Clinical Trial: Combination Chemotherapy in Treating Patients With Multiple Myeloma

This study is no longer recruiting patients.

Sponsored by: National Cancer Institute of Canada
Information provided by: National Cancer Institute (NCI)


RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. It is not yet known which combination chemotherapy regimen is most effective in treating patients with multiple myeloma.

PURPOSE: Randomized phase III trial to compare the effectiveness of various combination chemotherapy regimens in treating patients with multiple myeloma.

Condition Treatment or Intervention Phase
stage I multiple myeloma
stage II multiple myeloma
stage III multiple myeloma
 Drug: dexamethasone
 Drug: melphalan
 Drug: prednisone
 Procedure: chemotherapy
Phase III

MedlinePlus related topics:  Multiple Myeloma

Study Type: Interventional
Study Design: Treatment

Official Title: Phase III Randomized Study of Melphalan Combined With Dexamethasone or Prednisone As Induction Therapy With or Without Dexamethasone as Maintenance Therapy in Patients With Previously Untreated Stage I-III Multiple Myeloma

Further Study Details: 


OUTLINE: This is a randomized, multicenter study. Patients are stratified by center, stage (I or II vs III), creatinine (less than 2.0 mg/dL vs 2.0 mg/dL or greater), and intention to use prophylactic bisphosphonate (yes vs no).

  • Patients are randomized to 1 of 4 treatment arms.
  • Arms I and II: Patients receive induction comprising oral prednisone followed by oral melphalan on days 1-4.
  • Arms III and IV: Patients receive induction comprising oral melphalan and oral dexamethasone (DM) on days 1-4 of all courses and DM on days 15-18 of courses 1-3. Induction for arms I-IV continues every 4 weeks for 12 courses in the absence of disease progression or unacceptable toxicity. Patients with stable or responding disease after induction proceed to maintenance therapy.
  • Arms I and III: Patients undergo observation.
  • Arms II and IV: Patients receive oral DM on days 1-4. Maintenance therapy continues every 4 weeks for arms II and IV and every 3 months for arms I and III in the absence of disease progression or unacceptable toxicity. Patients on arms I-IV who develop disease progression proceed to reinduction.
  • Reinduction: Patients restart induction on the arm to which they were originally randomized. Reinduction continues every 4 weeks in the absence of stable response lasting 16 weeks, disease progression, or unacceptable toxicity. Patients who achieve a stable response lasting 16 weeks restart maintenance therapy. Patients who experience further disease progression during reinduction are taken off study. Quality of life is assessed at baseline, on day 1 of courses 1-3 and then every 3 courses during induction, and then every 3 months during maintenance therapy.

Patients are followed every 6 months.

PROJECTED ACCRUAL: A maximum of 600 patients will be accrued for this study within 6 years.


Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both



  • Histologically proven previously untreated stage I-III multiple myeloma
  • Patients with stage I disease must be symptomatic
  • Must meet at least 1 of the following conditions:
  • Plasma cells in osteolytic lesion or soft tissue tumor biopsy
  • At least 10% plasmacytosis in bone marrow aspirate and/or biopsy
  • Less than 10% plasma cells in bone marrow but at least 1 bony lesion
  • Detectable serum M-component of IgG, IgA, IgD, or IgE
  • If only light chain disease (urine M-protein) present, urinary excretion of light chain (Bence Jones) protein must be at least 1.0 g/24 hours


  • 18 and over

Performance status:

  • ECOG 0-4

Life expectancy:

  • Not specified


  • Not specified


  • Not specified


  • Not specified



  • No concurrent immunizations
  • No concurrent filgrastim (G-CSF) or other growth factors as prophylaxis
  • Concurrent epoetin alfa for anemia allowed


  • No prior chemotherapy

Endocrine therapy:




  • At least 2 years since prior medication for radiologic or endoscopic diagnosis of gastric or duodenal ulcer
  • Prior or concurrent bisphosphonates for hypercalcemia allowed

Location Information

      St. Mary's/Duluth Clinic Health System, Duluth,  Minnesota,  55805,  United States

Canada, Alberta
      Cross Cancer Institute, Edmonton,  Alberta,  T6G 1Z2,  Canada

      Tom Baker Cancer Center - Calgary, Calgary,  Alberta,  T2N 4N2,  Canada

Canada, British Columbia
      British Columbia Cancer Agency - Centre for the Southern Interior, Kelowna,  British Columbia,  V1Y 5L3,  Canada

      British Columbia Cancer Agency - Vancouver Island Cancer Centre, Victoria,  British Columbia,  V8R 6V5,  Canada

