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Multicenter Open Label Phase 2 Study of Isatuximab Plus Pomalidomide and Dexamethasone With Carfilzomib in Relapsed or Refractory Multiple Myeloma

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ClinicalTrials.gov Identifier: NCT04287855
Recruitment Status : Recruiting
First Posted : February 27, 2020
Last Update Posted : November 29, 2021
Sponsor:
Collaborators:
Sanofi
Celgene
Amgen
Intergroupe Francophone du Myelome
Information provided by (Responsible Party):
Poitiers University Hospital

Brief Summary:

Study a quadruplet-based regimen with Minimal Residual Disease (MRD) 10-5 negative rate as primary end point in patients with early Relapsed or Refractory Multiple Myeloma.

Therapeutic study, phase II, prospective, multicenter, open-label. The patients will be treated until progression. Each cycle of treatment lasts 28 days. Cycle 1 to 13 : treatment phase After cycle 13 : maintenance phase


Condition or disease Intervention/treatment Phase
Multiple Myeloma in Relapse Multiple Myeloma, Refractory Drug: Isatuximab Drug: Carfilzomib Drug: Pomalidomide Drug: Dexamethasone Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 90 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Multicenter Open Label Phase 2 Study of Isatuximab Plus Pomalidomide and Dexamethasone With Carfilzomib in Relapsed or Refractory Multiple Myeloma
Actual Study Start Date : August 28, 2020
Estimated Primary Completion Date : April 15, 2025
Estimated Study Completion Date : April 15, 2026


Arm Intervention/treatment
Experimental: Intervention
Isatuximab, Carfilzomib, Pomalidomide and Dexamethasone
Drug: Isatuximab
Isatuximab by IV route - Cycle 1 : 10mg/kg on days 1, 8, 15 and 22 per 28 days cycle. After cycle 1 : 10mg/kg on days 1 and 15 per 28 days cycle

Drug: Carfilzomib
Carfilzomib by IV route - Cycle 1 : 20/27 mg/m² on days 1-2, 8-9, 15-16 per 28 days cycle. Cycle 2-13 : 56mg/m² on days 1, 8, 15 per 28 days cycle. After cycle 13 : 56mg/m² on days 1 and 15 per 28 days cycle.

Drug: Pomalidomide
Pomalidomide by oral route - Cycle 1-2 : 3mg on days 1 to 21 per 28 days cycle. After cycle 2 : 4mg on days 1 to 21 per 28 days cycle.

Drug: Dexamethasone
Dexamethasone by oral route - Cycle 1-13 : 40/20 mg on days 1, 8, 15 and 22. Cycle 2-13 : 56mg/m² on days 1, 8, 15 per 28 days cycle. After cycle 13 : 56mg/m² on days 1 and 15 per 28 days cycle.




Primary Outcome Measures :
  1. Efficacy of trial treatment [ Time Frame: Up to 5 years ]
    Fraction of patients who experience a Minimal Residual Disease (MRD) 10-5 per IMWG (International Myeloma Working Group) criteria


Secondary Outcome Measures :
  1. Safety of trial treatment [ Time Frame: Up to 5 years ]
    List of AE frequency (AE assessed by Common Terminology Criteria for Adverse Events (CTCAE) criteria, version 5.0)

  2. Depth of response to the trial treatment [ Time Frame: Up to 5 years ]
    Per International Myeloma Working Group (IMWG) criteria

  3. Progression Free survival [ Time Frame: Up to 5 years ]
    Time to relapse or death, whichever occurs first



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Must be able to understand and voluntarily sign an informed consent form
  2. Must be able to adhere to the study visit schedule and other protocol requirements
  3. Male or female, age 18 years or older
  4. Life expectancy of > 6 months.
  5. Must have a in R1 and R2 relapse Multiple Myeloma with a measurable disease :

    • 1 to maximum 2 lines of therapy prior to study entry
    • Relapse Refractory or primary refractory or relapse
    • Must have received prior treatment with a Lenalidomide-containing regimen for at least 2 consecutive cycles
  6. Must have measurable disease as defined by the following: must have a clearly detectable and quantifiable monoclonal M-component value in the serum and/or urine :

    • IgG/IgA (serum M-component > 5g/l),
    • Light chain (serum M-component >1g/l or Bence Jones > 200mg/24H),
    • Serum FLC assay (including for IgD isotypes): involved FLC level > 10 mg/dl provided serum.

    FLC ratio is abnormal for patients not measurable on any of the 3 above criteria.

  7. Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2
  8. Wash out period without MM treatment must be of 28 days minimum before C1D1, except for anti CD-38 (See exclusion criteria#10).
  9. Adequate bone marrow function, documented within 72 hours and without transfusion 72 hours prior to the first intake of investigational product (C1J1) with no growth factor support (one week), defined as :

    • Absolute neutrophils ≥ 1 x109/L,
    • Untransfused Platelet count ≥ 75 x109/L,
    • Hemoglobin ≥ 8.5 g/dL.
  10. Adequate organ function defined as :

    • Serum total bilirubin < 2x upper limit of normal (ULN),
    • Clearance creatinine ≥ 30ml/min,
    • Serum SGOT/AST or SGPT/ALT < 3x upper limit of normal (ULN).
  11. Patients affiliated to an appropriate social security system.
  12. A man who is sexually active with a pregnant female or a FCBP* must agree to use a barrier method of birth control eg, condom with spermicidal foam/gel/film/cream/suppository, even if he has had a vasectomy. All men must also not donate sperm, spermatozoa during the study, for 5 months following treatment discontinuation.
  13. A woman FCBP* must understand and agree to use 2 reliable effective methods (a very effective method and an effective additional method) of contraception simultaneously without interruption :

    • For at least 28 days before starting experimental treatments,
    • Throughout the entire duration of experimental treatments,
    • During dose interruptions,
    • And for at least 5 months after the last dose of experimental treatments.
  14. All patients must agree to not donate blood during the treatment period, interruptions of treatment and at least 5 months after the last dose of treatment.
  15. All patients must understand and accept to comply with the conditions of the Pomalidomide pregnancy prevention plan (Appendix of the protocol).

Exclusion Criteria:

  1. Any other uncontrolled medical condition or comorbidity that might interfere with patient's participation, including simultaneous participation to another interventional clinical study.
  2. Known positive for HIV or active infectious hepatitis, type B or C.
  3. Patients with non-secretory MM and non-measurable MM
  4. Patient with terminal renal failure that require dialysis or clearance creatinine < 30 ml/min (calculated with MDRD formula)
  5. Any uncontrolled or severe cardiovascular or pulmonary disease determined by the investigator including :

    • NYHA functional classification III or IV congestive heart failure
    • LVEF (Left Ventricular Ejection Fraction) < 40%
    • Uncontrolled angina, hypertension or arrhythmia
    • Myocardial infarction in the past 6 months
  6. Prior history of malignancies, other than multiple myeloma, unless the patients has been free of the disease for ≥ 5 years. Exceptions include the following:

    • Basal or squamous cell carcinoma of the skin
    • Carcinoma in situ of the cervix or breast
    • Incidental histologic finding of prostate cancer (TNM stage of T1a or T1b)
  7. Evidence of central nervous system (CNS) involvement
  8. Ongoing active infection or other clinically significant uncontrolled cardiovascular events
  9. Unable to comply with IMids regulation to thromboprophylaxis, or teratogenic recommandations.
  10. Refractory to prior to anti CD38.Patients can be exposed to anti CD38 (any), BUT the wash out period for patient pre-treated with an anti CD38 antibody must be of 4,5 months minimum between last dose of previous anti-CD38 antibody and the first dose of isatuximab.
  11. Refractory to prior carfilzomib
  12. Known allergy to one of the study product (pomalidomide, isatuximab, carfilzomib) or dexamethasone
  13. Patient with a history of severe allergic reactions to thalidomide or lenalidomide
  14. Exposed to pomalidomide
  15. Known intolerance to infused protein products, sucrose, histidine, and PS80
  16. Contraindications to dexamethasone
  17. Any ongoing non hematological adverse event or medical history grade> 2 severity
  18. Pregnant or breast-feeding females
  19. Refusal to participate in the study
  20. Persons protected by a legal regime (guardianship, trusteeship)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04287855


Contacts
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Contact: LELEU Xavier, Professor +33 682 602 178 xavier.leleu@chu-poitiers.fr
Contact: KASMI Ahmed-Amine, Project manager +33 682 819 141 ahmed-amine.kasmi@chu-poitiers.fr

Locations
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France
CHU Poitiers Recruiting
Poitiers, France, 86000
Contact: Xavier LELEU, Pr    +33(0)549444444    xavier.leleu@chu-poitiers.fr   
Sponsors and Collaborators
Poitiers University Hospital
Sanofi
Celgene
Amgen
Intergroupe Francophone du Myelome
Investigators
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Principal Investigator: LELEU Xavier, Prof. Poitiers University Hospital
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Responsible Party: Poitiers University Hospital
ClinicalTrials.gov Identifier: NCT04287855    
Other Study ID Numbers: IsKPd - IFM2018-03
First Posted: February 27, 2020    Key Record Dates
Last Update Posted: November 29, 2021
Last Verified: November 2021

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Multiple Myeloma
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Neoplasms
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Paraproteinemias
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Lymphoproliferative Disorders
Immunoproliferative Disorders
Immune System Diseases
Dexamethasone
Pomalidomide
Anti-Inflammatory Agents
Antiemetics
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Immunologic Factors
Angiogenesis Inhibitors
Angiogenesis Modulating Agents