Overview

NMP in Relapsed / Refractory Myeloma

Status:
Unknown status
Trial end date:
2019-02-01
Target enrollment:
0
Participant gender:
All
Summary
The study will evaluate if the N-methyl-pyrrolidone (NMP) can be safely administered to humans at doses, which induce measurable immunological and anti-tumour effects in patients with myeloma who are resistant to or intolerant of lenalidomide and bortezomib.
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Peter MacCallum Cancer Centre, Australia
Collaborator:
Melbourne Health
Criteria
Inclusion Criteria:

1. Histologically confirmed diagnosis of plasma cell myeloma defined by WHO 2008 criteria

2. Measurable disease as defined by at least one of:

- serum M protein ≥5g/L

- urine M protein ≥ 200mg/24hrs

- involved serum free light chain ≥ 100mg/L

- measurable (by imaging at the discretion of the investigator) soft tissue
plasmacytoma

3. Relapsed, refractory or intolerant of both bortezomib and lenalidomide

Definitions:

- refractory at least 4 weeks of therapy administered, with less than a partial response
by IMWG criteria

- relapsed from previous response (PR or greater) to therapy, with subsequent disease
progression as defined as development of bone marrow dysfunction (fall in Hb of 20g/L
or platelet count <100 x 109/L) due to increased bone marrow plasmacytosis

- OR new lytic bone lesions

- OR increase in serum M protein of 5g/L

- OR absolute increase of involved serum free light chain of >250mg/L

- intolerant: grade 2 or higher toxicity unresponsive to dose adjustment 4. Prior
autologous stem cell transplant, unless ineligible for transplant by the discretion of
the investigator.

5. age ≥18 years 6. ECOG performance status <2 7. The following values within 7 days
of commencing NMP (blood transfusions prior to study entry are permitted)

- Haemoglobin >80g/L

- Absolute neutrophil count >1.0 x 109/L

- Platelet count ≥ 25 x 109/L

- Creatinine clearance >30ml/min (by Cockcroft/Gault)

- Bilirubin ≤ 3x upper limit of normal (ULN)

- ALT ≤ 3 x ULN

- Left ventricular ejection fraction (LVEF) ≥45% (by gated cardiac blood pool scan or
echocardiography) 9. Life expectancy > 3 months 10. Able to give written informed
consent 11. In the opinion of the investigator, willing and able to comply with
required study procedures 12. Able to take oral medications (no malabsorptive
condition)

Exclusion Criteria:

1. Pregnant or breastfeeding female patients

2. Female of child bearing potential unwilling or unable to use two methods of
contraception

3. Received chemotherapy, immunotherapy or biological therapy within two weeks of
enrolment. Prednisolone up to 20mg per day permitted for non-myeloma indications.

4. Patients with a history of another malignancy within 2 years of the baseline visit,
excluding treated non-melanotic skin cancer and in-situ carcinoma.

5. Patients with known CNS involvement unless previously treated and well controlled for
a period of ≥3 months AND which do not require the use of steroids.

6. Uncontrolled intercurrent illness including, but not limited to:

- Active or uncontrolled infection, including active HIV or viral (A, B or C)
hepatitis. NOTE: Patients with controlled infection on antibiotic or antifungal
therapy are eligible i.e. the patient should be afebrile for at least 72 hours
and be haemodynamically stable.

- Impaired cardiac function, including any of the following:

- Myocardial infarction within previous 3 months prior to starting study

- Symptomatic congestive heart failure (New York Heart Association Class III,
IV)

- Symptomatic coronary artery disease

- Cardiac arrhythmia not controlled by medication

- Clinically significant resting bradycardia (<50 beats per minute)

- Long QT syndrome or a known family history of long QT syndrome or QTc > 450
msec on baseline ECG (using the QTcF formula). If QTcF >450 msec and
electrolytes are not within normal ranges, electrolytes should be corrected
and then the patient re-screened for QTc

- Inability to monitor the QT/QTc interval on ECG

- Other clinically significant uncontrolled heart disease (e.g. unstable
angina or uncontrolled hypertension)

- Impaired hepatic or renal impairment (see inclusion criteria)

- Uncontrolled diarrhoea, nausea or vomiting

7. concomitant exposure to another investigational agent