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Trial registered on ANZCTR
Registration number
ACTRN12619001199101
Ethics application status
Approved
Date submitted
11/06/2019
Date registered
27/08/2019
Date last updated
9/12/2020
Date data sharing statement initially provided
27/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Frailty-stratified, randomised controlled Bayesian adaptive trial of bortezomib versus lenalidomide in transplant-ineligible myeloma (TI-NDMM) – the FRAIL-M study
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Scientific title
Frailty-stratified, randomised controlled Bayesian adaptive trial of bortezomib versus lenalidomide in transplant-ineligible myeloma (TI-NDMM) – the FRAIL-M study
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Secondary ID [1]
298413
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AMARC 19-01
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Secondary ID [2]
298509
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ALLG MM22
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Universal Trial Number (UTN)
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Trial acronym
FRAIL-M
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Multiple Myeloma
313126
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Condition category
Condition code
Cancer
311601
311601
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0
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Myeloma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Eligible patients will be randomised to received the either of the following:
- Velcade, Lenalidomide and Dexamethasone OR
- Velcade and Dexamethasone OR
- Lenalidomide and Dexamethasone
Lenalidomide will be administered at a dose of 10-25mg orally for Day 1 to 21 out of 28 Day cycle.
Velcade will be administered as subcutaneous injection at a dose of 1.0 - 1.3mg/m2 on Days 1, 8 and 15 out of 28 Day cycle. Dosage will be on body surface area and/or randmonised treatment arm.
Dexamethasone will be administered at a dose of 12-40mg orally on Days 1, 8 and 15 out of 28 Day cycle.
Dosages of each treatment will be based on body surface area and/or randmonised treatment arm.
All patients will continue on treatment until the either the development of progressive disease (PD), unacceptable toxicity, withdrawal of consent, or 6 years.
Adherence is monitored through hospital drug administration records and tablet adherence through drug packet return.
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Intervention code [1]
314662
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Treatment: Drugs
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Comparator / control treatment
Lenalidomide and Dexamethasone
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Control group
Active
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Outcomes
Primary outcome [1]
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To determine the overall response rate (ORR) (Partial Response [PR] or better), within each of 3 frailty defined strata via the international uniform response criteria for multiple myeloma
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Timepoint [1]
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After 4 cycles (28 days each cycle) of each allocated treatment regimen
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Primary outcome [2]
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To determine the occurrence of deliverability-limiting toxicity (DeLT) within each of 3 frailty defined strata via participant reported adverse events (such as nausea)
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Timepoint [2]
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Within the first 4 cycles of each allocated treatment regimen,
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Secondary outcome [1]
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Determine Progression Free Survival via routine blood tests
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Timepoint [1]
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At the completion of the study which is either progressive disease (PD), unacceptable toxicity, withdrawal of consent, or study closure.
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Secondary outcome [2]
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Define patient frailty utilising the Frailty Index
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Timepoint [2]
371381
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At study baseline and completion of the study which is either progressive disease (PD), unacceptable toxicity, withdrawal of consent, or study closure.
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Eligibility
Key inclusion criteria
1. Male and Female patients, equal to or greater 18 years of age.
2. Symptomatic NDMM as per IMWG criteria
3. Measurable disease as defined by a paraprotein 5g/L and/or an involved light chain isotype 100mg/l with an abnormal kappa:lambda ratio.
4. Not eligible for high-dose melphalan conditioned autologous stem cell transplantation (ASCT) due to age and/or co-morbidities.
5. No contraindication to the use of any of the study drugs.
6. Adequate liver function (total bilirubin less than 2.0x ULN, ALT less than 5.0x ULN) unless considered secondary to MM.
7. Adequate haematological parameters - Hb equal to or greater 80g/L (RBC transfusions as per institutional protocol are allowed); absolute neutrophil count equal to or greater 1.0 x 109/L; and, platelet count equal to or greater 50 x 109/L (equal to or greater 30 x 109/L if MM involvement in the marrow is greater than 50%) without platelet transfusion within 7 days of the screening platelet count.
8. Has provided written informed consent.
9. Women of childbearing potential must have a medically supervised pregnancy test with a minimum sensitivity of 25 mIU/mL performed before, during and after treatment.
10. Women of childbearing potential and male subjects who are sexually active with WOCP must agree to use 2 highly effective methods of contraception during the study and for 30 days following the last dose of study treatment including a male condom.
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Minimum age
18
Years
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Maximum age
No limit
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Gender
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Prior treatment for MM apart from localised radiotherapy and/or a short course of steroids (dexamethasone 160mg or equivalent) for emergency management of MM related symptoms.
2. Patients who have had myocardial infarction within 3 months prior to enrolment, or NYHA (New York Hospital Association) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, electrocardiographic evidence of acute ischemia or active conduction system abnormalities.
3. Creatinine clearance <30ml/min that persists after correction of recognisable reversible factors e.g. hypercalcaemia, dehydration, sepsis etc.
4. Any other serious or uncontrolled medical or psychiatric illness that could, in the investigators opinion, potentially interfere with the completion of treatment according to this protocol.
5. Known ongoing or active systemic infection, active hepatitis B or C infection, or known human immunodeficiency (HIV) positivity.
6. Women who are pregnant or lactating. Women of child-bearing potential must have a negative urine pregnancy test at Screening.
7. Patient (to whom it is relevant) who is unable or unwilling to meet the requirements of the lenalidomide pregnancy prevention program.
8. Active malignancy with the exception of any of the following:
a. Adequately treated basal cell carcinoma, squamous cell carcinoma or in situ cervical cancer.
b. Adequately treated stage 1 cancer from which the subject is currently in remission from and has been in remission for > 2 years.
c. Stage 1 prostate cancer that does not require treatment.
d. Any other cancer from which the subject has been disease-free for > 2 years.
9. Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule. This condition must be discussed with the patient prior to signing consent and registration in the trial.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1 / Phase 2
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Type of endpoint(s)
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/11/2019
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Actual
3/12/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
2
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,TAS,WA,VIC
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Recruitment hospital [1]
15407
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The Alfred - Melbourne
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Recruitment hospital [2]
15408
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St George Hospital - Kogarah
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Recruitment hospital [3]
15409
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Calvary Mater Newcastle - Waratah
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Recruitment hospital [4]
18180
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The Royal Adelaide Hospital - Adelaide
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Recruitment hospital [5]
18181
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Royal Hobart Hospital - Hobart
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Recruitment hospital [6]
18182
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Sunshine Hospital - St Albans
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Recruitment hospital [7]
18183
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Princess Alexandra Hospital - Woolloongabba
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Recruitment postcode(s) [1]
28728
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3004 - Melbourne
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Recruitment postcode(s) [2]
28729
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2217 - Kogarah
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Recruitment postcode(s) [3]
28730
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2298 - Waratah
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Recruitment postcode(s) [4]
32227
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5000 - Adelaide
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Recruitment postcode(s) [5]
32228
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7000 - Hobart
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Recruitment postcode(s) [6]
32229
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3021 - St Albans
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Recruitment postcode(s) [7]
32230
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4102 - Woolloongabba
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Medical Research Future Fund
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Address [1]
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Department of Health
GPO Box 9848
Canberra ACT 2601
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Country [1]
302960
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Australasian Leukaemia & Lymphoma Group
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Address
35 Elizabeth St,
Richmond VIC 3121
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Country
Australia
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Secondary sponsor category [1]
302917
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Other Collaborative groups
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Name [1]
302917
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Australasian Myeloma Research Consortium
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Address [1]
302917
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Alfred Hospital
55 Commercial Rd
Melbourne VIC 3004
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Country [1]
302917
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Alfred Hospital Ethics Commitee
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Ethics committee address [1]
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Alfred Health
55 Commercial Rd
Melbourne VIC 3004
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Ethics committee country [1]
303515
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Australia
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Date submitted for ethics approval [1]
303515
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02/09/2019
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Approval date [1]
303515
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04/11/2019
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Ethics approval number [1]
303515
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Summary
Brief summary
The primary purpose of this trial is to assess appropriate treatment approach newly diagnosed with multiple myeloma with respect to frailty assessment .
Who is it for?
You may be eligible to participate in this trial if you are aged 18 years or over, have been newly diagnosed with multiple myeloma and are a candidate for chemotherapy but not for autologous stem cell transplant.
Study details
Eligible participants will be treated with their allocated treatment regimen (bortezomib or lenalidomide) through randmonisation. All patients will continue on treatment until the either the development of progressive disease (PD), unacceptable toxicity or withdrawal of consent.
Participants will be required to have blood samples taken at the beginning of each cycle along with a medical exam in order for researchers to monitor whether the treatment is safe and whether it is effectively treating the myeloma.
It is hoped that the findings of this trial will establish the most appropriate treatment approach in the context of the Australian re-imbursement environment.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Andrew Spencer
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Address
93930
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Alfred Hospital
55 Commercial Road
Melbourne VIC 3004
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Country
93930
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Australia
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Phone
93930
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+61 3 9076 2000
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Fax
93930
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Email
93930
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aspencer@netspace.net.au
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Contact person for public queries
Name
93931
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Miss Flora Yuen
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Address
93931
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Alfred Hospital
55 Commercial Road
Melbourne VIC 3004
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Country
93931
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Australia
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Phone
93931
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+61 3 9076 5407
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Fax
93931
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Email
93931
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flora.yuen@alfred.org.au
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Contact person for scientific queries
Name
93932
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Prof Andrew Spencer
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Address
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Alfred Hospital
55 Commercial Road
Melbourne VIC 3004
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Country
93932
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Australia
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Phone
93932
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+61 3 9076 2000
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Fax
93932
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Email
93932
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aspencer@netspace.net.au
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No other documents available
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Summary results
No Results
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