E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10002022 |
E.1.2 | Term | Amyloidosis |
E.1.2 | System Organ Class | 10021428 - Immune system disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine the efficacy of bortezomib plus dexamethasone followed by HDM and auto-SCT in patients with newly diagnosed AL amyloidosis who are 18-70 years inclusive. |
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E.2.2 | Secondary objectives of the trial |
To asses the safety of bortezomib plus dexamethasone in the induction regimen followed by HDM and auto-SCT in patients with newly diagnosed AL amyloidosis who are 18-70 years inclusive. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Biopsy proven, systemic, untreated AL amyloidosis requiring systemic chemotherapy,
• Age 18 -70 years inclusive at the time of signing the informed consent form,
• Measurable plasma cell dyscrasia, defined as a detectable M-protein with serum electrophoresis and/or level of involved FLC> 50 mg/L,
• Life expectancy > 3 months,
• WHO performance status 0-2,
• NYHA 1-2,
• Negative pregnancy test at inclusion for women of childbearing potential,
• Written informed consent.
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E.4 | Principal exclusion criteria |
• Multiple Myeloma stage II and III (Durie and Salmon),
• Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form,
• Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule,
• Previous treatment for plasma cell dyscrasia
• Pregnant or breast feeding females.
• Presence of other active malignancy or a history of active malignancy during the past 5 years, with the exception of nonmelanoma skin cancer, stage 0 cervical carcinoma, or treated early-stage prostate cancer provided that prostate-specific antigen is within normal limits,
• Hypersensitivity to boron or mannitol,
• Uncontrolled infection,
• Symptomatic othostatic hypotension defined as a decrease in systolic blood pressure on standing of >20mmHg combined with symptoms like dizziness, cerebral and/or cardial ischemia,
• Symptomatic effusions, defined as pleural effusion or ascites needing drainage therapy,
•NT pro BNP level > 5000 pg/ml and troponin T>0.06 microgram/L (not high sensitivity assay) or NT proBNP level>5000 pg/ml and Troponin I > 2 times ULN.
- Positive for HIV or infectious hepatitis, B or C,
• Bilirubin > 2x upper limit of normal,
• Creatinin clearance < 30 ml/min (after rehydration),
• Absolute neutrophil count < 1.0 × 109/L,
• NCI CTCAE grade peripheral sensory neuropathy > grade 2,
• NCI CTCAE grade peripheral sensory neuropathy > grade 1 in the presence of neuropathic pain,
• NCI CTCAE grade peripheral motor neuropathy > grade 2
• Concurrent diagnosis of B-cel NHL or B-CLL,
• Previous organ transplantation.
• Unwilling or unable to use adeaquate contraception
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E.5 End points |
E.5.1 | Primary end point(s) |
• Hematological CR rate 6 months after auto-SCT.
Patients are considered a success if they received HDM and auto-SCT and are in CHR at 6 months, all other patients are considered a failure. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
About 10 months after inclusion of last patient |
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E.5.2 | Secondary end point(s) |
• OS
• PFS
• Hematological response rate after induction therapy
• Response rate, hematological and organ
• Time to response, hematological and organ
• Duration of hematological and organ response
• Time to next AL amyloidosis therapy
• Safety (type, frequency, and severity of adverse events (AE) and relationship of AE to study drug)
• Exploratory assessment of multiparameter flow cytometry quantification of bone marrow plasma cells and change in amyloid depostition in abdominal fat aspiration samples
• Evaluation of prognostic factors for survival included in te hematological and organ response criteria |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
About 10 months after inclusion of last patient. May be repeated at later analysis. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 14 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 9 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 9 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |