The GMMG-HD5 trial: bortezomib-based induction prior to high dose therapy and autologous stem cell transplantation followed by lenalidomide-based consolidation and maintenance therapy in patients with multiple myeloma

ISRCTN ISRCTN05745813
DOI https://doi.org/10.1186/ISRCTN05745813
Secondary identifying numbers GMMG-HD5
Submission date
28/10/2009
Registration date
11/11/2009
Last edited
11/11/2009
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Not provided at time of registration

Contact information

Prof Hartmut Goldschmidt
Scientific

Universitätsklinikum Heidelberg
Medizinische Klinik V und
Nationales Centrum für Tumorerkrankungen (NCT)
Im Neuenheimer Feld 410
Heidelberg
69120
Germany

Study information

Study designProspective multicentre multinational randomised parallel group open phase III clinical trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titlePhase III trial in patients with multiple myeloma to optimize bortezomib based induction (bortezomib, Adriamycin®, dexamethasone [PAd] vs. bortezomib, cyclophosphamide, dexamethasone [VCD]) prior to high dose therapy and autologous stem cell transplantation followed by lenalidomide based consolidation and maintenance therapy
Study acronymGMMG-HD5
Study hypothesisThe GMMG-HD5 trial is designed to address two independent primary objectives:
1. Demonstration of non-inferiority of VCD induction therapy compared to PAd induction therapy with respect to response rate (very good partial remission or better; response criteria of the International Myeloma Working Group [IMWG])
2. Determination of the best of four treatment strategies with respect to progression-free survival (PFS). The four treatment strategies are defined by PAd versus VCD induction treatment, High Dose melphalan Therapy (HDT) followed by autologous stem cell transplantation and maintenance treatment with lenalidomide for 2 years versus lenalidomide until complete remission (CR).
Ethics approval(s)Ethikkommission der Medizinischen Fakultaet Heidelberg, University of Heidelberg, submission planned for November 2009
ConditionMultiple myeloma
Intervention1. Patients are randomised into four treatment arms (A1, A2, B1, B2)
2. Patients included in arms A1/B1 are treated with 3 cycles PAd (bortezomib 1.3 mg/m^2 intravenous [iv] on days 1, 4, 8 and 11, doxorubicin 9 mg/m^2 iv on days 1 – 4, dexamethasone [Dex] orally [po] 20 mg/d on days 1 - 4, 9 - 12 and 17 - 20)
3. Patients in arm A2/B2 are treated with 3 cycles VCD (bortezomib 1.3 mg/m^2 iv on days 1, 4, 8 and 11, cyclophosphamide 900 mg/m^2 iv on day 1, dexamethasone po 40 mg/d on days 1 - 2, 4 - 5, 8 - 9, 11 - 12)
4. Stem cells are mobilised by CAD (cyclophosphamide iv 1 g/m^2 on day 1, doxorubicin 15 mg/m^2 iv on days 1 – 4, Dex po 40 mg/d on days 1 - 4) and G-CSF. At least 5 x 10^6 CD34+ cells/kg body weight have to be harvested.
5. High dose therapy (HDT, melphalan 200 mg/m^2) is started 4 - 6 weeks after CAD
6. For patients not reaching a CR after HDT1, a second HDT is performed within 2 – 3 months after HDT1. Thereafter, two cycles of lenalidomide 25 mg/d on days 1 - 21 are given, followed by a lenalidomide maintenance treatment (lenalidomide po 10 mg/d in the first three months, thereafter 15 mg/d).
7. In arms A1 and A2 lenalidomide maintenance will be given for a period of 2 years, in arms B1 and B2 until a CR is reached
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase III
Drug / device / biological / vaccine name(s)PAd (bortezomib/PS341 [Velcade®], doxorubicin [Adriamycin®], dexamethasone), VCD (bortezomib, cyclophosphamide, dexamethasone), melphalan, lenalidomide
Primary outcome measure1. Response to treatment (very good partial remission or better) after induction therapy
2. Progression free survival (i.e., time from randomisation to progression or death from any cause, whichever occurs first)
Patients will be investigated for progression after every treatment phase (induction, HDT, consolidation) and then every 3 months in maintenance treatment and follow up
Secondary outcome measures1. Overall survival defined as time from randomisation to death from any cause. Patients still alive or lost to follow up are censored at the date they were last known to be alive.
2. Response to be measured after induction, after transplantation, after consolidation and during maintenance
2.1. Partial remission (PR)
2.2. Very good partial remission (VGPR)
2.3. Complete remission (CR)
2.4. Molecular complete remission (mCR)
3. Toxicity ([serious] adverse events CTC grade 3 and grade 4, CTC-AE v4.0) related to induction, consolidation and maintenance treatment
4. Progression free survival from HDT (i.e., time from last HDT treatment to progression or death from any cause whichever occurs first)
Overall study start date01/01/2010
Overall study end date01/01/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants504
Participant inclusion criteria1. Confirmed diagnosis of multiple myeloma requiring systemic therapy
2. Measurable disease
3. Age 18 - 70 years inclusive, either sex
Participant exclusion criteria1. Previous chemotherapy or radiotherapy during the past 5 years except local radiotherapy in case of local myeloma progression
2. Severe cardiac dysfunction
3. Significant hepatic dysfunction
4. Patients known to be human immunodeficiency virus (HIV)-positive
5. Patients with active, uncontrolled infections
6. Patients with peripheral neuropathy or neuropathic pain, Common Toxicity Criteria (CTC) grade 2 or higher
7. Patients with a history of active malignancy during the past 5 years
8. Systemic AL amyloidosis
Recruitment start date01/01/2010
Recruitment end date01/01/2016

Locations

Countries of recruitment

  • France
  • Germany

Study participating centre

Universitätsklinikum Heidelberg
Heidelberg
69120
Germany

Sponsor information

Heidelberg University (Germany)
University/education

Im Neuenheimer Feld 672
Heidelberg
69120
Germany

Website http://www.uni-heidelberg.de/index_e.html
ROR logo "ROR" https://ror.org/038t36y30

Funders

Funder type

Industry

Celgene (Eurpope) (ref: RV-MM-GMMG-0423)
Private sector organisation / For-profit companies (industry)
Alternative name(s)
Celgene Corporation
Location
United States of America
Janssen Cilag (Europe) (ref: 26866138MMY3026)

No information available

Chugai (UK)

No information available

The Binding Site (UK)

No information available

University Hospital Heidelberg (Germany)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan