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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT02181413




Registration number
NCT02181413
Ethics application status
Date submitted
27/06/2014
Date registered
4/07/2014
Date last updated
19/11/2024

Titles & IDs
Public title
A Study of Oral Ixazomib Citrate (MLN9708) Maintenance Therapy in Participants With Multiple Myeloma Following Autologous Stem Cell Transplant
Scientific title
A Phase 3, Randomized, Placebo-Controlled, Double-Blind Study of Oral Ixazomib Citrate (MLN9708) Maintenance Therapy in Patients With Multiple Myeloma Following Autologous Stem Cell Transplant
Secondary ID [1] 0 0
U1111-1155-8695
Secondary ID [2] 0 0
C16019
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Multiple Myeloma 0 0
Autologous Stem Cell Transplant 0 0
Condition category
Condition code
Cancer 0 0 0 0
Other cancer types

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Ixazomib Citrate
Treatment: Drugs - Placebo

Placebo comparator: Placebo - Ixazomib citrate placebo-matching capsules, orally, once on Days 1, 8 and 15 in a 28-day cycle for Cycles 1 through 26 until PD, unacceptable toxicity, or discontinuation for alternate reasons.

Experimental: Ixazomib Citrate - Ixazomib citrate 3 mg, capsules, orally, once, on Days 1, 8 and 15 in a 28-day cycle for Cycles 1 through 4. Ixazomib citrate 4 mg, capsules, orally, once, on Days 1, 8 and 15 in a 28-day cycle for Cycles 5 through 26 until PD, unacceptable toxicity, or discontinuation for alternate reasons. Participants who have had any dose reductions due to adverse events (AEs) would not be dose escalated.


Treatment: Drugs: Ixazomib Citrate
Ixazomib citrate capsules

Treatment: Drugs: Placebo
Ixazomib citrate placebo-matching capsules
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Progression Free Survival (PFS)
Timepoint [1] 0 0
Randomization up to End of treatment (EOT) (24 months); thereafter followed up every 4 weeks (up to 45 months)
Secondary outcome [1] 0 0
Overall Survival (OS)
Timepoint [1] 0 0
Randomization up to end of follow up period (up to 107 months)
Secondary outcome [2] 0 0
Percentage of Participants With Any Best Response Category Before PD or Subsequent Therapy
Timepoint [2] 0 0
Randomization up to EOT (up to 24 months) and thereafter every 4 weeks until initiation of the next line of therapy (up to 107 months)
Secondary outcome [3] 0 0
Time to Progression (TTP)
Timepoint [3] 0 0
Randomization up to PD (up to 107 months)
Secondary outcome [4] 0 0
Second Progression Free Survival (PFS2)
Timepoint [4] 0 0
Randomization up to EOT (24 months); thereafter followed up every 4 weeks until initiation of next-line therapy and then every 12 weeks until second progressive disease (PD2) or death (up to 107 months)
Secondary outcome [5] 0 0
Time to Start of the Next Line of Therapy
Timepoint [5] 0 0
Randomization up to 107 months
Secondary outcome [6] 0 0
Time to End of the Next Line of Therapy
Timepoint [6] 0 0
Randomization up to 107 months
Secondary outcome [7] 0 0
Duration of the Next Line of Therapy
Timepoint [7] 0 0
Up to 107 months
Secondary outcome [8] 0 0
Percentage of Participants Who Develop a New Primary Malignancy
Timepoint [8] 0 0
Up to 107 months
Secondary outcome [9] 0 0
Number of Participants With Conversion to Minimal Residual Disease (MRD) Negative
Timepoint [9] 0 0
Baseline up to EOT (up to 24 months)
Secondary outcome [10] 0 0
Number of Participants With Maintenance of MRD Negativity
Timepoint [10] 0 0
Up to EOT (up to 24 months)
Secondary outcome [11] 0 0
Correlation Between MRD Status and Progression Free Survival (PFS)
Timepoint [11] 0 0
From randomization up to 107 months
Secondary outcome [12] 0 0
Correlation Between MRD Status and Overall Survival (OS)
Timepoint [12] 0 0
From randomization up to 107 months
Secondary outcome [13] 0 0
OS Benefits in a High-Risk Population
Timepoint [13] 0 0
Randomization up to 107 months
Secondary outcome [14] 0 0
PFS Benefits in a High-Risk Population
Timepoint [14] 0 0
Randomization up to 107 months
Secondary outcome [15] 0 0
Change From Baseline in Eastern Cooperative Oncology Group (ECOG) Performance Status Score
Timepoint [15] 0 0
Baseline up to EOT (up to Month 24)
Secondary outcome [16] 0 0
Number of Participants Who Experience at Least One Treatment Emergent Adverse Event (TEAE) or Serious Adverse Events (SAEs)
Timepoint [16] 0 0
Up to 107 months
Secondary outcome [17] 0 0
Number of Participants With Markedly Abnormal Clinical Laboratory Values Reported as TEAEs
Timepoint [17] 0 0
Up to 107 months
Secondary outcome [18] 0 0
Change From Baseline in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) Domain Score
Timepoint [18] 0 0
Baseline up to EOT (up to Month 24)
Secondary outcome [19] 0 0
Plasma Concentration of Ixazomib
Timepoint [19] 0 0
Day 1 of Cycle 1: 1 hour and 4 hours post-dose; Predose on Days 8 and 15 of Cycle 1, Days 1 and 8 of Cycle 2, Day 1 of Cycles 3 through 10 (each cycle length= 28 days)
Secondary outcome [20] 0 0
Time to Resolution of Peripheral Neuropathy (PN) Events
Timepoint [20] 0 0
Up to 107 months
Secondary outcome [21] 0 0
Time to Improvement of PN Events
Timepoint [21] 0 0
Up to 107 months

