The Role of Ixazomib in Autologous Stem Cell Transplant in Relapsed Myeloma - Myeloma XII (ACCoRd)
Status:
Recruiting
Trial end date:
2027-03-01
Target enrollment:
Participant gender:
Summary
Study design: Randomised, controlled, multi-centre, open-label, phase III trial (with a
single intervention registration phase).
Primary Objectives
The primary objectives of this study are to determine:
- The impact on Depth of Response (DoR: less than VGPR versus VGPR or better) when salvage
ASCT conditioning is augmented by the addition of a proteasome inhibitor
- The influence of a consolidation and maintenance strategy on the Durability of Response
(DuR:PFS)
Secondary objectives
The secondary objectives of this study are to determine:
- Overall survival
- Time to disease progression
- The overall response rate following ixazomib, thalidomide and dexamethasone (ITD)
re-induction
- Time to next treatment
- Progression-free survival 2 (PFS2)
- Duration of response
- Minimal Residual Disease (MRD) negative rate post re-induction, post-ASCT and conversion
after ITD consolidation
- Engraftment kinetics
- Toxicity and safety
- Quality of life (QoL)
Participant population (refer to protocol section 9 for a full list of eligibility criteria).
- Relapsed MM (with measurable disease by IMWG criteria) previously treated with ASCT
- First progressive disease (PD) at least 12 months since first ASCT, requiring therapy.
- ECOG Performance Status 0-2
- Aged at least 18 years
- Adequate full blood count and renal, hepatobiliary, pulmonary and cardiac function
- Written informed consent
Interventions: All participants will be registered at trial entry and will receive
re-induction therapy with 4-6, 28-day cycles of ixazomib, thalidomide and dexamethasone
(ITD), in order to reach maximum response. Participants who achieve at least stable disease
(SD) will be randomised on a 1:1 basis to receive either conventional ASCT (ASCTCon), using
melphalan, or augmented ASCT (ASCTAug), using melphalan with ixazomib. All participants
achieving or maintaining a minimal response (MR) or better following trial ASCT will undergo
a second randomisation to consolidation and maintenance or no further treatment. Participants
randomised to consolidation and maintenance will receive treatment as follows: consolidation
with 2 cycles of ITD and maintenance with ixazomib until disease progression.
Number of participants: 406 participants will be registered into the trial to allow 284
participants to be randomised at the first randomisation (R1) and 248 participants to be
randomised at the second randomisation (R2).