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Brief Title: Tinostamustine Conditioning and Autologous Stem Cell
Official Title: Phase 1/2 Open-label Trial of Tinostamustine Conditioning and Autologous Stem Cell Transplantation for Salvage Treatment in Relapsed / Refractory Multiple Myeloma (TITANIUM 1)
Study ID: NCT03687125
Brief Summary: Phase 1 The primary objectives of Phase 1 of this study are to: * Establish the safety, toxicity, and maximum tolerated dose (MTD) of the tinostamustine conditioning regimen. * Identify the recommended Phase 2 dose (RP2D) of tinostamustine for use in the Phase 2 portion of the study. The secondary objective of Phase 1 of this study is to: - Investigate the pharmacokinetics (PK) of tinostamustine.
Detailed Description: Study Design (Methodology): This is a 2-part, international, multi-center, open-label study of salvage treatment with tinostamustine conditioning followed by ASCT in participants with relapsed/ refractory multiple myeloma (MM). (ASCT is defined as salvage if the participant had already received a prior ASCT and undergoes a second ASCT after evidence of progressive disease \[PD\].) Phase 1 of the study employs a standard 3+3 dose escalation design with the objective of defining the dose limiting toxicities (DLTs) of the tinostamustine conditioning regimen and defining the MTD and RP2D for use in the Phase 2 portion of the study. The Safety Review Committee can make a decision to stop dose escalation or explore intermediary doses at any time. The total dose of tinostamustine will be administered on Day -1. Phase 2 of the study employs a 2-step sequential design (Simon, 1989). In Stage 1 of Phase 2, up to 31 participants initially will be enrolled. If lesser than or equal to (\<=) 25 participants of these initial 31 participants experience a response, then no additional participants will be enrolled. However, if greater than (\>) 25 participants in Stage 1 of Phase 2 experience a response, then enrollment in this cohort will continue, with up to 71 participants enrolled. In Phase 2 of the study, all participants will receive tinostamustine at the RP2D administered in Phase 1 according to the same schedule. After provision of written informed consent, participants will be screened for study eligibility within 28 days before Day 1 (the day of ASCT). Participants who have a minimum of 2×106 CD34+ cells/kg cryopreserved and are otherwise determined to be eligible, based on screening assessments, will be enrolled and receive the tinostamustine conditioning regimen. The tinostamustine dose will be administered 24 hours pre-ASCT (i.e., Day -1). On Day 1, ASCs will be administered intravenously (IV) according to standard institutional practice. Participants will receive supportive measures (including growth factor support post-ASCT, antimicrobial prophylaxis, red blood cell and platelet transfusion, and treatment for neutropenic fever) according to standard institutional practice.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
University of Alabama, Birmingham, Alabama, United States
University of Kansas Medical Center Kansas City, Kansas City, Kansas, United States
Memorial Sloan Kettering Cancer Centre, New York, New York, United States
Carolinas Healthcare System, Charlotte, North Carolina, United States
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, United States
University of Texas MD Anderson Cancer Center, Houston, Texas, United States
Froedtert & Medical College of Wisconsin, Cancer Center - Froedtert Hospital, Milwaukee, Wisconsin, United States
Oslo Myeloma Center, Oslo University Hospital, Oslo, , Norway
Universitatsspital Basel, Basel, , Switzerland
Universitatsspital Bern, Bern, , Switzerland
Department of Clinical Research Oncology/Hematology, Kantonsspital St. Gallen, Saint Gallen, , Switzerland
University Hospital Zurich, Zürich, , Switzerland
Name: Parameswaran Hari, MD
Affiliation: Study Chair
Role: STUDY_CHAIR
Name: Dagmar Hess
Affiliation: 2nd Study Chair
Role: STUDY_CHAIR