      British Columbia Cancer Agency, Vancouver,  British Columbia,  V5Z 4E6,  Canada

      Providence Health Care - Vancouver, Vancouver,  British Columbia,  V6Z 1Y6,  Canada

Canada, New Brunswick
      Doctor Leon Richard Oncology Centre, Moncton,  New Brunswick,  E1C 8X3,  Canada

      Moncton Hospital, Moncton,  New Brunswick,  E1C 6ZB,  Canada

      Saint John Regional Hospital, Saint John,  New Brunswick,  E2L 4L2,  Canada

Canada, Newfoundland and Labrador
      Newfoundland Cancer Treatment and Research Foundation, St. Johns,  Newfoundland and Labrador,  A1B 3V6,  Canada

Canada, Nova Scotia
      Nova Scotia Cancer Centre, Halifax,  Nova Scotia,  B3H 2Y9,  Canada

Canada, Ontario
      Algoma District Medical Group, Sault Sainte Marie,  Ontario,  P6B 1Y5,  Canada

      Cancer Care Ontario - Windsor Regional Cancer Centre, Windsor,  Ontario,  N8W 2X3,  Canada

      Cancer Care Ontario-Hamilton Regional Cancer Centre, Hamilton,  Ontario,  L8V 5C2,  Canada

      Cancer Care Ontario-London Regional Cancer Centre, London,  Ontario,  N6A 4L6,  Canada

      Credit Valley Hospital, Mississauga,  Ontario,  L5M 2N1,  Canada

      Hotel Dieu Health Sciences Hospital - Niagara, St. Catharines,  Ontario,  L2R 5K3,  Canada

      Humber River Regional Hospital, Weston,  Ontario,  M9N 1N8,  Canada

      Kingston Regional Cancer Centre, Kingston,  Ontario,  K7L 5P9,  Canada

      Lakeridge Health Oshawa, Oshawa,  Ontario,  L1G 2B9,  Canada

      Northeastern Ontario Regional Cancer Centre, Sudbury, Sudbury,  Ontario,  P3E 5J1,  Canada

      Princess Margaret Hospital, Toronto,  Ontario,  M5G 2M9,  Canada

      Southlake Regional Health Centre, Newmarket,  Ontario,  L3Y 2P9,  Canada

      St. Michael's Hospital - Toronto, Toronto,  Ontario,  M5B 1W8,  Canada

      Toronto East General Hospital, Toronto,  Ontario,  M4C 3E7,  Canada

      Toronto General Hospital, Toronto,  Ontario,  M5G 2C4,  Canada

      Toronto Sunnybrook Regional Cancer Centre, Toronto,  Ontario,  M4N 3M5,  Canada

      Trillium Health Centre, Mississauga,  Ontario,  L5B 1B8,  Canada

      William Osler Health Centre, Brampton,  Ontario,  L6W 2Z8,  Canada

Canada, Prince Edward Island
      Queen Elizabeth Hospital, PEI, Charlottetown,  Prince Edward Island,  C1A 8T5,  Canada

Canada, Quebec
      CHUS-Hopital Fleurimont, Fleurimont,  Quebec,  J1H 5N4,  Canada

      Hopital Charles Lemoyne, Greenfield Park,  Quebec,  J4V 2H1,  Canada

      Hopital de L'Enfant Jesus, Quebec City,  Quebec,  G1J 1Z4,  Canada

      Hopital du Saint-Sacrement, Quebec, Quebec City,  Quebec,  G1S 4L8,  Canada

      McGill University, Montreal,  Quebec,  H2W 1S6,  Canada

Canada, Saskatchewan
      Allan Blair Cancer Centre, Regina,  Saskatchewan,  S4T 7T1,  Canada

Study chairs or principal investigators

Chaim Shustik, MD,  Study Chair,  Royal Victoria Hospital - Montreal   

More Information

Clinical trial summary from the National Cancer Institute's PDQ® database


Shustik C, Belch A, Meyer R, et al.: Melphalan-dexamethasone is not superior to melphalan-prednisone as induction therapy in multiple myeloma. [Abstract] Proceedings of the American Society of Clinical Oncology 20: A-1191, 2001.

Study ID Numbers:  CDR0000064328; CAN-NCIC-MY7; NCI-V95-0713
Record last reviewed:  September 2003
Last Updated:  October 13, 2004
Record first received:  November 1, 1999 Identifier:  NCT00002678
Health Authority: Unspecified processed this record on 2005-04-08

Cache Date: April 9, 2005