This phase II trial studies how well ixazomib citrate and lenalidomide after stem cell transplant work in treating patients with newly diagnosed multiple myeloma. Ixazomib citrate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Biological therapies, such as lenalidomide, may stimulate the immune system in different ways and stop cancer cells from growing. Giving ixazomib citrate together with lenalidomide may be effective in treating multiple myeloma.
PRIMARY OBJECTIVES: I. Establish safety and efficacy of oral ixazomib citrate (MLN 9708) and lenalidomide in the maintenance setting post autologous stem cell transplant (ASCT) in myeloma patients. SECONDARY OBJECTIVES: I. Incidence of secondary primary malignancy. II. Evaluate the best response rate (stringent complete response \[sCR\]/near complete response \[nCR\]/very good partial response \[VGPR\]/partial response \[PR\]). III. Evaluate time to progression. IV. Evaluate time to next therapy. V. Evaluate the tolerability and toxicity. VI. Evaluate M. D. Anderson Symptom Inventory (MDASI)-myeloma symptom evaluation. OUTLINE: Beginning 60-180 days post-transplant, patients receive ixazomib citrate orally (PO) on days 1, 8, and 15 and lenalidomide PO on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 30 days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
64
M D Anderson Cancer Center
Houston, Texas, United States
Progression-free Survival
Monitored using the method of Thall et al. Estimated using the Kaplan-Meier method. Log-rank test will be performed to test the difference in time-to-event distributions between patient groups. Cox proportional hazards model will be used to include multiple covariates in the time-to-event analysis.
Time frame: Time from autologous stem cell transplant (ASCT) to time of clinical progression or death or the time of last contact, assessed up to 30 days after completion of study treatment
Best Response Rate (Stringent Complete Response [sCR]/Near Complete Response [nCR]/Very Good Partial Response [VGPR]/Partial Response [PR])
Estimated along with 95% confidence intervals.
Time frame: through out study treatment and up to 30 days after completion of study treatment, up to 119 months
Treatment-related Unmanageable Toxicities, Including Grade 3 Non-hematologic Effects, or Grade 4 Hematologic Effects
Toxicity data will be summarized by frequency tables.
Time frame: throughout study treatment and up to 30 days after completion of study treatment, up to 119 months
Number of Participants Incidence of New Primary Malignancy
Count of participants
Time frame: through out study treatment and up to 30 days after completion of study treatment, up to 119 months
Overall Survival
Estimated using the Kaplan-Meier method. Cox proportional hazards model will be used to include multiple covariates. Log-rank test will be performed to test the difference in time-to-event distributions between patient groups. Cox proportional hazards model will be used to include multiple covariates in the time-to-event analysis.
Time frame: through out study treatment and up to 30 days after completion of study treatment, up to 119 months
M. D. Anderson Symptom Inventory (MDASI)-Myeloma Symptom Evaluation
Analyzed with descriptive analysis. The MDASI-MM scores measure the how severe the symptoms are, so higher scores are considered to be worse patient outcomes. Five subscales are derived from the 26 questions of the MDASI-MM questionnaire: 1. mean core (13 MDASI core symptom items), ranges from 0 to 130. 2. mean severity (13 MDASI core plus 7 MM-specific items), ranges from 0 to 200. 3. mean interference (6 interference items), ranges from 0 to 60. 4. mean WAW (interference with work, general activity, and walking), ranges from 0 to 30. 5. mean REM (interference with relations with people, enjoyment of life, and mood), ranges from 0 to 30. has context menu
Time frame: through out study treatment and up to 30 days after completion of study treatment, up to 119 months
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