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A Clinical Study of Daratumumab Subcutaneous (Dara-SC) Administration in Combination with Carfilzomib and Dexamethasone (DKd) Compared with Carfilzomib and Dexamethasone (Kd) in Participants with Multiple Myeloma who have been Previously Treated with Daratumumab to Evaluate Daratumumab Retreatment

Phase 1
Conditions
Multiple Myeloma
MedDRA version: 21.0Level: LLTClassification code 10028228Term: Multiple myelomaSystem Organ Class: 100000004864
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2018-004185-34-DK
Lead Sponsor
Janssen-Cilag International N.V.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
88
Inclusion Criteria

1. At least 18 years of age.
2.1 Measurable disease at screening as defined by any of the following: Serum M-protein level =1.0 g/dL in participants with immunoglobulin G
(IgG) type, or serum M-protein level =0.5 g/dL in participants with non-IgG type, or urine M-protein level =200 mg/24 hours; or Light chain multiple myeloma without measurable disease in the serum or the urine: Serum immunoglobulin free light chain (FLC) =10 mg/dL and abnormal serum immunoglobulin kappa lambda FLC ratio.
3.1 Evidence of a response (partial response or better based on investigator's determination of response by IMWG criteria) to daratumumab-containing therapy with response duration of at least 4 months.
4.1 Participants must have progressed from or be refractory to their last line of treatment. Relapsed or refractory disease as defined below:
Relapsed disease is defined as an initial response to previous treatment, followed by confirmed PD by IMWG criteria >60 days after cessation of
treatment. Refractory disease is defined as <25% reduction in M-protein or confirmed PD by IMWG criteria during previous treatment or 60 days after cessation of treatment.
5.1 Received 1 to 3 prior line(s) of treatment of which one contained daratumumab and completed daratumumab at least 3 months prior to
randomization. A single line of therapy may consist of 1 or more agents, and may include induction, hematopoietic stem cell transplantation, and maintenance therapy. Radiotherapy, bisphosphonate, or a single short course of corticosteroids (no more than the equivalent of dexamethasone
6. ECOG Performance Status score of 0, 1, or 2.
7. Pretreatment clinical laboratory values meeting the following criteria during the Screening Phase:
a) hemoglobin =8 g/dL (=5mmol/L) (without prior RBC transfusion within 7 days before the laboratory test; recombinant human erythropoietin use is permitted);
b) absolute neutrophil count (ANC) =1.0 × 10^9/L (prior growth factor support is permitted but must be without support within the 7 days prior to the laboratory test);
c) platelet count =75 ×10^9/L for participants in whom <50% of bone marrow nucleated cells are plasma cells; otherwise platelet count of = 50×10^9/L. Transfusions are not permitted within 7 days of testing to achieve this minimum platelet count. Please see the complete list of criteria 7 in Protocol Am on pg.39
8.1 Women of childbearing potential must commit to either abstain continuously from heterosexual sexual intercourse or to use 2 methods of reliable birth control simultaneously. This includes one highly effective form of contraception (tubal ligation, intrauterine device, hormonal [birth control pills, injections, hormonal patches, vaginal rings or implants] or partner's vasectomy) and one additional effective contraceptive method (male latex or synthetic condom, diaphragm, or cervical cap). A reduction in the effectiveness of oral contraceptives during carfilzomib treatment cannot be excluded. In addition, because of the increased risk of venous thromboembolic events associated with carfilzomib, women should avoid the use of hormonal contraceptives that are associated with a risk of thrombosis during treatment with carfilzomib. Women of childbearing potential who are using oral contraceptives or a hormonal method of contraception that is associated with a risk of thrombosis should switch to an alternative method of
highly effective contraception. Contraception must begin with study treatment initiation and continue f

Exclusion Criteria

Any potential participant who meets any of the following criteria will be excluded from participating in the study:
1. Criterion deleted per Amend 2
2. Previoustreatment with carfilzomib.
3. Previous treatment with daratumumab within the last 3 months prior to randomization.
4.1 Discontinuation of daratumumab due to a daratumumab-related AE.
5. Allergies, hypersensitivity, or intolerance to daratumumab, hyaluronidase, mAbs, human proteins, or their excipients (refer to the IB), or known sensitivity to mammalian derived products. Known history of allergy to Captisol (a cyclodextrin derivative used to solubilize carfilzomib).
6. Contraindications to the use of any components of the backbone treatment regimens, per local prescribing information.
7. Received an investigational intervention (including investigational vaccines) or used an invasive investigational medical device within 4 weeks before randomization (except for investigational anti-myeloma treatments, which cannot be taken within 2 weeks or 5PK half-lives of the treatment from the first dose of daratumumab, whichever is longer, before the date of randomization).
8.1 Received an investigational intervention (including investigational vaccines) or used an invasive investigational medical device within 4 weeks before randomization (except for investigational anti-myeloma treatments, which cannot be taken within 2 weeks or 5 PK half-lives of the treatment from the date of randomization, whichever is longer)9. Pregnant, or breast-feeding, or planning to become pregnant while enrolled in this study or within 3 months after the last dose of study intervention.
10. Plans to father a child while enrolled in this study or within 3 months after the last dose of study intervention.
11. Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg, compromise the
12.1. Received anti-myeloma treatment within 2 weeks or 5 PK half-lives of the treatment from the date of randomization, whichever is longer. The only exception is emergency use of a short course of corticosteroids (equivalent of dexamethasone 40 mg/day for a maximum of 4 days; see Appendix 10) up to 21 days before treatment. A list of anti-myeloma treatments with the corresponding PK half-lives is provided in the Site Investigational Product Procedures Manual.
13. Received autologous stem cell transplant within 12 weeks before the date of randomization, or the participant has previously received allogeneic stem cell transplant (regardless of timing).
14. Plans to undergo a stem cell transplant prior to progression of disease on this study.
15. Focal radiation therapy within 14 days prior to randomization with the exception of palliative radiotherapy for symptomatic management but not on measurable extramedullary plasmacytoma. Radiotherapy within 14 days prior to randomization on measurable extramedullary plasmacytoma is not permitted even in the setting of palliation for symptomatic management.
16. Clinical signs of meningeal involvement of multiple myeloma.
17. Please see the protocol for exlusion criteria 17.
18.1 Participant is:
a) known to be seropositive for human immunodeficiency virus (HIV), with 1 or more of the following:
i. Not receiving highly active antiretroviral therapy (ART)
ii. Had a change in ART within 6 months of the start of screening
iii. Receiving ART that may interfere with study treatment (consult Sponsor for review of medication prior

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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