Eligibility
Key inclusion criteria
1. Adult male or female participants 18 years or older with a confirmed diagnosis of symptomatic multiple myeloma according to standard criteria.
2. Documented results of cytogenetics/ fluorescence in situ hybridization (FISH) obtained at any time before transplant, and International Staging System (ISS) staging at the time of diagnosis available.
3. Underwent standard of care (SOC) induction therapy (induction therapy must include proteasome inhibitor (PI) and/or immunomodulating drugs (IMiD)-based regimens as primary therapy for multiple myeloma), followed by a single autologous stem cell transplant (ASCT) with a high-dose melphalan (200 mg/m^2) conditioning regimen, within 12 months of diagnosis. Vincristine, Adriamycin [doxorubicin], and dexamethasone (VAD) is not an acceptable induction therapy for this trial.
4. Started screening no earlier than 75 days after transplant, completed screening within 15 days, and randomized no later than 115 days after transplant.
5. Must have not received post-ASCT consolidation therapy.
6. Documented response to ASCT (PR, VGPR, CR/stringent complete response [sCR]) according to IMWG criteria.
7. ECOG performance status of 0 to 2.
8. Female participants who:

* If they are of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 90 days after the last dose of study drug, AND
* Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods for the female partner] and withdrawal are not acceptable methods of contraception.) Male participants, even if surgically sterilized (ie, status postvasectomy), who:
* Agree to practice effective barrier contraception during the entire study treatment period and through 90 days after the last dose of study drug, AND
* Must also adhere to the guidelines of any treatment-specific pregnancy prevention program, if applicable, OR
* Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods for the female partner] and withdrawal are not acceptable methods of contraception.)
9. Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the participant at any time without prejudice to future medical care.
10. Suitable venous access for the study-required blood sampling.
11. Is willing and able to adhere to the study visit schedule and other protocol requirements.
12. Must meet the following clinical laboratory criteria at study entry:

