Discontinuation Study

Trial Title: Discontinuation Study

NCT ID: NCT05866757

Condition: Multiple Myeloma
Cancer
Hematologic Cancer

Conditions: Official terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Hematologic Neoplasms

Conditions: Keywords:
Multiple Myeloma
Cancer

Study type: Interventional

Study phase: N/A

Overall status: Recruiting

Study design:

Allocation: Non-Randomized

Intervention model: Parallel Assignment

Intervention model description: Patients will be divided in the following groups: Group 1: Patients with biochemically detectable disease who have failed to achieve Complete remission (CR) or Very good Partial Remission (VGPR) by IMWG criteria and/or MRD-positive and/or high risk features. They will continue maintenance therapy until disease progression with monitoring every 3 months as per standard of care (SOC), or more often if required. Group 2: Patients in biochemical remission, who meet IMWG criteria for very good partial response (VGPR) or complete response (CR and and sustained MRD (defined as MRD-negative at two time points that are at least 1 year apart) without high risk features This group will be divided in the following subgroups: Subgroup A: Patients who prefer to continue on maintenance therapy. Maintenance will continue until disease progression. Subgroup B: Patients who prefer to discontinue maintenance therapy.

Primary purpose: Other

Masking: None (Open Label)

Intervention:

Intervention type: Other
Intervention name: Discontinuation of maintenance treatment
Description: The discontinuation of maintenance treatment in multiple myeloma. Classed as interventional due to treatment being taken away.
Arm group label: Discontinuation - Group 2 Subgroup B

Summary: An interventional, non-randomised study to assess the risk of progression after discontinuation of maintenance therapy in sustained MRD negative complete remission by flow cytometry MM patients without high-risk features who have completed at least two years of maintenance therapy or who have discontinued maintenance due to side effects. The primary endpoint is to assess the rates of sustained MRD negativity by NGF in the bone marrow at 12 months after discontinuation of maintenance therapy.

Detailed description: Up to 70 patients over 18 years of age who have a diagnosis of Multiple Myeloma and have completed at least 2 years of lenalidomide maintenance therapy. Participants would be divided in two groups: Group 1. Patients with detectable disease who have not achieved CR or VGPR as per IMWG criteria and/or detectable MRD and/or high risk features detectable disease, failed to achieve Complete Remission (CR) or Very Good Partial Remission (VGPR) continuing on maintenance therapy. Group 2. Patients who meet International Myeloma working Group (IMWG) criteria for very good partial response (VGPR) or complete response (CR). Patients who have achieved sustained MRD negative remission by next generation flow cytometry (NGF),defined by IMWG as MRD-negative at two time points that are at least 1 year apart, To the participants in this group will be offered to discontinue maintenance therapy, and it will be further divided in the following subgroups: Subgroup A) Patients who are willing to continue maintenance therapy. Subgroup B) Patients who are willing to discontinue maintenance therapy and continue monitoring. This subgroup will also include patients who have discontinued maintenance therapy earlier than 2 years due to side effects but also achieved sustained MRD negative CR might be also included. The number of the study participants will be limited by the number of patients treated in Cork University Hospital who are meeting inclusion criteria.

Criteria for eligibility:
Criteria:
Inclusion Criteria: 1. 18 years of age or over 2. Patient with diagnosis of multiple myeloma as per IMWC in first line of treatment (induction, consolidation, ASCT, maintenance is considered single line therapy for the purpose of this study, also discontinuation of 1 maintenance regimen due to toxicity and start of another is considered single line therapy for the purpose of this study). 3. Received at least 2 years of maintenance therapy, defined as any anti-myeloma therapy to prevent disease recurrence and prolong time in remission 4. Patients who have discontinued maintenance therapy earlier than 2 years due to side effects but also achieved sustained MRD negative CR might be also included 5. Patients must be able to understand and be willing to sign a voluntary informed consent form and agree to compliance with the protocol schedule, with the knowledge that they may withdraw consent at any time without impact on future medical care. Exclusion Criteria: 1. Patients who have received more than one line of therapy (induction, consolidation, ASCT, maintenance is considered single line therapy for the purpose of this study, also discontinuation of 1 maintenance regimen due to toxicity and start of another is considered single line therapy for the purpose of this study) or patients who have not completer two years of maintenance therapy, unless maintenance was discontinued voluntarily and the patient has achieved sustainable MRD negative remission.. 2. Patients with plasma cell disorders other than MM: lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, AL amyloidosis, POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, and Skin changes), etc... 3. Prior organ transplant or condition requiring immunosuppressive therapy. 4. Prior allogenic haematopoietic cell transplant 5. Treatment with any investigational therapy that does not include maintenance as a part of the treatment strategy. 6. Unable to sign an informed consent form.

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: Cork University Hospital

Address:
City: Cork
Country: Ireland

Status: Recruiting

Contact:
Last name: Dr Vitaliy Mykytiv

Phone: 00353214922000
Email: vitaliy.mykytiv@hse.ie

Investigator:
Last name: Vitaliy Mykytiv
Email: Principal Investigator

Start date: August 28, 2023

Completion date: August 2025

Lead sponsor:
Agency: University College Cork
Agency class: Other

Collaborator:
Agency: Cancer Research@UCC
Agency class: Other

Source: University College Cork

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT05866757