  10. Female subjects: If they are of childbearing potential, agree to one of the following:

    Practice 2 effective methods of contraception, at the same time, from the time of signing the form through 90 days after the last dose of trial drug, AND must also adhere to the guidelines of any treatment-specific pregnancy prevention program (appendix 1), if applicable, OR Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [e.g., calendar, ovulation, symptothermal, post-ovulation methods] and withdrawal are not acceptable methods of contraception.)

  11. Male subjects: even if surgically sterilized (i.e., status post-vasectomy), must agree to one of the following: Agree to practice effective barrier contraception during the entire trial treatment period and through 90 days after the last dose of trial drug, OR Must also adhere to the guidelines of any treatment-specific pregnancy prevention program (appendix 1), if applicable, OR Agree to practice true abstinence when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods] and withdrawal are not acceptable methods of contraception). Willing to return to enrolling institution for follow-up during the Active Treatment Phase of the trial. Agree not to donate sperm for at least 90 days after the last dose of carfilzomib
  12. Willing to provide samples for planned research
  13. > 6 months

Exclusion criteria

Exclusion Criteria:

  1. MGUS or low-risk smoldering myeloma.
  2. Diagnosed or treated for another ≤ 2 years before trial enrollment or previously diagnosed with another malignancy and have any evidence of residual disease. NOTE: Subjects with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
  3. If any of the following exist at screening, subject will not be eligible for trial because this trial involves an agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown: Pregnant women Nursing women Men or women of who are unwilling to employ adequate (per protocol)
  4. Other co-morbidity which would interfere with subject's ability to participate in trial, e.g. uncontrolled infection, uncompensated heart or lung disease
  5. Other concurrent chemotherapy, or any ancillary therapy considered investigational.

    NOTE: Bisphosphonates are considered to be supportive care rather than therapy, and are thus allowed while on protocol treatment.

  6. Peripheral neuropathy > Grade 3 on clinical examination or grade 2 with pain within 30 days prior to C1D1.
  7. Major surgery ≤14 days prior to C1D1.
  8. Evidence of current uncontrolled cardiovascular conditions, including hypertension, cardiac arrhythmias, congestive heart failure, unstable angina, or myocardial infarction within the past 6 months. Note: Prior to trial entry, any abnormality at screening must be documented by the investigator as not medically relevant.
  9. Known (HIV) positive.
  10. Known surface antigen-positive status, or known or suspected active infection.
  11. Any medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol.
  12. Known allergies, , or intolerance to , monoclonal antibodies or human proteins, or their (refer to respective package inserts or Investigator's Brochure), or known sensitivity to mammalian-derived products.

    Known allergies, hypersensitivity, or intolerance to trial drugs.

  13. Inability to comply with protocol/procedures.
  14. \< 40% for patients treated with carfilzomib.
Terms in these criteria, in plain language(24)

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.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

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.

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.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

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.

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.

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.

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.

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.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

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.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

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.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
80 participants (estimated)

Study arms

  • Experimental
    High-risk SMM and MM

    Twelve cycles of Carfilzomib-Lenalidomide-Dexamethason. Each cycle is 28 days. Carfilzomib intravenous, days 1, 8 and 15 (starting dose, 20 mg/m2 on day 1 of cycle 1; target dose, 56 mg/m2 thereafter) during cycles 1 through 12. Lenalidomide 25 mg orally once a day (3 weeks on/one week off) for 52 weeks. Dexamethasone 40 mg weekly for 16 weeks then 20 mg weekly for 16 weeks and thereafter 10 mg weekly for 16 weeks. Maintenance (1 year): Carfilzomib intravenous days 1 and 15 (56 mg/m2) during cycles 13 through 24. Lenalidomide 10 mg orally once a day (3 weeks on/one week off) for 52 weeks Dexamethasone 10 mg weekly for 52 weeks.

    Drug: Carfilzomib · Drug: Lenalidomide · Drug: Dexamethasone

  • Experimental
    Intermediate-risk SMM

    Lenalidomide 25 mg orally once a day (3 weeks on/one week off) for 52 weeks. Dexamethasone 40 mg weekly for 16 weeks, then 20 mg weekly for 16 weeks. Maintenance (1 year): Lenalidomide 10 mg orally once a day (3 weeks on/one week off) for 52 weeks.

    Drug: Lenalidomide · Drug: Dexamethasone

Interventions

  • Carfilzomib will be administered intravenously three times per cycle (28 day cycles) for cycle 1-12. Thereafter twice per cycle for cycle 13-24

    Also known as: Kyprolis

  • Lenalidomide PO once daily on days 1-21 of a 28 day cycle

    Also known as: Revlimid

  • Dexamethasone will be administered weekly

    Also known as: Dexasone

06

What researchers measure

Primary outcomes

  1. Rate of MRD negativity

    Minimal residual disease (MRD) as determined VDJ sequencing

    Time frame: 36 months after study enrollment

Secondary outcomes

  1. Progression free survival

    Rates of progression free survival with progression being determined by IMWG response criteria

    Time frame: Up until 3 years after treatment

  2. Overall survival

    Overall survival as determened by the Icelandic National Cause of Death Registry

    Time frame: Up until 3 years after treatment

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 16, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03815279
Lead sponsor
Landspitali University Hospital
Collaborators
Amgen, Celgene, University of Iceland, Memorial Sloan Kettering Cancer Center
Responsible party
Sponsor
First posted
Jan 24, 2019
Start date
Jun 24, 2019
Primary completion
Jan 2024 (estimated)
Completion
Jan 2028 (estimated)
Last update
Aug 16, 2019

Study contacts

Sigurdur Y Kristinsson, MD, PhD
principal investigator · Landspitali University Hospital

Oversight

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

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

No contact was published for this record. The registry link below has the sponsor’s details.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Carfilzomib

Start the discussion