This protocol is a national, multicenter, comparative, open-label, randomized trial comparing the progression free survival (PFS) of two pre-transplant conditioning regimens (BUMEL versus. MEL-200). A total of 460 patients will be enrolled in the study. Scheduled evaluations and study visits will take place during the pre-treatment, treatment and follow-up periods. The pre-treatment period includes the screening visit in which participants provide informed consent in writing in order to take part in the study. The patient is then assessed to determine his/her eligibility. The selection process will begin 21 days before the first dose of medication is administered (days -21 to 0). During the treatment period, eligible patients will be included in the study and given six cycles of induction treatment with bortezomib/ lenalidomide / dexamethasone (VRD-GEM). Each cycle will last 28 days, during which SC bortezomib will be administered on days 1, 4, 8 and 11, oral lenalidomide on days 1-21 of each cycle, and oral dexamethasone on days 1-4 and 9-12 of the cycle. After the first three induction cycles, and in the absence of progression or unacceptable toxicity, peripheral blood hematopoietic stem cells will be mobilized and collected using G-CSF for later autologous transplantation. Patients will be randomized in a 1:1 allocation ratio to receive conditioning treatment with MEL-200 versus BUMEL. Randomization will take place at the beginning of the study, once the screening is complete and the patient's eligibility verified. Three months after transplantation, patients will receive two cycles of consolidation treatment with VRD-GEM at the same doses administered during induction treatment. Once the treatment phase is complete, patients will begin the follow-up phase in which they will be visited every three months to evaluate disease progression and survival
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
460
Hospital Son Espases (Son Dureta)
Mallorca, Balearic Islands, Spain
Hospital Son Llátzer
Palma de Mallorca, Balearic Islands, Spain
Hospital Durán i Reynals - ICO L´Hospitalet
L'Hospitalet de Llobregat, Barcelona, Spain
H. Althaia, Xarxa Asistencial de Manresa
Manresa, Barcelona, Spain
Hospital de Gran Canaria Dr. Negrín
Las Palmas de Gran Canaria, Canary Islands, Spain
Progression Free Survival to measure the treatment efficacy
Time frame: 2 years
Complete response rates to measure the treatment efficacy
Time frame: 1 year
Evaluation of minimal residual disease immunofixation negative-CR after each phase of treatment
Time frame: 1 year
Overall survival
Time frame: Time to death
Describe the adverse events to evaluate the safety and tolerability
Time frame: 4 years
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Hospital Esp. de Jerez de la Frontera
Jerez de la Frontera, Cádiz, Spain
Hospital Nuestra Señora del Prado
Talavera de La Reina, Madrid, Spain
Complejo Universitario de Toledo
Toledo, Madrid, Spain
Hospital General de Albacete
Albacete, Spain
Hospital Univ. Fundación de Alcorcón
Alcorcón, Spain
...and 64 more locations