IXAZOMIB Plus Lenalidomide and Dexamethasone Versus Placebo Plus Lenalidomide and Dexamethasone in Adult Patients With Newly Diagnosed Multiple Myeloma
Condition: Multiple Myeloma
MeSH terms: Multiple Myeloma; Neoplasms, Plasma Cell
Intervention: Ixazomib; Placebo; Dexamethasone; Lenalidomide
Intervention description: IXAZOMIB capsules.; IXAZOMIB matching-placebo capsules.; Dexamethasone tablets.; Lenalidomide capsules.
Intervention MeSH terms: Dexamethasone; Lenalidomide; Ixazomib
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 705.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Newly Diagnosed multiple myeloma; multiple myeloma; MLN9708; IXAZOMIB; Proteasome inhibitor; Tourmaline MM2

Summary:

      The purpose of this study is to provide continued access to ixazomib and/or lenalidomide to
      participants who are continuing to have clinical benefit and to continue collecting relevant
      safety data to monitor safety in participants with Newly Diagnosed Multiple Myeloma (NDMM)
      who are not eligible for stem cell transplant.
    

Eligibility criteria:

        Inclusion Criteria:

          1. Male or female participants 18 years or older diagnosed with Multiple Myeloma
             according to standard criteria who have not received prior treatment for multiple
             myeloma.

          2. Participants for whom lenalidomide and dexamethasone treatment is appropriate and who
             are not eligible for high-dose therapy followed by stem-cell transplantation (HDT-SCT)
             for 1 or more of the following reasons:

               -  The participant is 65 years of age or older.

               -  The participant is less than 65 years of age but has significant comorbid
                  condition(s) that are, in the opinion of the investigator, likely to have a
                  negative impact on tolerability of HDT-SCT.

          3. Measurable disease as specified in study protocol.

          4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.

          5. Meet the clinical laboratories criteria as specified in the protocol.

          6. Female participants who are post menopausal, surgically sterile, or agree to practice
             2 effective methods of contraception or agree to practice true abstinence, and must
             also agree to ongoing pregnancy testing; must also adhere to the guidelines of the
             lenalidomide pregnancy prevention program.

          7. Male participants who agree to practice effective barrier contraception or agree to
             practice true abstinence AND must adhere to the guidelines of the lenalidomide
             pregnancy prevention program.

          8. Suitable venous access for the study-required blood sampling.

          9. Must be able to take concurrent aspirin 70 mg to 325 mg daily (or enoxaparin if
             aspirin allergic).

         10. Voluntary written consent.

         11. Participant is willing and able to adhere to the study visit schedule and other
             protocol requirements.

        Exclusion Criteria:

          1. Prior treatment for multiple myeloma with either standard of care treatment or
             investigational regimen.

          2. Diagnosed and treated for another malignancy within 5 years before randomization or
             previously diagnosed with another malignancy and have any evidence of residual
             disease. Participants with nonmelanoma skin cancer or carcinoma in situ of any type
             are not excluded if they have undergone complete resection.

          3. Inability or unwillingness to receive antithrombotic therapy.

          4. Female participants who are lactating or pregnant.

          5. Major surgery or radiotherapy within 14 days before randomization.

          6. Infection requiring intravenous antibiotics within 14 days before the first dose of
             study drug.

          7. Central nervous system involvement.

          8. Diagnosis of Waldenstrom's macroglobulinemia, polyneuropathy, organomegaly,
             endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome, plasma cell
             leukemia, primary amyloidosis, myelodysplastic syndrome, or myeloproliferative
             syndrome.

          9. Evidence of current uncontrolled cardiovascular conditions within 6 months prior to
             randomization, including: Uncontrolled hypertension, cardiac arrhythmias, or
             congestive heart failure; Unstable angina, or Myocardial infarction.

         10. Systemic treatment with strong inhibitors of CYP1A2 (fluvoxamine, enoxacin,
             ciprofloxacin), strong inhibitors of CYP3A (clarithromycin,
             telithromycin,itraconazole, voriconazole, ketoconazole, nefazodone, posaconazole) or
             strong CYP3A inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin,
             phenobarbital), or use of Ginkgo biloba or St. John's wort within 14 days before
             randomization in the study.

         11. Active hepatitis B or C virus infection, or known human immunodeficiency virus (HIV)
             positive.

         12. Comorbid systemic illnesses or other severe concurrent disease which, in the judgment
             of the investigator, would make the participant inappropriate for entry into this
             study or interfere significantly with the proper assessment of safety and toxicity of
             the prescribed regimens (e.g., peripheral neuropathy that is Grade 1 with pain or
             Grade 2 or higher of any cause).

         13. Psychiatric illness/social situation that would limit compliance with study
             requirements.

         14. Known allergy to any of the study medications.

         15. Inability to swallow oral medication, inability or unwillingness to comply with the
             drug administration requirements, or gastrointestinal (GI) procedure that could
             interfere with the oral absorption or tolerance of treatment.

         16. Treatment with any investigational products within 60 days before randomization.