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Addition of Daratumumab to Combination of Bortezomib and Dexamethasone in Participants With Relapsed or Refractory Multiple Myeloma

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ClinicalTrials.gov Identifier: NCT02136134
Recruitment Status : Active, not recruiting
First Posted : May 12, 2014
Results First Posted : February 10, 2017
Last Update Posted : June 1, 2018
Sponsor:
Information provided by (Responsible Party):
Janssen Research & Development, LLC

May 1, 2014
May 12, 2014
December 20, 2016
February 10, 2017
June 1, 2018
August 15, 2014
January 11, 2016   (Final data collection date for primary outcome measure)
Progression-free Survival (PFS) [ Time Frame: From the date of randomization to either progressive disease or death, whichever occurs first (approximately 3 years) ]
PFS was defined as duration from date of randomization to either progressive disease (PD)/death, whichever occurred first. PD was defined as meeting any one of following criteria: Increase of greater than equal to (>=)25 percent (%) in level of serum M-protein from lowest response value and absolute increase must be >=0.5 gram per deciliter (g/dL); Increase of >=25% in 24-hour urinary light chain excretion (urine M-protein) from lowest response value and absolute increase must be >=200 mg/24hours; Only in participants without measurable serum and urine M-protein levels: increase of >=25% in difference between involved and uninvolved FLC levels from lowest response value and absolute increase must be >10 mg/dL; Definite increase in size of existing bone lesions or soft tissue plasmacytomas; Definite development of new bone lesions or soft tissue plasmacytomas; Development of hypercalcemia (corrected serum calcium >11.5 mg/dL) that can be attributed solely to PC proliferative disorder.
Percentage of participants with progression-free survival (PFS) [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
PFS is defined as a duration from the date of randomization to either progressive disease or death, whichever occurs first.
Complete list of historical versions of study NCT02136134 on ClinicalTrials.gov Archive Site
  • Time to Disease Progression (TTP) [ Time Frame: From the date of randomization to the date of first documented evidence of progression or death due to PD whichever occurs first (approximately 3 years) ]
    TTP was defined as time from date of randomization to date of first documented evidence of progressive disease (PD). PD was defined as meeting any one of following criteria: Increase of >=25% in level of serum M-protein from lowest response value and absolute increase must be >=0.5 g/dL; Increase of >=25% in 24-hour urinary light chain excretion (urine M-protein) from lowest response value and absolute increase must be >=200 mg/24hours; Only in participants without measurable serum and urine M-protein levels: increase of >=25% in difference between involved and uninvolved free light chain (FLC) levels from lowest response value and absolute increase must be >10 milligram per deciliter (mg/dL); Definite increase in size of existing bone lesions or soft tissue plasmacytomas; Definite development of new bone lesions or soft tissue plasmacytomas; Development of hypercalcemia (corrected serum calcium >11.5 mg/dL) that can be attributed solely to Plasma Cell (PC) proliferative disorder.
  • Percentage of Participants With a Very Good Partial Response (VGPR) or Better [ Time Frame: Up to disease progression (approximately of 3 years) ]
    Response rate of VGPR or better was defined as the percentage of participants who achieved VGPR and CR (including sCR) according to the IMWG criteria during or after the study treatment. IMWG criteria for VGPR: Serum and urine M-component detectable by immunofixation but not on electrophoresis, or >=90% reduction in serum M-protein plus urine M-protein <100 mg/24 hours, if the serum and urine M-protein are not measurable, a decrease of >90% in the difference between involved and uninvolved FLC levels is required in place of the M-protein criteria, in addition to the above criteria, if present at baseline, a >=50% reduction in the size of soft tissue plasmacytomas is also required; CR: Negative immunofixation on the serum and urine, disappearance of any soft tissue plasmacytomas, and <5% PCs in bone marrow; sCR: CR and normal FLC ratio, absence of clonal PCs by immunohistochemistry, immunofluorescence or 2 to 4 color flow cytometry.
  • Overall Response Rate (ORR) [ Time Frame: Up to disease progression (approximately of 3 years) ]
    The Overall response rate was defined as the percentage of participants who achieved stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) according to the International Myeloma Working Group (IMWG) criteria, during the study or during follow up. IMWG criteria for PR: >=50% reduction of serum M-protein and reduction in 24 hour urinary M-protein by >=90% or to <200 mg/24 hours, if the serum and urine M-protein are not measurable, a decrease of >=50% in the difference between involved and uninvolved FLC levels is required in place of the M-protein criteria, in addition to the above criteria, if present at baseline, a >=50% reduction in the size of soft tissue plasmacytomas is also required.
  • Percentage of Participants With Negative Minimal Residual Disease (MRD) [ Time Frame: Up to disease progression (approximately of 3 years) ]
    The Minimal Residual Disease negativity rate was defined as the percentage of participants who had negative MRD assessment at any timepoint after the first dose of study drugs by evaluation of bone marrow aspirates or whole blood. MRD was assessed in participants who achieved complete response or stringent complete response (CR/sCR). IMWG criteria for CR: Negative immunofixation on the serum and urine, disappearance of any soft tissue plasmacytomas, and <5% PCs in bone marrow; sCR: CR plus normal FLC ratio, absence of clonal PCs by immunohistochemistry, immunofluorescence or 2 to 4 color flow cytometry.
  • Overall Survival (OS) [ Time Frame: Up to the end of the study (approximately of 3 years) ]
    Overall Survival was measured from the date of randomization to the date of the participant's death.
  • Time to Disease Progression (TTP) [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
    TTP is defined as the time from the date of randomization to the date of first documented evidence of progression, as defined in the International Myeloma Working Group (IMWG) criteria.
  • Percentage of Participants With Overall Response [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
    The Overall Response is defined a stringent complete response (sCR), complete response, very good partial response (VGPR) or partial response (PR) as per IMWG Criteria.
  • Duration of response [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
    Duration of response will be calculated from the date of initial documentation of a response to the date of first documented evidence of progressive disease, as defined in the IMWG criteria.
  • Time to Response [ Time Frame: Baseline, up to 9 weeks ]
    Time to response is defined as the time from the date of first dose of study treatment to the date of the first documentation of observed response.
  • Percentage of Participants With a Very Good Partial Response (VGPR) or Better [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
    VGPR is defined as a greater than 90% reduction in blood myeloma protein (M-protein) plus urine myeloma protein less than 100 mg per 24 hours.
  • Percentage of participants with Minimal Residual Disease (MRD) [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
    MRD will be assessed in participants who achieve ≥ VGPR by analyzing bone marrow aspiration specimens.
  • Percentage of participants with overall survival (OS) [ Time Frame: Baseline, up to the end of the study, an expected average of 3 years ]
    OS will be measured from the date of randomization to the date of the participant's death.
Not Provided
Not Provided
 
