Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Published Results
Trial Contact Information
Registry Information

Alternate Title

Thalidomide, Dexamethasone, and Clarithromycin in Treating Patients Who Have Undergone a Previous Autologous or Syngeneic Bone Marrow or Stem Cell Transplant for Multiple Myeloma

Basic Trial Information

Phase	Type	Status	Age	Sponsor	Protocol IDs
Phase II	Treatment	Closed	Not specified	NCI, Pharmaceutical / Industry	FHCRC-1767.00 5589, CELGENE-FHCRC-1767.00, NCT00182663

Objectives

1. Determine the toxicity of maintenance therapy comprising thalidomide, dexamethasone, and clarithromycin in patients with multiple myeloma who have undergone prior autologous or syngeneic bone marrow or peripheral blood stem cell transplantation.
2. Determine the median time to disease progression in patients treated with this regimen.
3. Determine overall survival and disease-free survival of patients treated with this regimen.

Entry Criteria

Disease Characteristics:

• Diagnosis of multiple myeloma
  • Any stage disease



• Has undergone prior high-dose (i.e., ≥ 140 mg/m²) melphalan therapy and autologous or syngeneic bone marrow or peripheral blood stem cell transplantation within the past 30-120 days

Prior/Concurrent Therapy:

Biologic therapy

• See Disease Characteristics
• Recovered from prior autologous or syngeneic bone marrow or peripheral blood stem cell transplantation
• Combination therapy with thalidomide, clarithromycin, and steroids prior to transplantation allowed provided disease responded to the combination therapy

Chemotherapy

• See Disease Characteristics

Endocrine therapy

• See Biologic therapy

Radiotherapy

• Not specified

Surgery

• Not specified

Other

• No prior or concurrent participation on another transplant clinical trial that has evaluated (or is evaluating) disease-free survival or overall survival
• No other concurrent anticancer therapy

Patient Characteristics:

Age

• Not specified

Performance status

• Karnofsky 70-100%

Life expectancy

• Not specified

Hematopoietic

• Platelet count > 50,000/mm³ (transfusion independent)
• Absolute granulocyte count > 1,500/mm³ (for 5 calendar days after recovery from high-dose melphalan therapy)

Hepatic

• SGOT or SGPT ≤ 2.5 times upper limit of normal
• Bilirubin ≤ 2 mg/mL (unless due to Gilbert's disease)

Renal

• Not specified

Cardiovascular

• No history of myocardial infarction
• No history of deep vein thrombosis
• No history of arterial occlusions
• LVEF ≥ 45%
• No congestive heart disease
• No coronary artery disease

Pulmonary

• No history of pulmonary emboli

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile female patients must use effective contraception for ≥ 4 weeks before, during, and for ≥ 4 weeks after the completion of study treatment (during and for 4 weeks after the completion of study treatment for male patients)
• No blood, ova, or sperm donation during study treatment
• No history of seizures
• No allergy to any study drugs
• No untreated systemic infection

Expected Enrollment

A total of 30 patients will be accrued for this study within 2-3 years.

Outcomes

Toxicity
Median time to disease progression
Survival

Outline

Patients receive oral thalidomide once daily, oral dexamethasone once weekly, and oral clarithromycin twice daily for up to 1 year in the absence of disease progression or unacceptable toxicity. After completion of 1 year of treatment, patients discontinue oral clarithromycin, receive tapering doses of oral dexamethasone once weekly for 8 weeks, and continue to receive oral thalidomide once daily in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically.

Holmberg LA, Brandvold A, Bensinger W I: Maintenance therapy with low dose thalidomide, dexamethasone and clarithromycin (biaxin) (BLT-D) following autologous transplant (ASCT) for multiple myeloma (MM). [Abstract] Blood 108 (11): A-5442, 2006.

Trial Contact Information

Trial Lead Organizations

Fred Hutchinson Cancer Research Center

Leona Holmberg, MD, PhD, Principal investigator		Ph: 206-667-6447 Email: lholmber@fhcrc.org

Registry Information
Official Title		Maintenance Therapy with Thalidomide, Dexamethasone and Clarithromycin (Biaxin) Following Autologous/Syngeneic Transplant for Multiple Myeloma
Trial Start Date		2003-06-09
Trial Completion Date		2018-10-09 (estimated)
Registered in ClinicalTrials.gov		NCT00182663
Date Submitted to PDQ		2005-07-05
Information Last Verified		2008-10-21
NCI Grant/Contract Number		CA15704

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