FeAsiBility of a Treatment Free Interval in Newly Diagnosed MM Patients Treated With Daratumumab-lenalidomide-dexamethasone (HOVON174MM)

Официальное название

FeAsiBility of a Treatment Free Interval in Newly Diagnosed mUltiple myeLOma Patients Treated With DaratumUmab-Lenalidomide-DexamethaSone- the FABULOUS Study. A Nationwide Open-label Randomized Phase III Clinical Trial Comparing Daratumumab-lenalidomide-dexamethasone Continuously Versus Including a Treatment Free Interval

Обзор

In the Netherlands, the standard treatment for multiple myeloma is a combination of different medicines named daratumumab-lenalidomide-dexamethasone, abbreviated as Dara-Rd. In many patients this treatment results in suppressing the disease for a long time. The treatment is continued until it is not effective anymore and the disease progresses. But until now it is unknown whether continuous therapy also leads to prolonging life. In addition, there are concerns about side effects, leading to a reduced quality of life, the development of severe toxicity that remains, which hampers subsequent therapy, and high costs due to prolonged treatment. There are indications that temporarily stopping treatment is safe, leading to fewer side effects and allows recovering from toxicity or damage due to treatment. This may improve the quality of life.

Вмешательства

• Препарат Daratumumab Injection
  Patients who have been treated with 12 cycles of Daratumumab-Lenalidomide-Dexamethasone (Dara-Rd) will be randomized between Arm A (continuous therapy) and Arm B (treatment free interval)
• Препарат Dexamethasone
  Patients who have been treated with 12 cycles of Daratumumab-Lenalidomide-Dexamethasone (Dara-Rd) will be randomized between Arm A (continuous therapy) and Arm B (treatment free interval)
• Препарат Lenalidomide capsule
  Patients who have been treated with 12 cycles of Daratumumab-Lenalidomide-Dexamethasone (Dara-Rd) will be randomized between Arm A (continuous therapy) and Arm B (treatment free interval)

Первичные конечные точки

• Compare Event-Free Survival (EFS) [Срок оценки: Approximately up to 57 (EFS) months after randomization of the first patient]
• Compare Progression Free Survival (PFS) [Срок оценки: Approximately up to 69 (PFS) months after randomization of the first patient]

Вторичные конечные точки (12)

• Compare adverse event burden [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare patient-reported outcome measures (PROMs) [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare cost-effectiveness between arms [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Determine the length of the treatment-free interval [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Determine time to (maximal) response response [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare time to next treatment [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare time from randomization to progression on second-line therapy [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare Overall Survival [Срок оценки: Approximately up to 69 months after randomization of the last patient]
• Compare the discontinuation rate [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Evaluate cumulative doses [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare dose reductions [Срок оценки: Approximately up to 69 months after randomization of the first patient]
• Compare toxicity [Срок оценки: Approximately up to 69 months after randomization of the first patient]

Критерии участия

Критерии включения

• Patient was diagnosed with MM, based on the IMWG criteria, and measurable disease at the time of diagnosis (appendix A).
• Age ≥ 18 years.
• Patient was treated with 12 cycles (13 cycles is accepted) of Dara-Rd and will continue treatment with Dara-Rd. Reduced dosing of lenalidomide, but not to less than 5 mg, and previous discontinuation or dose reduction of dexamethasone is allowed.
• Partial response or better after treatment with 12 cycles of Dara-Rd, without signs of biochemical progression.
• ANC ≥ 1.0x109/L and platelets ≥ 75x109/L.
• Patient is capable of giving informed consent.
• Written informed consent.

Критерии исключения

• Patient with non-secretory MM at diagnosis of the disease, i.e., before the start of treatment with Dara-Rd.
• Patient in whom a plasmacytoma was the only measurable parameter at diagnosis of the disease, i.e., before the start of treatment with Dara-Rd.
• Patient in whom urine M-protein was the only measurable parameter at diagnosis of the disease, i.e., before the start of treatment with Dara-Rd.
• Patient in whom treatment with daratumumab, lenalidomide or both has been discontinued for whatever reason (patients may only have discontinued dexamethasone).
• Patient in whom continuation of treatment with Dara-Rd is deemed not feasible because of medical reasons.
• Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Нидерланды · 38 центров

• NL-Den Bosch-JBZ — 's-Hertogenbosch
• NL-Almere-FLEVOZIEKENHUIS — Almere Stad
• NL-Amersfoort-MEANDERMC — Amersfoort
• NL-Amsterdam- UMC — Amsterdam
• NL-Amsterdam-AmsterdamUMC — Amsterdam
• NL-Apeldoorn-GELREAPELDOORN — Apeldoorn
• NL-Arnhem-RIJNSTATE — Arnhem
• NL-Assen-WZA — Assen
• … и ещё 30 центров

Идентификаторы

NCT: NCT06187441 · HO174 · 2023-508586-33-00

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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