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Fixed Dose Radioimmunotherapy (Zevalin) for Patients With Incomplete Response to Chemo Prior to Autologous Stem Cell Transplant for Multiple Myeloma

Information source: Tufts Medical Center
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Multiple Myeloma

Intervention: indium-111-ibritumomab tiuxetan (Drug); 90Y Zevalin (Drug)

Phase: Phase 2

Status: Completed

Sponsored by: Tufts Medical Center

Official(s) and/or principal investigator(s):
Andreas K Klein, MD, Principal Investigator, Affiliation: Tufts Medical Center

Summary

The study involves the use of a targeted form of radiation, in addition to standard high dose chemotherapy and stem cell transplant for multiple myeloma. The use of targeted radiation is designed to kill more multiple myeloma cells while avoiding the side effects of standard radiation. This type of targeted radiation (also known as radioimmunotherapy) has been approved by the Food and Drug Administration (FDA) for the treatment of a related disease, lymphoma under the trade name, Zevalin©. Zevalin© has been added to high dose chemotherapy and stem cell transplants for patients with lymphoma and is now being studied in this clinical trial for patients with multiple myeloma. This trial is only available at Tufts Medical Center. The proposed clinical trial will test whether CD20-targeted radio-immunotherapy can be safe and effective when integrated into a standard regimen of myeloablative chemotherapy and autologous stem cell rescue in patients with measurable disease prior to high dose chemotherapy and autologous stem cell transplant for multiple myeloma.

Clinical Details

Official title: A Phase II, Safety and Efficacy Study of Fixed Dose Radioimmunotherapy (Zevalin, Yttrium-90 Ibritumomab Tiuxetan) for Patients With Incomplete Response to Chemotherapy Prior to Autologous Stem Cell Transplant for Multiple Myeloma

Study design: Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Safety (rate of occurrence of defined toxic events) and Efficacy (objective response rate)

Secondary outcome:

Evaluate the kinetics of engraftment in patients who proceed to myeloablative chemotherapy after receiving 90Y Zevalin® (ibritumomab tiuxetan).

Evaluate whether the degree of CD20 expression on plasma cells and/or targeting of post-germinal center B cells correlate with toxicity, response, biodistribution and other clinical parameters.

Detailed description: Patients with multiple myeloma measurable disease following stem cell mobilization with institution standard high dose cyclophosphamide and peripheral blood stem cell collection are candidates for participation on this trial. 90Y Zevalin targets CD20 expressed on the surface of mature B-cells and is FDA approved for relapsed/refractory low grade lymphoma. This is a single arm, phase II safety and efficacy study of 90-Y Zevalin in multiple myeloma. Subjects will receive cold antibody (Rituximab 100mg/m2) followed by 5 mCi test

dose of 111-In Zevalin on transplant day - 21. Gamma camera images are obtained 48 to 72

hours after 111-In Zevalin to document appropriate / expected distribution of radiotracer.

On transplant day - 14, subjects will receive another cold antibody dose followed by 90Y

Zevalin 0. 4 mg/kg (max 32 mCi) as single dose. Subjects are admitted for transplant on day

- 3 and proceed with institution standard high dose melphalan (200mg/m2) on day -2. Subjects

are followed for safety for 6 weeks after transplant.

Eligibility

Minimum age: 18 Years. Maximum age: 70 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Meet established criteria for the diagnosis of multiple myeloma

- Durie-Salmon stage II or III disease

- Measurable disease in the serum and/or urine

- Scheduled to receive high dose chemotherapy and autologous stem cell transplant for

multiple myeloma

- Individuals who have previously undergone autologous stem cell transplant are

eligible for this study provided more than 6 months have elapsed from the prior transplant.

- Minimum stem cell dose of 4x106 CD34+ MNC / kg stored for autologous stem cell

rescue.

- Adequate hematologic reserve as evidenced by ANC ≥ 1500/mm3 and platelets ≥

100,000/mm3.

- Serum direct bilirubin ≤ 2. 0 mg/dl and transaminases ≤ 3x institution upper limit of

normal.

- Serum creatinine ≤ 2 mg/dl with creatinine clearance ≥ 60 ml/min (either calculated

or measured). Exclusion Criteria:

- Stage I or smoldering myeloma, isolated plasmacytoma, or benign monoclonal gammopathy

- Non-secretory multiple myeloma

- Pregnant or lactating women

- Males and females who do not agree to practice approved methods of birth control for

the duration of the study

- Presence of active infection

- Receipt of previous radiation therapy to critical organs exceeding any of the

following limits: kidney 500 cGy, liver 1000 cGy, lungs 500 cGy

Locations and Contacts

Tufts Medical Center, Boston, Massachusetts 02111, United States
Additional Information

Starting date: April 2008
Last updated: December 8, 2014

Page last updated: August 23, 2015

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