* Absolute neutrophil count (ANC) = 1,000 per cubic milliliter (/mm^3) and platelet count = 75,000/mm^3. Platelet transfusions to help participants meet eligibility criteria are not allowed within 3 days before randomization.
* Total bilirubin = 1.5 * the upper limit of the normal range (ULN).
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = 3 * ULN.
* Calculated creatinine clearance = 30 milliliter per minute (mL/min).
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Multiple myeloma that has relapsed following primary therapy or is not responsive to primary therapy. For this study, stable disease following ASCT will be considered nonresponsive to primary therapy.
2. Double (tandem) ASCT.
3. Radiotherapy within 14 days before the first dose of study drug.
4. Diagnosed or treated for another malignancy within 5 years before randomization or previously diagnosed with another malignancy with evidence of residual disease. Participants with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
5. Female participants who are lactating and breastfeeding or have a positive serum pregnancy test during the Screening period.
6. Major surgery within 14 days before randomization.
7. Central nervous system involvement.
8. Infection requiring intravenous (IV) antibiotic therapy or other serious infection within 14 days before randomization.
9. Diagnosis of Waldenstrom's macroglobulinemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, plasma cell leukemia, primary amyloidosis, myelodysplastic syndrome, or myeloproliferative syndrome.
10. Evidence of current uncontrolled cardiovascular conditions, including uncontrolled hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure, unstable angina, or myocardial infarction within the past 6 months.
11. Systemic treatment with strong cytochrome P450 3A (CYP3A) inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of Ginkgo biloba or St. John's wort within 14 days before randomization in the study.
12. Active hepatitis B or C virus infection, or known human immunodeficiency virus (HIV) positive.
13. Comorbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the participant inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens (eg, peripheral neuropathy that is Grade 1 with pain or Grade 2 or higher of any cause).
14. Psychiatric illness/social situation that would limit compliance with study requirements.
15. Known allergy to any of the study medications, their analogues, or excipients in the various formulations of any agent.
16. Inability to swallow oral medication, inability or unwillingness to comply with the drug administration requirements, or gastrointestinal (GI) procedure that could interfere with the oral absorption or tolerance of treatment.
17. Treatment with any investigational products within 60 days before the first dose of the study drug regimen.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
16/07/2014
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
8/09/2023
Sample size
Target
Accrual to date
Final
656
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
Recruitment hospital [1] 0 0
St George Hospital - Kogarah
Recruitment hospital [2] 0 0
Calvary Mater Newcastle - Waratah
Recruitment hospital [3] 0 0
Westmead Hospital - Westmead
Recruitment hospital [4] 0 0
Icon Cancer Care South Brisbane - South Brisbane
Recruitment hospital [5] 0 0
Gold Coast University Hospital - Southport
Recruitment hospital [6] 0 0
Royal Adelaide Hospital - Adelaide
Recruitment hospital [7] 0 0
The Queen Elizabeth Hospital - Woodville South
Recruitment hospital [8] 0 0
Austin Health - Heidelberg
Recruitment hospital [9] 0 0
The Alfred Hospital - Melbourne
Recruitment postcode(s) [1] 0 0
2217 - Kogarah
Recruitment postcode(s) [2] 0 0
2298 - Waratah
Recruitment postcode(s) [3] 0 0
2145 - Westmead
Recruitment postcode(s) [4] 0 0
4101 - South Brisbane
Recruitment postcode(s) [5] 0 0
4215 - Southport
Recruitment postcode(s) [6] 0 0
5000 - Adelaide
Recruitment postcode(s) [7] 0 0
5011 - Woodville South
Recruitment postcode(s) [8] 0 0
3084 - Heidelberg
Recruitment postcode(s) [9] 0 0
3004 - Melbourne
Recruitment outside Australia
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United States of America
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Arkansas
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United States of America
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Minnesota
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New York
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West Virginia
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Argentina
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Buenos Aires
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Santa Fe
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Argentina
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Ciudad Autonoma de Buenos Aires
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Sachsen
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Hamburg
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Hannover
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Ludwigshafen
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Tubingen
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Greece
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Attiki
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Athens
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Greece
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Thessaloniki
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Budapest
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Debrecen
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Nahariya
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Petach Tikva
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Ramat-Gan
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Israel
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Rehovot
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Israel
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Safed
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Israel
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Tel Aviv
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Israel
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Tzrifin
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Abruzzo
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Lazio
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Italy
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Lombardia
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Italy
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Marche
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Piemonte
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Italy
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Potenza
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Umbria
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Bologna
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Brescia
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Firenze
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Genova
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Meldola
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Nagoya
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Tachikawa
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Incheon
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Oslo
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Stavanger
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Mazowieckie
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Slaskie
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Brzozow
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Lodz
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Braga
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Coimbra
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Barcelona
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Navarra
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Madrid
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Murcia
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Spain
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Salamanca
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Spain
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Sevilla
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Sweden
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Skane Lan
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Sweden
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Vastra Gotalands Lan
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Sweden
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Stockholm
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Sweden
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Uppsala
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Switzerland
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Basel-Stadt (de)
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Switzerland
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Zurich (de)
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Kaohsiung
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Taiwan
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Taipei
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Taiwan
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Taoyuan City
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Country [155] 0 0
United Kingdom
State/province [155] 0 0
Hampshire
Country [156] 0 0
United Kingdom
State/province [156] 0 0
London, City Of
Country [157] 0 0
United Kingdom
State/province [157] 0 0
Oxfordshire
Country [158] 0 0
United Kingdom
State/province [158] 0 0
Surrey
Country [159] 0 0
United Kingdom
State/province [159] 0 0
Yorkshire
Country [160] 0 0
United Kingdom
State/province [160] 0 0
Leicester
Country [161] 0 0
United Kingdom
State/province [161] 0 0
London
Country [162] 0 0
United Kingdom
State/province [162] 0 0
Swansea