Addition of Daratumumab to Combination of Bortezomib and Dexamethasone in Participants With Relapsed or Refractory Multiple Myeloma
Phase 3 Study Comparing Daratumumab, Bortezomib and Dexamethasone (DVd) vs Bortezomib and Dexamethasone (Vd) in Subjects With Relapsed or Refractory Multiple Myeloma
The purpose of this study is to assess the effects of administration of daratumumab when combined with VELCADE (bortezomib) and dexamethasone compared with bortezomib and dexamethasone alone, for participants with relapsed or refractory multiple myeloma.
This is an open-label (physicians and participants know the identity of the assigned treatment), randomized (the study medication is assigned by chance), multicenter, active-controlled study comparing daratumumab, VELCADE, and dexamethasone (DVd) with VELCADE and dexamethasone (Vd) in participants with relapsed or refractory multiple myeloma. Approximately 480 participants will be randomly assigned in a 1:1 ratio to receive either DVd or Vd. Randomization will be stratified by International Staging System (ISS), number of prior treatment programs (1 vs. 2 or 3 vs. >3), and prior VELCADE treatment ("no" vs. "yes"). Within each stratum, participants will be randomized to one of the treatment groups.The study will consist of a Screening Phase, a Treatment Phase, and a Follow-up Phase. Participants will be treated until disease progression, unacceptable toxicity, or other reasons to discontinue the study.
Interventional
Phase 3
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Multiple Myeloma
  • Drug: Daratumumab
    Daratumumab will be administered as an IV infusion at a dose of 16 mg/kg weekly for the first 3 cycles, on Day 1 of Cycles 4-9, and then every 4 weeks thereafter.
  • Drug: VELCADE (Bortezomib)
    VELCADE will be administered at a dose of 1.3 mg/m2 subcutaneously (SC) on Days 1, 4, 8 and 11 of each 21-day cycle. Eight VELCADE treatment cycles are to be administered.
    Other Name: VELCADE
  • Drug: Dexamethasone
    Dexamethasone will be administered orally at 20 mg on Days 1, 2, 4, 5, 8, 9, 11 and 12 of the first 8 VELCADE treatment cycles.
  • Experimental: Daratumumab+VELCADE+dexamethasone
    Daratumumab, VELCADE and dexamethasone
    Interventions:
    • Drug: Daratumumab
    • Drug: VELCADE (Bortezomib)
    • Drug: Dexamethasone
  • Active Comparator: VELCADE+dexamethasone
    VELCADE and dexamethasone
    Interventions:
    • Drug: VELCADE (Bortezomib)
    • Drug: Dexamethasone
Palumbo A, Chanan-Khan A, Weisel K, Nooka AK, Masszi T, Beksac M, Spicka I, Hungria V, Munder M, Mateos MV, Mark TM, Qi M, Schecter J, Amin H, Qin X, Deraedt W, Ahmadi T, Spencer A, Sonneveld P; CASTOR Investigators. Daratumumab, Bortezomib, and Dexamethasone for Multiple Myeloma. N Engl J Med. 2016 Aug 25;375(8):754-66. doi: 10.1056/NEJMoa1606038.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
499
480
June 15, 2021
January 11, 2016   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Must have had documented multiple myeloma
  • Must have received at least 1 prior line of therapy for multiple myeloma
  • Must have had documented evidence of progressive disease as defined based on Investigator's determination of response of International Myeloma Working Group (IMWG) criteria on or after their last regimen
  • Must have an Eastern Cooperative Oncology Group Performance Status score of 0, 1, or 2
  • Must have achieved a response (partial response [PR] or better based on investigator's determination of response by the IMWG criteria) to at least 1 prior regimen in the past

