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An open label, multicenter, phase II study of Elranatamab as single agent for the treatment of relapsed or refractory myeloma in patients previously exposed to three-drug classes

Phase 1
Recruiting
Conditions
Multiple Myeloma
Therapeutic area: Diseases [C] - Hemic and Lymphatic Diseases [C15]
Therapeutic area: Diseases [C] - Neoplasms [C04]
Registration Number
CTIS2023-504273-21-00
Lead Sponsor
Pethema Fundacion
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
All
Target Recruitment
50
Inclusion Criteria

Relapse multiple myeloma patients that have received at least 1 or 2 prior lines of therapy including at least to one proteasome inhibitor (bortezomib, carfilzomib or ixazomib), one immunomodulatory drug (lenalidomide is mandatory and patients can be also have been exposed to pomalidomide) and at least one anti-CD38 monoclonal antibody (daratumumab or isatuximab)., Subject must have pretreatment clinical laboratory values meeting the following criteria during the Screening Phase: hemoglobin =8 g/dL; absolute neutrophil count (ANC) = 1.0 x 109/L; platelet count = 25 x109/L; aspartate aminotransferase (AST) =2.5 x upper limit of normal (ULN); alanine aminotransferase (ALT) =2.5 x ULN; total bilirubin =2 x ULN, except in subjects with congenital hyperbilirubinemia, such as Gilbert syndrome (bilirubin =3 x ULN); estimated creatinine clearance > 30 mL/min/1.73 m2; corrected serum calcium <14 mg/dL (<3.5 mmol/L); or free ionized calcium <6.5 mg/dL (<1.6 mmol/L)., Women of childbearing potential must be using a highly effective method of birth control consistent with local regulations regarding the use of birth control methods for subjects participating in clinical studies (see Appendix 13), Women of childbearing potential must have a negative serum pregnancy test at screening within 10-14 days and 24 hours before starting treatment. Females of reproductive potential must agree either to abstain continuously from heterosexual sexual intercourse or to use two methods of reliable birth control simultaneously., Male Participants: Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. Male participants are eligible to participate if they agree to the following during the intervention period and for at least 100 days: refrain from donating sperm PLUS either: be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent OR must agree to use contraception/barrier., Patients must be refractory to the last line of therapy, defined as progression while receiving treatment or in the first 60 days after the last dose of treatment., Patient must have a measurable secretory disease defined as either serum monoclonal protein of = 0,5 g/dl or urine monoclonal (light chain) protein = 200 mg/24 h. For patients in whom disease is only measurable by serum FLC, the involved FLC should be = 10mg/L (100 mg/dl), with an abnormal serum FLC ratio., Male or female, 18 years or older (at the time consent is obtained)., Patient who, in the investigator’s opinion, is able to comply with the protocol requirements., Prior diagnosis of MM as defined according to IMWG criteria., Patient has given voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to their future medical care., Patients must have an ECOG performance status of 0 or 1., Left-ventricular ejection fraction (LVEF) =40% (MUGA scan or ECHO).

Exclusion Criteria

Subject has a diagnosis of primary amyloidosis, monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), POEMS syndrome (defined by the presence of peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasma-cells proliferative disorder, and skin changes) or plasma cell leukemia., Impaired cardiovascular function and/or clinically significant cardiovascular diseases, defined as any of the following within 6 months: acute myocardial infarction, acute coronary syndromes (e-g- unstable angina, coronary artery bypass graft, coronary angioplasty or stenting); clinically significant cardiac arrhythmias (e.g. uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia); thromboembolic or cerebrovascular events (e.g. transient ischemic attack, cerebrovascular accident, deep vein thrombosis, or pulmonary embolism); QTcF interval =470 msecs., Subject has meningeal involvement of multiple myeloma., Pregnant of lactating females., Known human immunodeficiency virus (HIV) infection, active infectious hepatitis A, B or C or chronic hepatitis B or C., Any serious and/or unstable pre-existing medical, psychiatric disorder or other conditions (including lab abnormalities) not mentioned above that could interfere with participant’s safety, obtaining informed consent or compliance to the study procedures., Subject who received any of the following within the last 14 days of initiation of study treatment: major surgery (except patients recovered from kyphoplasty) or use of any anti-myeloma drug therapy., Investigational drug within prior 30 days or within 5 half-lives of the investigational drug (whichever is longer)., Prior anti-BCMA treatment., Subject has peripheral neuropathy or neuropathic pain grade 2 or higher, as defined by the National Cancer Institute Terminology Criteria for Adverse Events (NCI CTCAE) Version 5., History of Guillain-Barré syndrome (GBS) or GBS variants, or history of any Grade =3 peripheral motor polyneuropathy., Stem cell transplant within 12 weeks prior to enrolment., Active Graft vs. Host Disease (GVHD) (other than Grade 1 skin involvement), or GVHD requiring treatment., Any active, uncontrolled bacterial, fungal, or viral infection. Active infections must be resolved at least 14 days prior to enrolment., Patients who require administration of live attenuated vaccine within 4 weeks of the first dose of study intervention., Prior history of malignancies other than MM, unless the subject has been free of the disease for > 2 years. Exceptions include: basal or squamous cell carcinoma of the skin, carcinoma in situ of the cervix or breast, incidental histological finding of prostate cancer (TNM stage of T1a or T1b).

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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