Phase II study of Bortezomib, Adriamycin and Dexamethasone (PAD) therapy for previously untreated patients with multiple myeloma: Impact of minimal residual disease (MRD) in patients with deferred ASCT.
Description
Design:
PADIMAC is non-randomised, single arm, multicentre phase II trial evaluating the safety of multiple myeloma patients that have achieved a Complete Response (CR) or Very Good Partial Response (VGPR) post induction therapy on the Bortezomib, Adriamycin and Dexamethasone (PAD) regimen not proceeding to have an Autologous Stem Cell Transplant (ASCT).
Treatment:
Previously untreated multiple myeloma patients will receive PAD (4-6 21 day cycles). After PAD therapy, patients with less than a partial response (PR) will be offered salvage treatment before proceeding to autologous stem cell transplant (ASCT). Patients achieving PR will undergo peripheral blood stem cell harvest (PBSCH) and proceed to High Dose Therapy (HDT) and ASCT. Patients in complete response (CR) or very good partial response (VGPR) will undergo PBSCH and will receive no further treatment. These patients will be offered ASCT at relapse, if appropriate.
Key inclusion/exclusion criteria:
Inclusion
- Previously untreated patients with symptomatic myeloma
- Suitable for high dose therapy and ASCT
- Age ≥18 years
- ECOG 0-3
- Measurable disease
- Adequate hepatic, renal and haematological function
- Adequate pulmonary function
- Cardiac ejection fraction 40% by echocardiography or MUGA scan
Exclusion
- Grade 2 or worse peripheral neuropathy or neuropathic pain
- Known allergy contributable to compounds containing boron or mannitol
- Active infection with HIV, hepatitis B or C
- Pregnant or lactating women
Duration of recruitment:
2 years
Aim
The overall aim of the trial is to provide a reliable estimate of the 2-year progression free survival for patients who receive no further treatment after achieving a major response to induction therapy with PAD.