ClinicalTrials.gg
WithdrawnNCT06682637Updated Apr 1, 2025

Melflufen for Elderly Patients With Relapsed Myeloma

A Phase 2 interventional study of Melflufen and Dexamethasone in Relapse Multiple Myeloma, sponsored by Fondazione EMN Italy Onlus. Withdrawn at 10 sites in Italy. Open to participants aged 70 Years to 80 Years. Per ClinicalTrials.gov, last updated 2025-04-01.

Sponsored by Fondazione EMN Italy Onlus · Phase 2, Interventional, and Other

Why this study was withdrawn
Clinical trial never activated, not authorized by CA
Phase
Phase 2
Study type
Interventional
Enrollment
0
Allocation
Not applicable
Ages
70 Years to 80 Years
Sex
All
01

Study summary

This is a pilot study aimed to evaluate the efficacy and tolerability of melflufen plus dexamethasone in elderly patients at second relapse.

Thirty elderly patients at second or subsequent relapse.

02

Conditions studied

  • Relapse Multiple Myeloma

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03

In context

Multiple Myeloma

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

Browse Multiple Myeloma studies →

Lead sponsor

Fondazione EMN Italy Onlus is the lead sponsor of 21 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
70 Years to 80 Years
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

  • Patients affected by MM progressed or after 2 or more .
  • Patient is, in the investigator's opinion, willing and able to comply with the study visits and procedures required per protocol.
  • Patient has provided written in accordance with federal, local, and institutional guidelines prior to initiation of any study-specific activities or procedures. Subject does not have kind of condition that, in the opinion of the Investigator, may compromise the ability of the subject to give written informed consent and patient is, in the investigator(s) opinion, willing and able to comply with the protocol requirements.
  • ≥ 3 months
  • Previous exposure to, at least, one drug of all the following categories: an anti-CD38 MoAbs, an IMiD, and a proteasome inhibitor.
  • Age ≥ 70 and ≤ 85 years.
  • performance status ≤2.
  • Subject must have serum monoclonal paraprotein (M-protein) level ≥0.5 g/dL or urine M-protein level ≥200 mg/24 hours, or serum immunoglobulin involved free light chain ≥10 mg/dL and abnormal serum immunoglobulin kappa lambda free light chain ratio.
  • ≥40% as determined by a MUGA scan or ECHO.
  • Adequate hepatic function characterized by the following:

oTotal ≤1.5 x . oAST ≤2.5 x ULN oALT ≤2.5 x ULN.

  • Estimated ≥30 mL/min (according to the Cockcroft Gault formula, by 24-hour urine collection for creatinine clearance, or per the local institutional standard method).
  • Adequate BM function characterized by the following:

    • ≥1.0 × 109/L (use of granulocyte-colony stimulating factors is permitted if completed at least 7 days prior to planned start of dosing).
    • count ≥50 × 109/L (transfusion support is not permitted).
    • ≥8 g/dL (transfusion support is permitted).
  • Non-vasectomized male patients agree to practice appropriate methods of

Exclusion criteria

Exclusion Criteria:

  • Previous exposure to chemotherapy (i.e. melphalan, high-dose melphalan and/or cyclophosphamide) with the exception of patients who have received an stem cell transplantion with a progression free survival of at least 36 month.
  • Plasma cell leukemia.
  • Systemic amyloid light chain amyloidosis.
  • POEMS Syndrome.
  • Central Nervous System (CNS) disease localization.
  • Subject with another tumor, not including MM, that required ongoing treatment or therapy completed less than 6 months before eligibility confirmation, and considered at substantial risk of relapse in the following 12 months.
  • Active , , SARS-CoV2, , or any active, uncontrolled bacterial, fungal, or viral infection. Active infections must be resolved at least 14 days prior to eligibility confirmation.
  • Subject has any concurrent medical condition or disease (e.g. active systemic infection) that is likely to interfere with study procedures or results, or that in the opinion of the investigator would constitute a hazard for participating in this study.
  • Subject has cardiac disease, including:

    • Myocardial infarction within 6 months before trial eligibility
    • Uncontrolled disease/condition related to or affecting cardiac function (e.g. unstable angina, congestive heart failure, Class III-IV)
    • Clinically significant abnormalities.
Terms in these criteria, in plain language(20)

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.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

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.

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.

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.

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.

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).

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.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

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.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

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.

05

Study design

Phase
Phase 2
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    Melflufen and Dexamethasone

    * Melflufen 40 mg total dose (30 mg in patients with body weight ≤60 kg and/or in patients with eGFR\<45 mL/min) intravenously on day 1. * Dexamethasone 10 mg orally or intravenously on day 1-2, 8-9, 15-16, 22-23.

    Drug: Melflufen · Drug: Dexamethasone

Interventions

  • Pepaxti 20 mg powder for concentrate for solution for infusion

  • SOLDESAM 8 mg/2 ml solution for injection SOLDESAM 0.2% oral drops, solution

06

What researchers measure

Primary outcomes

  1. Overall Response Rate

    rate of participants who achieve a PR or better (PR+VGPR+CR+sCR) according to IMWG response criteria during the treatment.

    Time frame: approximately 6 months after the enrolled of the last participant and an updated analysis will be conducted at approximately 8 to 12 months.

Secondary outcomes

  1. DURATION OF RESPONSE

    the time from the date of first documented response (≥PR) to the date of first confirmed PD.

    Time frame: after 2.5 years

  2. PROGRESSION-FREE SURVIVAL

    the time from the date of 1st dose of study drug to the date of first confirmed PD or death due to any cause, whichever occurs first.

    Time frame: after 6 months

  3. TIME TO PROGRESSION

    the time from the date of 1st dose of study drug to the date of first documented PD

    Time frame: after 2.5 years

  4. PROGRESSION-FREE SURVIVAL 2

    the time from the date of 1st dose of study drug to the date of event, which is defined as death from any cause or PD that starts after the next line of therapy, whichever occurs first.

    Time frame: after 2.5 years

  5. OVERALL SURVIVAL

    the time from the date of 1st dose of study drug to the date of death.

    Time frame: after 2.5 years

  6. TIME TO RESPONSE

    the time from the date of 1st dose of study drug to the first documented response (≥PR).

    Time frame: after 2.5 years

07

Study locations

10 sites
  • A.O.U. delle Marche
    Ancona, Italy
  • Ospedale Nuovo di Legnano
    Legnano, Italy
  • Ospedale Niguarda
    Milano, Italy
  • Ospedale S. Carlo Borromeo
    Milano, Italy
  • Policlinico Giaccone Divisione Ematologia e Centro Trapianti di Midollo
    Palermo, Italy
  • A.O.U. di Parma
    Parma, Italy
  • A.O.U. Pisana
    Pisa, Italy
  • I.R.C.C.S. Ospedale Casa Sollievo della Sofferenza
    San Giovanni Rotondo, Italy
  • A.O.U. Città della Salute e della Scienza di Torino-SSD Clinical trials
    Torino, Italy
  • Ospedale S. Maria della Misericordia di Udine
    Udine, Italy
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2025 to primary completion in Mar 2025, 0 months.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 8, 2024
First posted
Nov 12, 2024
StartActual
Mar 26, 2025
Primary completionActual
Mar 26, 2025
CompletionActual
Mar 26, 2025
Last update
Apr 1, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 1, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06682637
Lead sponsor
Fondazione EMN Italy Onlus
Responsible party
Sponsor
First posted
Nov 12, 2024
Start date
Mar 26, 2025
Primary completion
Mar 26, 2025
Completion
Mar 26, 2025
Last update
Apr 1, 2025

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Melphalan flufenamide

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