A Randomized Phase III Study Comparing Conventional Dose Treatment Using a Combination of Lenalidomide, Bortezomib and Dexamethasone (RVD) to High-Dose Treatment with Peripheral Stem Cell Transplant in the Initial Management of Myeloma in Patients up to 65 Years of Age
Summary
The purpose of this study is to explore the drug combination, lenalidomide, bortezomib and dexamethasone alone or when combined with autologous stem cell transplantation to see what side effects it may have and how well it works for treatment of newly diagnosed multiple myeloma.
Objective
To compare progression-free survival (PFS) between Arm A (RVD)and Arm B (RVD Auto PSCT)
Prior systemic therapy for MM (localized radiotherapy allowed if at least 7 days before study entry, corticosteroids for the treatment of their myeloma allowed if dose > Primary amyloidosis (AL) or myeloma complicated by amylosis
Receiving any other investigational agents
Known brain metastases
Poor tolerability or allergy to any of the study drugs or compounds of similar composition
Platelet count > ANC > Hemoglobin > Hepatic impairment (>/= 1.5 x institutional upper limit of normal (ULN) or AST (SGOT), ALT (SGPT), or alkaline phosphatase >2 x ULN). Potential participants with benign hyperbilirubinemia are eligible.
Renal insufficiency (serum creatinine >2.0 mg/dl or creatinine clearance > Respiratory compromise (carbon monoxide diffusing capacity (DLCO) > Clinical signs of heart or coronary failure or left ventricular ejection fraction (LVEF) > Intercurrent illness including, but not limited to ongoing or active severe infection, known infection with hepatitis B or C virus, poorly controlled diabetes, severe uncontrolled psychiatric disorder or psychiatric illness/social situations that would limit compliance with study requirements
Previous history of another malignant condition, except for localized cancers that have been adequately treated. This includes completely resected basal cell carcinoma or squamous cell carcinoma of the skin, in situ malignancy, good risk prostate cancer after curative therapy and/or considered appropriate for watchful waiting, and stage I cervical cancer. If invasive malignancy was experienced 2 or more years ago and confirmed as cured, these participants may be considered for the study on case by case basis with principal investigator (PI) discussion.
Inability to comply with an anti-thrombotic treatment regimen
Peripheral neuropathy >/= Grade 2
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