The study objectives of this study are to determine the effects, safety, and pharmacokinetics of bendamustine for multiple myeloma to a regimen of bendamustine and prednisolone.
The study objectives of this study are to determine the effects, safety, and pharmacokinetics of bendamustine for untreated and maladjustment to hematopoietic stem cell transplantation (HSCT) multiple myeloma to a regimen of bendamustine and prednisolone.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
5
SyB L-0501 (150 mg/m2/day) will be administered by intravenous drip infusion for 60 min for 2 consecutive days and the course will be observed for the next 26 days. This is taken as one cycle and administration is repeated for 2-9 cycles (when a plateau is not reached after nine cycles, administration of up to an additional three cycles for a maximum of 12 cycles is possible).
Prednisolone will be administered (60 mg/m2/day) orally for 4 consecutive days and the course will be observed for the next 24 days.
Research site
Nagoya, Aichi-ken, Japan
Research site
Fukuoka, Fukuoka, Japan
Research site
Isehara, Kanagawa, Japan
Complete Response (CR) Rate [Based on the Modified Southwest Oncology Group (SWOG) Criteria]
The proportion of subjects evaluated as CR was calculated. CR (modified SWOG) requires all of the followings: 1. Decline in serum myeloma protein by ≥75% to ≤25 g/L 2. Reduction in 24 h urinary protein by ≥90% to ≤200 mg/24 h 3. No increase in skeletal destruction 4. Serum calcium within normal range 5. No blood transfusion required in the previous 3 months
Time frame: Up to 36 weeks
CR Rate [Based on the International Myeloma Working Group (IMWG) Criteria]
The proportion of subjects evaluated as CR \[strict CR (sCR) + CR\] was calculated. sCR (IMWG): CR as defined below plus Normal FLC ratio and absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence CR (IMWG): Negative immunofixation on the serum and urine and disappearance of any soft tissue plasmacytomas and \<5% plasma cells in bone marrow
Time frame: Up to 36 weeks
Response Rate (Based on the IMWG Criteria)
The proportion of subjects evaluated as response \[sCR + CR + very good partial response (VGPR) + Partial Response (PR)\] was calculated. VGPR (IMWG): Serum and urine M-protein detectable by immunofixation but not on electrophoresis or 90% or greater reduction in serum M-protein plus urine M-protein level \<100mg per 24 h PR (IMWG): ≥50% reduction of serum M-protein and reduction in 24 h urinary M-protein by ≥90% or to \<200mg per 24 h
Time frame: Up to 36 weeks
CR Rate Based on the (Bladé) Criteria
The proportion of subjects evaluated as CR was calculated. CR (Bladé) requires all of the followings: 1. Absence of the original monoclonal paraprotein in serum and urine by immunofixation, maintained for a minimum of 6 weeks. The presence of oligoclonal bands consistent with oligoclonal immune reconstitution does not exclude CR. 2. \<5% plasma cells in a bone marrow aspirate and also on trephine bone biopsy, if biopsy is performed. If absence of monoclonal protein is sustained for 6 weeks it is not necessary to repeat the bone marrow, except in patients with non-secretory myeloma where the marrow examination must be repeated after an interval of at least 6 weeks to confirm CR. 3. No increase in size or number of lytic bone lesions (development of a compression fracture does not exclude response) 4. Disappearance of soft tissue plasmacytomas
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Time frame: Up to 36 weeks
Response Rate (Based on the Bladé Criteria)
The proportion of subjects evaluated as response (CR + PR) was calculated. PR (Bladé) requires 1. or all of the others: 1. Some, but not all, of the criteria for CR are fulfilled 2. ≥50% reduction in the level of the serum monoclonal paraprotein, maintained for a minimum of 6 weeks. 3. Reduction in 24 h urinary light chain excretion either by ≥90% or to \<200 mg, maintained for a minimum of 6 weeks. 4. For patients with non-secretory myeloma only, ≥50% reduction in plasma cells in a bone marrow aspirate and on trephine biopsy, if biopsy is performed, maintained for a minimum of 6 weeks. 5. ≥50% reduction in the size of soft tissue plasmacytomas (by radiography or clinical examination). 6. No increase in size or number of lytic bone lesions (development of a compression fracture does not exclude response).
Time frame: Up to 36 weeks
Response Rate (Based on the Modified SWOG Criteria)
The proportion of subjects evaluated as response (CR + PR) was calculated. PR (SWOG) requires the followings: 1. Decline in myeloma protein of ≥25%-\<74% in serum myeloma protein 2. Reduction in 24h urinary myeloma protein of ≥25%-\<89% 3. No increase in skeletal destruction 4. Serum calcium within normal range
Time frame: Up to 36 weeks
Progression-Free Survival (PFS)
PFS is the period from patient registration to either the date of recurrence, exacerbation, progression or death. Recurrence, exacerbation, progression were assessed from serum M-protein, urine M-protein, serum free light chain (FLC), the percentage of marrow plasma cells, disappearance of clonal plasma cells, plasma cell tumor in soft tissue, and bone lesion.
Time frame: Up to 2 years
Time to Treatment Failure (TTF)
TTF is the period from patient registration to either the date of recurrence, exacerbation, progression, death or discontinuation of treatment.
Time frame: Up to 2 years
Duration of Response (DOR)
DOR is the period from the date of achieving CR or PR to either the date of recurrence, exacerbation, progression or death.
Time frame: Up to 2 years
Overall Survival (OS)
OS is the period from the date of patient registration to the date of death.
Time frame: Up to 2 years
Number of Subjects With Adverse Event, Related Adverse Event, Serious Adverse Event, and Related Serious Adverse Event
Adverse events were evaluated using Common Terminology Criteria for Adverse Events (CTCAE) v4.02, Japan Clinical Oncology Group/Japan Society of Clinical Oncology (JCOG/JSCO) version, and were encoded using Medical Dictionary for Regulatory Activities (MedDRA).
Time frame: Up to 2 years
Number of Adverse Events, Related Adverse Events, Serious Adverse Events, and Related Serious Adverse Events
Adverse events were evaluated using Common Terminology Criteria for Adverse Events (CTCAE) v4.02, Japan Clinical Oncology Group/Japan Society of Clinical Oncology (JCOG/JSCO) version, and were encoded using Medical Dictionary for Regulatory Activities (MedDRA).
Time frame: Up to 2 years
Number of Subjects With Abnormality (Grade ≥3) in Laboratory Test Values
Abnormalities in laboratory test values in overall study period were analyzed. Severity of abnormalities were evaluated using CTCAE. grade 1 : mild grade 2 : moderate grade 3 : severe or medically significant but not immediately life-threatening grade 4 : life threatening or disabling grade 5 : death related to AE
Time frame: Up to 2 years
Number of Abnormalities (Grade ≥3) in Laboratory Test Values
Abnormalities in laboratory test values in overall study period were analyzed. Severity of abnormalities were evaluated using CTCAE.
Time frame: Up to 2 years
Pharmacokinetic Parameters (Cmax)
Plasma pharmacokinetics (Cmax) of unchanged bendamustine
Time frame: On Day 1 only
Pharmacokinetic Parameters (Tmax)
Plasma pharmacokinetics (tmax) of unchanged bendamustine
Time frame: On Day 1 only
Pharmacokinetic Parameters (AUC)
Plasma pharmacokinetics (AUC) of unchanged bendamustine
Time frame: On Day 1 only
Pharmacokinetic Parameters (t1/2)
Plasma pharmacokinetics (t1/2) of unchanged bendamustine
Time frame: On Day 1 only