Funding & Sponsors
Primary sponsor type
Commercial sector/industry
Name
Takeda
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to determine the effect of ixazomib citrate maintenance therapy on progression-free survival (PFS), compared to placebo, in participants with newly diagnosed multiple myeloma (NDMM) who have had a response (complete response \[CR\], very good partial response \[VGPR\], or partial response \[PR\]) to induction therapy followed by high-dose therapy (HDT) and autologous stem cell transplant (ASCT).
Trial website
https://clinicaltrials.gov/study/NCT02181413
Trial related presentations / publications
Kaiser M, Beksac M, Gulbrandsen N, Schjesvold F, Hajek R, Moreau P, de Arriba de la Fuente F, Mateos MV, West S, Spencer A, Rajkumar SV, Suryanarayan K, Czorniak M, Li C, Teng Z, Labotka R, Dimopoulos MA. Adverse event management in the TOURMALINE-MM3 study of post-transplant ixazomib maintenance in multiple myeloma. Ann Hematol. 2020 Aug;99(8):1793-1804. doi: 10.1007/s00277-020-04149-5. Epub 2020 Jul 1. Erratum In: Ann Hematol. 2021 Jan;100(1):297-302. doi: 10.1007/s00277-020-04302-0.
Schjesvold F, Goldschmidt H, Maisnar V, Spicka I, Abildgaard N, Rowlings P, Cain L, Romanus D, Suryanarayan K, Rajkumar V, Odom D, Gnanasakthy A, Dimopoulos M. Quality of life is maintained with ixazomib maintenance in post-transplant newly diagnosed multiple myeloma: The TOURMALINE-MM3 trial. Eur J Haematol. 2020 May;104(5):443-458. doi: 10.1111/ejh.13379. Epub 2020 Feb 22.
Dimopoulos MA, Gay F, Schjesvold F, Beksac M, Hajek R, Weisel KC, Goldschmidt H, Maisnar V, Moreau P, Min CK, Pluta A, Chng WJ, Kaiser M, Zweegman S, Mateos MV, Spencer A, Iida S, Morgan G, Suryanarayan K, Teng Z, Skacel T, Palumbo A, Dash AB, Gupta N, Labotka R, Rajkumar SV; TOURMALINE-MM3 study group. Oral ixazomib maintenance following autologous stem cell transplantation (TOURMALINE-MM3): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet. 2019 Jan 19;393(10168):253-264. doi: 10.1016/S0140-6736(18)33003-4. Epub 2018 Dec 10.
Public notes

Contacts
Principal investigator
Name 0 0
Study Director
Address 0 0
Takeda
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/study/NCT02181413