Study to determine whether ixazomib citrate (MLN9708) as maintenance therapy has an effect on progression free survival and overall survival compared to placebo in patients with newly diagnosed multiple myeloma who have received induction therapy followed by high-dose therapy and autologous stem-cell transplantation

• Register: EUCTR
• Last refreshed on: 8 August 2022
• Main ID: EUCTR2013-002076-41-PL
• Date of registration: 10/06/2014
• Prospective Registration: Yes
• Primary sponsor: Takeda Development Center Americas, Inc.
• Public title: Study to determine whether ixazomib citrate (MLN9708) as maintenance therapy has an effect on progression free survival and overall survival compared to placebo in patients with newly diagnosed multiple myeloma who have received induction therapy followed by high-dose therapy and autologous stem-cell transplantation
• Scientific title: A Phase 3, Randomized, Placebo-Controlled, Double-Blind Study of Oral Ixazomib Citrate (MLN9708) Maintenance Therapy in Patients With Multiple Myeloma Following Autologous Stem Cell Transplant
• Date of first enrolment: 25/07/2014
• Target sample size: 652
• Recruitment status: Authorised-recruitment may be ongoing or finished
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2013-002076-41
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes; Randomised: yes; Open: no; Single blind: no; Double blind: yes; Parallel group: yes; Cross over: no; Other: no; If controlled, specify comparator, Other Medicinial Product: no; Placebo: yes; Other: no; Number of treatment arms in the trial: 2
• Phase: Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): yes Therapeutic use (Phase IV): no

Countries of recruitment

Argentina, Australia, Austria, Belgium, Brazil, Canada, Colombia, Czech Republic, Czechia, Denmark, France, Germany, Greece, Hungary, Israel, Italy, Japan, Korea, Republic of, Mexico, Netherlands, Norway, Poland, Portugal, Singapore, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine, United Kingdom, United States

Contacts

• Name: Drug Information Call Center
• Affiliation: Takeda Development Center Americas, Inc

• Name: Drug Information Call Center
• Affiliation: Takeda Development Center Americas, Inc

Key inclusion & exclusion criteria

Inclusion criteria:
1. Adult male or female patients 18 years or older with a confirmed diagnosis of symptomatic multiple myeloma according to standard criteria.
2. Documented results available for cytogenetics/ fluorescence in situ hybridization (FISH) obtained at any time before transplant and for ISS staging at the time of diagnosis.
3. Underwent SoC induction therapy (induction therapy must include PI and/or IMiD-based regimens as primary therapy for multiple myeloma), followed by a single ASCT with a high-dose melphalan (200 mg/m2) conditioning regimen, within 12 months of diagnosis. Vincristine, Adriamycin (doxorubicin), and dexamethasone (VAD) is not an acceptable induction therapy for this trial.
4. Started screening no earlier than 75 days after transplant, completed screening within 15 days, and randomized no later than 115 days after transplant.
5. Patient must have not received post-ASCT consolidation therapy.
6. Documented response to ASCT (PR, VGPR, CR/stringent complete response [sCR]) according to IMWG criteria.
7. ECOG performance status of 0 to 2.
8. Female patients who:
* If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 90 days after the last dose of study drug, AND
* Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods] and withdrawal are not acceptable methods of contraception.)
Male patients, even if surgically sterilized (ie, status postvasectomy), who:
* Agree to practice effective barrier contraception during the entire study treatment period and through 90 days after the last dose of study drug, AND
* Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods for the female partner] and withdrawal are not acceptable methods of contraception.)
9. Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.
10. Suitable venous access for the study-required blood sampling.
11. Patient is willing and able to adhere to the study visit schedule and other protocol requirements.
12. Patients must meet the following clinical laboratory criteria at study entry:
* Absolute neutrophil count (ANC) = 1,000/mm3 and platelet count = 75,000/mm3. Platelet transfusions to help patients meet eligibility criteria are not allowed within 3 days before randomization.
* Total bilirubin = 1.5 x the upper limit of the normal range (ULN).
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
* 3 = ULN.
* Calculated creatinine clearance = 30 mL/min.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 600
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 52

