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Salwender H, Bertsch U, Weisel K, Duerig J, Kunz C, Benner A, Blau IW, Raab MS, Hillengass J, Hose D, Huhn S, Hundemer M, Andrulis M, Jauch A, Seidel-Glaetzer A, Lindemann HW, Hensel M, Fronhoffs S, Martens U, Hansen T, Wattad M, Graeven U, Munder M, Fenk R, Haenel M, Scheid C, Goldschmidt H. Rationale and design of the German-speaking myeloma multicenter group (GMMG) trial HD6: a randomized phase III trial on the effect of elotuzumab in VRD induction/consolidation and lenalidomide maintenance in patients with newly diagnosed myeloma. BMC Cancer 2019; 19:504. [PMID: 31138244 PMCID: PMC6537200 DOI: 10.1186/s12885-019-5600-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/12/2019] [Indexed: 12/03/2022] Open
Abstract
Background Despite major advances in therapy, multiple myeloma is still an incurable malignancy in the majority of patients. To increase survival, deeper remissions (i.e. CR) translating into longer PFS need to be achieved. Incorporation of new drugs (i.e. bortezomib and lenalidomide) as induction and maintenance treatment in an intensified treatment concept, including high dose melphalan (200 mg/m2), has resulted in increased CR rates, and is considered the standard of care for younger patients. Elotuzumab in combination with lenalidomide and dexamethasone has given better results as lenalidomide and dexamethasone alone in a phase III trial. The GMMG-HD6 trial will be the first phase III trial investigating the role of elotuzumab in combination with bortezomib, lenalidomide and dexamethasone (VRD) induction/consolidation and lenalidomide maintenance within a high dose concept. Methods GMMG-HD6 is a randomized, open, multicenter phase III trial. The planned recruitment number is 564 NDMM patients. All patients will receive 4 VRD cycles as induction and undergo peripheral blood stem cell mobilization and harvesting. Thereafter they will be treated with high dose melphalan therapy plus autologous stem cell transplantation followed by 2 cycles of VRD consolidation and lenalidomide maintenance. Patients in arm B1 + B2 will additionally receive elotuzumab in the induction phase, whereas patients in A2 + B2 will be treated with elotuzumab added to consolidation and maintenance. The primary endpoint of the trial is PFS. Secondary objectives and endpoints are OS, CR rates after induction therapy comparing the two arms VRD (A1 + A2) vs VRD + elotuzumab (B1 + B2), CR rates after consolidation treatment, best response to treatment during the study, time to progression (TTP), duration of response (DOR), toxicity and quality of life. Results Since this is the publication of a study protocol of an ongoing study, no results can be presented. Discussion This phase III trial is designed to evaluate whether the addition of elotuzumab to an intensified treatment concept with high dose melphalan chemotherapy plus autologous stem cell transplantation and induction, consolidation and maintenance treatment with bortezomib and lenalidomide is able to improve PFS compared to the same concept without elotuzumab. Trial registration NCT02495922 on June 24th, 2015.
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Affiliation(s)
- Hans Salwender
- Asklepios Hospital Hamburg, Altona, Hematology, Oncology and Palliative Care, 22763, Hamburg, Germany.
| | - Uta Bertsch
- University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - Katja Weisel
- University Hospital Tuebingen, Tuebingen, Germany.,University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Jan Duerig
- University Hospital Essen, Essen, Germany
| | - Christina Kunz
- German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Axel Benner
- German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Igor W Blau
- Charité Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Dirk Hose
- University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | | | | | - Mindaugas Andrulis
- Institute of Pathology, Klinikum Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Anna Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Andrea Seidel-Glaetzer
- Cordination Center for Clinical Trials, University of Heidelberg (KKS), Heidelberg, Germany
| | | | | | - Stefan Fronhoffs
- Zentrum fuer ambulante Haematologie und Onkologie Siegburg, Siegburg, Germany
| | | | - Timon Hansen
- University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | - Ullrich Graeven
- Krankenhaus Maria Hilf Moenchengladbach, Moenchengladbach, Germany
| | | | - Roland Fenk
- University Hospital Duesseldorf, Dusseldorf, Germany
| | | | | | - Hartmut Goldschmidt
- University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
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