RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which combination chemotherapy regimen is more effective for multiple myeloma. PURPOSE: This randomized phase III trial is comparing two combination chemotherapy regimens to see how well they work in treating patients with stage II or stage III multiple myeloma.
OBJECTIVES: * Compare the partial and complete response rates in patients with multiple myeloma treated with induction therapy comprising idarubicin and dexamethasone vs vincristine, doxorubicin, and dexamethasone. * Compare the disease progression, time to achieve maximal response, and duration of response in patients treated with these 2 regimens. * Compare the quality of life of patients treated with these 2 regimens. OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive oral idarubicin and oral dexamethasone daily on days 1-4. Treatment continues every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients also receive oral dexamethasone daily on days 8-11 during course 1 only. * Arm II: Patients receive oral dexamethasone daily, doxorubicin IV continuously, and vincristine IV continuously on days 1-4. Courses repeat as in arm I. Patients receive additional dexamethasone as in arm I. Patients without a maximal response after completion of course 4 may receive up to 2 additional courses. Quality of life is assessed at baseline and then prior to each study course. Patients are followed for survival. PROJECTED ACCRUAL: A total of 200 patients (100 per arm) will be accrued for this study within 2 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Enrollment
200
Birmingham Heartlands Hospital
Birmingham, England, United Kingdom
Addenbrooke's Hospital at Cambridge University Hospitals NHS Foundation Trust
Cambridge, England, United Kingdom
Royal Liverpool and Broadgreen Hospitals NHS Trust
Liverpool, England, United Kingdom
Comparison of response rates
Time to achieve a maximal response
Duration of response
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New Cross Hospital
Wolverhampton, England, United Kingdom
Centre for Cancer Research and Cell Biology at Belfast City Hospital
Belfast, Northern Ireland, United Kingdom
Aberdeen Royal Infirmary
Aberdeen, Scotland, United Kingdom
Vale Of Leven D G Hospital
Alexandria, Scotland, United Kingdom
Dumfries Royal Infirmary
Dumfries, Scotland, United Kingdom
Ninewells Hospital and Medical School
Dundee, Scotland, United Kingdom
West of Scotland Cancer Centre
Glasgow, Scotland, United Kingdom
...and 2 more locations