Exclusion criteria:
1. Multiple myeloma that has relapsed following primary therapy or is not responsive to primary therapy. For this study, SD following ASCT will be considered nonresponsive to primary therapy.
2. Double (tandem) ASCT.
3. Radiotherapy within 14 days before the first dose of study drug.
4. Diagnosed or treated for another malignancy within 5 years before randomization or previously diagnosed with another malignancy with evidence of residual disease. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
5. Female patients who are lactating and breastfeeding or have a positive serum pregnancy test during the Screening period.
6. Major surgery within 14 days before randomization.
7. Central nervous system involvement.
8. Infection requiring IV antibiotic therapy or other serious infection within 14 days before randomization.
9. Diagnosis of Waldenstrom’s macroglobulinemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, plasma cell leukemia, primary amyloidosis, myelodysplastic syndrome, or myeloproliferative syndrome.
10. Evidence of current uncontrolled cardiovascular conditions, including uncontrolled hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure, unstable angina, or myocardial infarction within the past 6 months.
11. Systemic treatment with strong CYP3A inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of Ginkgo biloba or St. John’s wort within 14 days before randomization in the study.
12. Active hepatitis B or C virus infection, or known human immunodeficiency virus (HIV) positive.
13. Comorbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens (eg, PN that is Grade 1 with pain or Grade 2 or higher of any cause).
14. Psychiatric illness/social situation that would limit compliance with study requirements.
15. Known allergy to any of the study medications, their analogues, or excipients in the various formulations of any agent.
16. Inability to swallow oral medication, inability or unwillingness to comply with the drug administration requirements, or gastrointestinal (GI) procedure that could interfere with the oral absorption or tolerance of treatment.
17. Treatment with any investigational products within 60 days before the first dose of the study drug regimen.


Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes

Health Condition(s) or Problem(s) studied

Therapeutic area: Diseases [C] - Cancer [C04]

Newly diagnosed multiple myeloma (NDMM) following induction therapy and autologous stem cell transplant (ASCT)
MedDRA version: 21.0 Level: LLT Classification code 10028228 Term: Multiple myeloma System Organ Class: 100000004864

Intervention(s)

Product Name: Ixazomib Capsules 0.5 mg
Pharmaceutical Form: Capsule, hard
INN or Proposed INN: ixazomib citrate
CAS Number: 1239908-20-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 0.5-
Pharmaceutical form of the placebo: Capsule, hard
Route of administration of the placebo: Oral use

Trade Name: NINLARO
Product Name: Ixazomib Capsules 2.3 mg
Pharmaceutical Form: Capsule, hard
INN or Proposed INN: ixazomib citrate
CAS Number: 1239908-20-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 2.3-
Pharmaceutical form of the placebo: Capsule, hard
Route of administration of the placebo: Oral use

Trade Name: NINLARO
Product Name: Ixazomib Capsules 3.0 mg
Pharmaceutical Form: Capsule, hard
INN or Proposed INN: ixazomib citrate
CAS Number: 1239908-20-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 3.0-
Pharmaceutical form of the placebo: Capsule, hard
Route of administration of the placebo: Oral use

Trade Name: NINLARO
Product Name: Ixazomib Capsules 4.0 mg
Pharmaceutical Form: Capsule, hard
INN or Proposed INN: ixazomib citrate
CAS Number: 1239908-20-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 4.0-
Pharmaceutical form of the placebo: Capsule, hard
Route of administration of the placebo: Oral use

Primary Outcome(s)

Primary end point(s): Progression-free survival (PFS), defined as the time from the date of randomization to the date of first documentation of disease progression, as evaluated by an independent review committee (IRC) using IMWG (International Myeloma Working Group) criteria, or death due to any cause, whichever occurs first

Timepoint(s) of evaluation of this end point: Baseline up to End of treatment (24 months); thereafter followed up every 4 weeks until progression of disease or death (up to Month 107)

Secondary Objective: * Determine the effect of ixazomib maintenance therapy on OS compared to placebo

Main Objective: To determine the effect of ixazomib maintenance therapy on PFS, compared to placebo, in patients with NDMM who have had a response (CR, very good partial response [VGPR], or partial response [PR]) to induction therapy followed by HDT and ASCT

Secondary Outcome(s)

Timepoint(s) of evaluation of this end point: Baseline up to Follow up period (107 months)

Secondary end point(s): Overall survival (OS), measured as the time from the date of randomization to the date of death

Secondary ID(s)

NCT02181413

2013-002076-41-BE

C16019

Source(s) of Monetary Support

Takeda Development Center Americas, Inc

Ethics review

Status: Approved
Approval date: 07/07/2014
Contact: