DKD方案治疗一线VRD(VCD)方案诱导后疗效不佳的多发性骨髓瘤的有效性和安全性研究

注册号:

Registration number:

ChiCTR2500099167 

最近更新日期:

Date of Last Refreshed on:

2025-03-23 19:00:41 

注册时间:

Date of Registration:

2025-03-19 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

DKD方案治疗一线VRD(VCD)方案诱导后疗效不佳的多发性骨髓瘤的有效性和安全性研究

Public title:

A study on the efficacy and safety of the DKD regimen for the treatment of multiple myeloma with suboptimal response to frontline VRD (VCD) regimen induction

注册题目简写:

English Acronym:

研究课题的正式科学名称:

DKD方案治疗一线VRD(VCD)方案诱导后疗效不佳的多发性骨髓瘤的有效性和安全性研究

Scientific title:

A study on the efficacy and safety of the DKD regimen for the treatment of multiple myeloma with suboptimal response to frontline VRD (VCD) regimen induction

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李燕 

研究负责人:

李燕 

Applicant:

Yan Li 

Study leader:

Yan Li 

申请注册联系人电话:

Applicant telephone:

+86 13639935315

研究负责人电话:

Study leader's
telephone:

+86 991 8563855

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

liyan232917@139.com

研究负责人电子邮件:

Study leader's E-mail:

2638955549@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国新疆乌鲁木齐市天池路91号

研究负责人通讯地址:

中国新疆乌鲁木齐市天池路91号

Applicant address:

No. 91, Tianchi Road, Urumqi, Xinjiang, China

Study leader's address:

No.91, Tianchi Road, Tianshan District, Urumqi, Xinjiang

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

新疆维吾尔自治区人民医院

Applicant's institution:

People’s Hospital of Xinjiang Uygur Autonomous Region

研究负责人所在单位:

新疆维吾尔自治区人民医院

Affiliation of the Leader:

People‘s Hospital of Xinjiang Uygur Autonomous Region

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

KY2024121909

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

新疆维吾尔自治区人民医院伦理委员会

Name of the ethic committee:

Ethics Committee of People's Hospital of Xinjiang Uygur Autonomous Region

伦理委员会批准日期:

Date of approved by ethic committee:

2024-12-19 00:00:00

伦理委员会联系人:

祖米来提·安尼瓦尔

Contact Name of the ethic committee:

Zumilaiti·Anniwaer

伦理委员会联系地址:

中国新疆乌鲁木齐市天池路91号

Contact Address of the ethic committee:

No.91, Tianchi Road, Tianshan District, Urumqi, Xinjiang

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 991 8563333

伦理委员会联系人邮箱:

Contact email of the ethic committee:

450548505@qq.com

研究实施负责(组长)单位:

新疆维吾尔自治区人民医院

Primary sponsor:

People‘s Hospital of Xinjiang Uygur Autonomous Region

研究实施负责(组长)单位地址:

中国新疆乌鲁木齐市天池路91号

Primary sponsor's address:

No.91, Tianchi Road, Tianshan District, Urumqi, Xinjiang

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

新疆维吾尔自治区

市(区县):

Country:

China

Province:

Xinjiang Uygur Autonomous Region

City:

单位(医院):

新疆维吾尔自治区人民医院

具体地址:

天山区天池路91号

Institution
hospital:

People‘s Hospital of Xinjiang Uygur Autonomous Region

Address:

No.91, Tianchi Road, Tianshan District, Urumqi, Xinjiang

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

self-selected topic

研究疾病:

多发性骨髓瘤  

Target disease:

Multiple myeloma

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

IV期临床试验 

Study phase:

4

研究设计:

单臂 

Study design:

Single arm 

研究目的:

初步评价DKD方案治疗一线VRD(VCD)方案诱导后疗效不佳的多发性骨髓瘤的有效性和安全性研究,以期给临床工作提供更多的数据支持。 主要疗效指标包括:接受DKD诱导后的≥VGPR率; 次要疗效指标包括: 替换后的≥CR 率;,两个亚组替换方案后的缓解率提高情况(2疗程未达PR患者亚组的最佳ORR率(PR,VGPR,CR),4疗程未达VGPR患者亚组的最佳>VGPR率);MRD阴性率;,2年PFS率;安全性等。  

Objectives of Study:

A preliminary study to evaluate the efficacy and safety of the DKD regimen in the treatment of multiple myeloma patients who responded poorly to first-line VRD (or VCD) induction therapy, aiming to provide more data support for clinical practice. Primary efficacy endpoints include: the rate of ≥VGPR after DKD induction. Secondary efficacy endpoints include: the rate of ≥CR after regimen switch; the improvement in response rate after regimen switch in two subgroups (the best ORR rate [PR, VGPR, CR] in the subgroup of patients who did not achieve PR after 2 courses, and the best >VGPR rate in the subgroup of patients who did not achieve VGPR after 4 courses); MRD negativity rate; 2-year PFS rate; and safety.

药物成份或治疗方案详述:

1) 诱导治疗: DKD,2-4 疗程诱导(28 天/疗程) 卡非佐米:第 1 疗程 20mg/m2,iv,d1,随后 70mg/m2,iv,d8、15。第 2 疗程开始 70mg/m2,iv,d1、8、15。 达雷妥尤单抗注射液:第 1 疗程 8 mg/kg d1,2 , 16 mg/kg2d8,15,22;之后按获批的用法给予。 达雷妥尤单抗注射液(皮下制剂):1800mg/次,皮下注射,频次同注射液。 地塞米松 20mg PO,d1、2、4、5、8、9、11、12; 28 天为 1 周期。 2)巩固治疗 DKD 方案治疗 4-8 个周期(28 天/疗程): 计划移植患者如获得≥PR,随后在临床医生判断下接受自体造血干细胞移植,移植后在第 90-120 天之间,移植后巩固 4 个疗程。如不计划移植患者:可采用同方案巩固 8 疗程。(期间如连续两次 MRD阴性可直接进入维持治疗)。 3)维持治疗:使用 DK 方案维持治疗 2 年(28 天/疗程)使用减量的原方案进行维持:卡非佐米 70mg/m2 第 1、15 天,达雷妥尤单抗(每四周一次)维持 2 年,直至出现新的 PD 或不耐受。 4)辅助治疗方案: 根据 2021 V1.0 NCCN-癌症相关静脉血栓栓塞疾病指南进行 VTE评分(附件 2),低风险患者推荐不预防或阿司匹林预防,中高风险注患者推荐低分子肝素,华法林或新型小分子抗凝剂(利伐沙班),预防深静脉血栓的发生。高危感染者,每周期 2-3 天免疫球蛋白 5.0g/天静注;阿昔洛韦口服,无磺胺过敏史,可用复方磺胺甲恶唑(由经治医生判断指征及疗程)。 

Description for medicine or protocol of treatment in detail:

1) Induction therapy: DKD, 2-4 courses of induction (28 days/course) Cafizomide: 20mg/m2 for the first course of treatment, iv,d1, Subsequently, 70mg/m2, iv,d8 15. The second treatment course starts at 70mg/m2, iv,d1815. Daretomumab injection: first course of treatment 8 mg/kg d1,2, 16 mg/kg2d8,15,22; Afterwards, it will be given according to the approved usage. Daletomumab injection (subcutaneous preparation): 1800mg/time, subcutaneous injection, with the same frequency as the injection. Dexamethasone 20mg PO, d1245891112; 28 days is one cycle. 2) Consolidate the treatment plan for DKD for 4-8 cycles (28 days/course): If the planned transplant patient obtains ≥ PR, they will then undergo autologous hematopoietic stem cell transplantation under the judgment of the clinical doctor. Between the 90th and 120th day after transplantation, they will receive four courses of consolidation after transplantation. If there is no plan to transplant patients: the same protocol can be used to consolidate 8 courses of treatment. If MRD is negative twice in a row during this period, maintenance treatment can be directly initiated. 3) Maintenance treatment: Use the DK regimen for 2 years (28 days/course) and maintain with a reduced dose of the original regimen: Carfilzomib 70mg/m2 on days 1 and 15, and Daretomumab (once every four weeks) for 2 years until new PD or intolerance occurs. 4) Adjuvant treatment plan: According to the 2021 V1.0 NCCN guidelines for cancer-related venous thromboembolism, VTE scoring is recommended (Attachment 2). Low risk patients are advised not to use prophylaxis or aspirin for prophylaxis, while medium to high-risk patients are advised to use low molecular weight heparin, warfarin, or a novel small molecule anticoagulant (rivaroxaban) to prevent the occurrence of deep vein thrombosis. High risk infected individuals should receive intravenous immunoglobulin 5.0g/day 2-3 days a week; Acyclovir can be taken orally without a history of sulfonamide allergy, and compound sulfamethoxazole can be used (the indications and course of treatment should be determined by the treating physician). 

纳入标准:

Inclusion criteria

排除标准:

1.非活动性多发性骨髓瘤,伴骨髓外病变、原发性淀粉样变性、MGUS(意义未明的单克隆丙种球蛋白病)、华氏巨球蛋白血症、POEMS综合征、浆细胞白血病或冒烟型骨髓瘤;
2.既往接受过其他抗肿瘤治疗的患者,在筛选前3年内患有除多发性骨髓瘤外的其他恶性肿瘤史(除外已治愈且3年内复发风险极低的恶性肿瘤,如皮肤基底细胞癌及下列原位癌:鳞状上皮细胞癌、膀胱原位癌、子宫内膜原位癌、宫颈原位癌/不典型增生、前列腺癌偶然组织学发现(TNM 分期为T1a或者T1b)或乳腺原位癌);
3.存在3个及以上的细胞遗传学高危因素(根据NCCN 2024 V1:Del(1p32),t(4;14),t(14;16),t(14;20),del(17p)/17单体/TP53突变,1q21获得/扩增,MYC异位,高危基因表达谱(GEP));
4.不易控制的精神病受试者;
5.研究者认为不宜参加本试验的受试者。(任何可能会影响方案依从性或受试者提供知情同意的能力的临床显著医学疾病);
6.患者对环氧酮类蛋白酶体抑制剂有过敏史;患有已知的过敏,或对硼酸盐、甘露醇、皮质类固醇、单克隆抗体或人类蛋白或它们的辅料不耐受,或已知对哺乳动物衍生品过敏的患者。
7.已知的显著心脏异常包括: a.充血性心力衰竭,纽约心脏协会(NYHA)III级或IV级或已知左心室射血分数<40% b.不受控制的心绞痛、心律失常或高血压 c.过去6个月内的心肌梗死 d.临床显著的心包疾病或心脏淀粉样变。 e.任何其他不受控制或严重的心血管疾病 f.症状性心肌缺血 g.控制不佳的由临床意义的传导异常;
8.女性患者处于孕期或哺乳期;
9.根据受试者自我报告或病历审查,存在以下任何情况的证据: a.入组前4周内接受过大手术或严重创伤性损伤; b.甲、乙、丙型肝炎感染活动期或已知HBV-DNA或HCV-RNA阳性; c.已知HIV阳性; d.炎症性肠病及其他免疫相关疾病患者; e.需要静脉输液抗感染治疗的活动性感染; f.其他恶性肿瘤、不易控制的感染、严重的躯体疾病或精神疾病有可能会干扰对本临床研究的参与;在首次给药前2周内进行过大手术,或者没有从早期手术中完全康复,或者在患者预期参与研究期间或在研究药物末次给药后2周内计划进行手术。注:计划在局部麻醉下实施手术操作的患者可以参加研究。后凸成形术或椎骨成形术不视作大手术;
10.首次给药前4周内,曾经接受过研究药物(包括研究性疫苗)治疗或曾使用侵入性的研究性医疗器械,或现正在入组某项干预性调查研究;
11.已知或怀疑不能遵守研究方案(例如,因为酗酒、药物依赖或心理障碍等)的患者,或研究者认为在任何条件下,参与研究不符合患者的最大利益(例如,对他们的健康有危害),或可能阻碍、限制或混淆研究方案所规定的评估的患者。

Exclusion criteria:

1. Non-active multiple myeloma with extramedullary lesions, primary amyloidosis, MGUS (monoclonal gammopathy of unknown significance), Waldenström's macroglobulinemia, POEMS syndrome, plasma cell leukemia, or smoldering myeloma; 2. Patients who have previously received other anti-tumor treatments and have a history of other malignant tumors within 3 years prior to screening (except for malignant tumors that have been cured and have a very low risk of recurrence within 3 years, such as basal cell carcinoma of the skin and the following in-situ cancers: squamous cell carcinoma, bladder carcinoma in situ, endometrial carcinoma in situ, cervical carcinoma in situ/atypical hyperplasia, incidental histologic finding of prostate cancer (TNM stage T1a or T1b), or breast carcinoma in situ); 3. Presence of 3 or more high-risk cytogenetic factors (according to NCCN 2024 V1: Del(1p32), t(4;14), t(14;16), t(14;20), del(17p)/17p monosomy/TP53 mutation, 1q21 gain/amplification, MYC translocation, high-risk gene expression profiling (GEP)); 4. Subjects with poorly controlled psychiatric disorders; 5. Subjects deemed unsuitable for participation in this trial by the investigator (any clinically significant medical condition that may affect protocol compliance or the subject's ability to provide informed consent); 6. Patients with a history of allergy to epoxyketone proteasome inhibitors; known allergies or intolerance to borates, mannitol, corticosteroids, monoclonal antibodies, or human proteins or their excipients, or known allergy to mammalian derivatives; 7. Known significant cardiac abnormalities including: a. Congestive heart failure, New York Heart Association (NYHA) class III or IV, or known left ventricular ejection fraction <40% b. Uncontrolled angina, arrhythmias, or hypertension c. Myocardial infarction within the past 6 months d. Clinically significant pericardial disease or cardiac amyloidosis e. Any other uncontrolled or severe cardiovascular disease f. Symptomatic myocardial ischemia g. Poorly controlled clinically significant conduction abnormalities; 8. Female patients who are pregnant or lactating; 9. Evidence of any of the following conditions based on self-report or medical record review: a. Major surgery or severe traumatic injury within 4 weeks prior to enrollment b. Active hepatitis A, B, or C infection or known positive HBV-DNA or HCV-RNA c. Known HIV positive d. Patients with inflammatory bowel disease and other immune-related diseases e. Active infections requiring intravenous antibiotic therapy f. Other malignancies, uncontrolled infections, severe somatic diseases, or psychiatric disorders that may interfere with participation in this clinical study; major surgery within 2 weeks prior to the first dose, or incomplete recovery from earlier surgery, or planned surgery during the patient's expected participation in the study or within 2 weeks after the last dose of the study drug. Note: Patients scheduled for surgical procedures under local anesthesia may participate in the study. Kyphoplasty or vertebroplasty are not considered major surgeries; 10. Within 4 weeks prior to the first dose, have received investigational drugs (including investigational vaccines) or used invasive investigational medical devices, or are currently enrolled in an interventional investigational study; 11. Patients known or suspected to be unable to comply with the study protocol (e.g., due to alcoholism, drug dependency, or psychological disorders), or patients for whom the investigator believes participation in the study is not in their best interest under any conditions (e.g., poses a hazard to their health), or who may hinder, limit, or confuse the assessments specified in the study protocol;

研究实施时间:

Study execute time:

From 2024-12-31 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-04-01 00:00:00 To 2026-12-01 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

37

Group:

Test group

Sample size:

干预措施:

DKD方案治疗

干预措施代码:

Intervention:

DKD treatment plan

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

新疆维吾尔自治区 

市(区县):

 

Country:

China

Province:

Xinjiang Uygur Autonomous Region

City:

单位(医院):

新疆维吾尔自治区人民医院 

单位级别:

三级甲等 

Institution
hospital:

People‘s Hospital of Xinjiang Uygur Autonomous Region

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

新疆维吾尔自治区 

市(区县):

 

Country:

China

Province:

Xinjiang Uygur Autonomous Region

City:

单位(医院):

和田地区人民医院 

单位级别:

三级甲等 

Institution
hospital:

Hotan District People’s Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

新疆维吾尔自治区 

市(区县):

 

Country:

China

Province:

Xinjiang Uygur Autonomous Region

City:

单位(医院):

新疆医科大学第二附属医院 

单位级别:

三级甲等 

Institution
hospital:

The Second Affiliated Hospital of Xinjiang Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

非常好的部分缓解率

指标类型:

主要指标

Outcome:

The rate of Very Good Partial Response (VGPR)

Type:

Primary indicator

测量时间点:

2疗程

测量方法:

Measure time point of outcome:

2 courses

Measure method:

指标中文名:

2年无进展生存率

指标类型:

次要指标

Outcome:

2-year progression-free survival (PFS) rate

Type:

Secondary indicator

测量时间点:

第2年

测量方法:

Measure time point of outcome:

the second year

Measure method:

指标中文名:

不良事件(AE)

指标类型:

次要指标

Outcome:

Adverse Event(AE)

Type:

Secondary indicator

测量时间点:

整个治疗过程中

测量方法:

Measure time point of outcome:

the whole treatment process

Measure method:

指标中文名:

替换治疗后的≥CR 率

指标类型:

次要指标

Outcome:

>=CR rate after substitution therapy

Type:

Secondary indicator

测量时间点:

2疗程

测量方法:

Measure time point of outcome:

2 courses

Measure method:

指标中文名:

客观缓解率

指标类型:

次要指标

Outcome:

objective response rate

Type:

Secondary indicator

测量时间点:

2疗程

测量方法:

Measure time point of outcome:

2 courses

Measure method:

指标中文名:

>非常好的部分缓解率

指标类型:

次要指标

Outcome:

>The rate of Very Good Partial Response (VGPR)

Type:

Secondary indicator

测量时间点:

4疗程

测量方法:

Measure time point of outcome:

4 courses

Measure method:

指标中文名:

MRD阴性率

指标类型:

次要指标

Outcome:

MRD negativity rate

Type:

Secondary indicator

测量时间点:

2疗程

测量方法:

Measure time point of outcome:

2 courses

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 70 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

公开原始数据日期:试验完成后公开,最晚不超过试验结束后6个月。 共享原始数据的途径:本研究将采用临床试验公共管理平台ResMan进行原始数据的共享。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Date of Raw Data Disclosure: The raw data will become publicly accessible upon trial completion, with availability no later than 6 months post-trial completion. Mechanism for Raw Data Sharing: The raw data from this study will be shared via ResMan Clinical Trial Management Platform, a public registry for clinical trial data management.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CFR和EDC

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CFR and EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-03-19 14:42:31