Study Comparing Carfilzomib, Lenalidomide, and Dexamethasone (CRd) vs Lenalidomide and Dexamethasone (Rd) in Subjects With Relapsed Multiple Myeloma

Trial ID or NCT#



not recruiting iconNOT RECRUITING


The primary objective was to compare progression-free survival in adults with relapsed multiple myeloma who are receiving CRd vs participants receiving Rd in a randomized multicenter setting.

Official Title

A Randomized, Multicenter, Phase 3 Study Comparing Carfilzomib, Lenalidomide, and Dexamethasone (CRd) vs Lenalidomide and Dexamethasone (Rd) in Subjects With Relapsed Multiple Myeloma

Eligibility Criteria

Ages Eligible for Study: Older than 18 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: No
Inclusion Criteria:
  1. 1. Symptomatic multiple myeloma2. Measurable disease, as defined by one or more of the following (assessed within 21 days prior to randomization):
    1. * Serum M-protein ≥ 0.5 g/dL * Urine Bence-Jones protein ≥ 200 mg/24 hours * For immunoglobulin A (IgA) patients whose disease can only be reliably measured by serum quantitative immunoglobulin (qIgA) ≥ 750 mg/dL (0.75 g/dL)3. Prior treatment with at least one, but no more than three, regimens for multiple myeloma4. Documented relapse or progressive disease on or after any regimen5. Achieved a response to at least one prior regimen6. Age ≥ 18 years7. Life expectancy ≥ 3 months8. Eastern Cooperative Oncology Group (ECOG) performance status 0-29. Adequate hepatic function, with serum alanine aminotransferase (ALT) ≤ 3.5 times the upper limit of normal and serum direct bilirubin ≤ 2 mg/dL (34 µmol/L) within 21 days prior to randomization10. Absolute neutrophil count ≥ 1.0 × 10\^9/L within 21 days prior to randomization11. Hemoglobin ≥ 8 g/dL (80 g/L) within 21 days prior to randomization12. Platelet count ≥ 50 × 10\^9/L (≥ 30 × 10\^9/L if myeloma involvement in the bone marrow is \> 50%) within 21 days prior to randomization13. Creatinine clearance (CrCl) ≥ 50 mL/minute within 21 days prior to randomization14. Written informed consent in accordance with federal, local, and institutional guidelines15. Females of childbearing potential must agree to ongoing pregnancy testing and to practice contraception16. Male subjects must agree to practice contraception
Exclusion Criteria:
  1. 1. If previously treated with bortezomib (alone or in combination), progression during treatment2. If previously treated with a lenalidomide and dexamethasone (len/dex) combination:
    1. * Progression during the first 3 months of initiating treatment * Any progression during treatment if the len/dex combination was the subject's most recent line of therapy3. Discontinuation of previous lenalidomide or dexamethasone due to intolerance; subjects intolerant to bortezomib are not excluded4. Prior carfilzomib treatment5. POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)6. Waldenström's macroglobulinemia or IgM myeloma7. Plasma cell leukemia (\> 2.0 × 10\^9/L circulating plasma cells by standard differential)8. Chemotherapy or investigational agent within 3 weeks prior to randomization or antibody therapy within 6 weeks prior to randomization9. Radiotherapy to multiple sites or immunotherapy/antibody therapy within 28 days prior to randomization; localized radiotherapy to a single site within 7 days prior to randomization10. Corticosteroid therapy at a dose equivalent to dexamethasone \> 4 mg/day within 21 days prior to randomization11. Pregnant or lactating females12. Major surgery within 21 days prior to randomization13. Acute active infection requiring treatment (systemic antibiotics, antivirals, or antifungals) within 14 days prior to randomization14. Known human immunodeficiency virus infection15. Active hepatitis B or C infection16. Myocardial infarction within 4 months prior to randomization, New York Hear Association (NYHA) Class III or IV heart failure, uncontrolled angina, history of severe coronary artery disease, severe uncontrolled ventricular arrhythmias, sick sinus syndrome, or electrocardiographic evidence of acute ischemia or Grade 3 conduction system abnormalities unless subject has a pacemaker17. Uncontrolled hypertension or uncontrolled diabetes within 14 days prior to randomization18. Other malignancy, including myelodysplastic syndromes (MDS), within the past 3 years with the exception of a) adequately treated basal cell carcinoma, squamous cell skin cancer, or thyroid cancer; b) carcinoma in situ of the cervix or breast; c) prostate cancer of Gleason Grade 6 or less with stable prostate-specific antigen levels; or d) cancer considered cured by surgical resection or unlikely to impact survival during the duration of the study, such as localized transitional cell carcinoma of the bladder or benign tumors of the adrenal or pancreas19. Significant neuropathy (Grades 3-4, or Grade 2 with pain) within 14 days prior to randomization20. Known history of allergy to Captisol® (a cyclodextrin derivative used to solubilize carfilzomib)21. Contraindication to any of the required concomitant drugs or supportive treatments, including hypersensitivity to all anticoagulation and antiplatelet options, antiviral drugs, or intolerance to hydration due to preexisting pulmonary or cardiac impairment22. Ongoing graft-vs-host disease23. Subjects with pleural effusions requiring thoracentesis or ascites requiring paracentesis within 14 days prior to randomization24. Any other clinically significant medical disease or condition that, in the Investigator's opinion, may interfere with protocol adherence or a subject's ability to give informed consent


Caroline Berube
Caroline Berube
Clinical Associate Professor, Medicine - Hematology
Jason Gotlib
Professor of Medicine (Hematology)

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