Exclusion Criteria:

  • Has received daratumumab or other anti-CD38 therapies previously
  • Is refractory to VELCADE or another PI, like ixazomib and carfilzomib (had progression of disease while receiving VELCADE therapy or within 60 days of ending VELCADE therapy or another PI therapy, like ixazomib and carfilzomib
  • Is intolerant to VELCADE (ie, discontinued due to any adverse event while on VELCADE treatment)
  • Has received anti-myeloma treatment within 2 weeks or 5 pharmacokinetic half-lives of the treatment, whichever is longer, before the date of randomization. The only exception is emergency use of a short course of corticosteroids (equivalent of dexamethasone 40 milligram per day [mg/day] for a maximum of 4 days) before treatment. A list of anti-myeloma treatments with the corresponding pharmacokinetic half-lives is provided in the Site Investigational Product Procedures Manual (IPPM).
  • Has a history of malignancy (other than multiple myeloma) within 3 years before the date of randomization
  • Has any concurrent medical condition or disease (eg, active systemic infection) that is likely to interfere with study procedures
Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
No
Contact information is only displayed when the study is recruiting subjects
Australia,   Brazil,   Czechia,   Germany,   Hungary,   Korea, Republic of,   Mexico,   Netherlands,   Poland,   Russian Federation,   Spain,   Sweden,   Turkey,   Ukraine,   United States
Czech Republic
 
NCT02136134
CR103995
2014-000255-85 ( EudraCT Number )
54767414MMY3004 ( Other Identifier: Janssen Research & Development, LLC )
Yes
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Not Provided
Janssen Research & Development, LLC
Janssen Research & Development, LLC
Not Provided
Study Director: Janssen Research & Development, LLC Clinical trial Janssen Research & Development, LLC
Janssen Research & Development, LLC
May 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP