A Phase 1/2 Multicenter, Open-label Study to Assess the Safety, Pharmacokinetics and Efficacy of CC-92480 Monotherapy and in Combination with Dexamethasone in Subjects with Relapsed and Refractory Multiple Myeloma
Overview
- Phase
- Phase 2
- Status
- Recruiting
- Sponsor
- Celgene Corp.
- Enrollment
- 46
- Locations
- 8
- Primary Endpoint
- Safety: Type, frequency, seriousness, severity and relationship of AEs to CC- 92480 and dexamethasone; changes from baseline in clinically-relevant physical findings, vital signs, selected laboratory analytes, ECGs and ECHO/MUGA scans.
Overview
Brief Summary
Part 1:
- To assess the pharmacokinetics (PK), safety/tolerability and define the maximally tolerated dose (MTD)/recommended Phase 2 dose (RP2D) of CC-92480 (also known as BMS-986348 and mezigdomide) in combination with dexamethasone in conjunction with a minimum of two CC-92480 dosing schedules.
- To assess the PK, safety/tolerability and define the MTD/RP2D of CC-92480 monotherapy on the QD 21/28 dosing schedule. Part 2:
- To determine the efficacy of CC-92480 in combination with dexamethasone in subjects with RRMM in cohort expansion, as measured by overall response rate (ORR).
Eligibility Criteria
- Ages
- 18 years to 65+ years (65+ Years, 18-64 Years)
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Subject is ≥ 18 years of age at the time of signing the informed consent form (ICF).
- •Males must agree to refrain from donating sperm while on CC-92480 for 94 days after the last dose of CC-
- •Females must agree to refrain from donating ova while on CC-92480 for 184 days after last dose.
- •All subjects must agree to refrain from donating blood while on CC- 92480 and for 28 days after its discontinuation.
- •Subject must understand and voluntarily sign an ICF prior to any study-related assessments/procedures being conducted.
- •Subject is willing and able to adhere to the study visit schedule and other protocol requirements.
- •Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1 or
- •Subjects must have a documented diagnosis of MM and measurable disease at enrollment. Measurable disease is defined as: a. M-protein quantities ≥ 0.5 g/dL by sPEP or b. ≥ 200 mg/24 hour urine collection by uPEP or c. Serum FLC levels > 100 mg/L (milligrams/liter) involved light chain and an abnormal kappa/lambda (κ/λ) ratio in subjects without measurable serum or urine M-protein or d. for subjects with immunoglobulin class A (IgA) myeloma whose disease can only be reliably measured by quantitative immunoglobulin measurement, a serum IgA level ≥ 0.50 g/dL
- •All subjects must have: a. received at least 3 prior anti-myeloma regimens including at least 2 consecutive cycles of lenalidomide, pomalidomide, a proteasome inhibitor, a glucocorticoid and a CD38 antibody (note: induction with or without bone marrow transplant and with or without maintenance therapy is considered one regimen), b. documented disease progression on or within 60 days from the last dose of their last myeloma therapy, i. subjects who had CAR-T therapy as their last myeloma therapyare eligible as long as they have documented disease progression following CAR-T therapy, c. in addition to criteria above (a and b), subjects enrolled in Part 2, must have disease refractory to an immunomodulatory agent (lenalidomide and/or pomalidomide), a glucocorticoid, a proteasome inhibitor, and a CD38 antibody. Refractory is defined as disease that is nonresponsive on therapy (failure to achieve minimal response or development of progressive disease), or progresses within 60 days of last dose.
- •Subjects must have the following laboratory values: a. Absolute neutrophil count (ANC) ≥ 1.25 x 10 to the power 9 /L without growth factor support for ≥ 7 days (≥ 14 days for pegfilgrastim). ANC of ≥ 1.00 x 109/L is permitted for the dose expansion cohorts (Part 2). b. Hemoglobin (Hgb) ≥ 8 g/dL. c. Platelets (plt) ≥ 75 x 10 to the power 9 /L without transfusion for ≥ 7 days (≥ 50 x 10 to the power 9 /L for subjects with > 50% plasma cells in bone marrow). d. Corrected serum calcium ≤ 13.5 mg/dL (≤ 3.4 mmol/L). e. Creatinine clearance (CrCl) based on Cockcroft-Gault formula ≥ 45 mL/min. f. AST/SGOT and ALT/SGPT ≤ 3.0 x upper limit of normal (ULN). g. Serum bilirubin ≤ 1.5 x ULN or < 3.0 mg/dL for subjects with documented Gilbert's syndrome. h. Uric acid ≤ 7.5 mg/dL (446 μmol/L). i. PT/INR < 1.5 x ULN and partial thromboplastin time (PTT) < 1.5 x ULN, (for subjects not receiving therapeutic anticoagulation).
Exclusion Criteria
- •Subject has a significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
- •Subject is undergoing dialysis.
- •Subjects with peripheral neuropathy ≥ Grade
- •Subjects with gastrointestinal disease that may significantly alter the absorption of CC-
- •Subject has impaired cardiac function or clinically significant cardiac disease, including any of the following: • LVEF < 45% as determined by ECHO or MUGA scan at Screening. • Complete left bundle branch, bifascicular block or other clinically significant abnormal electrocardiographic (ECG) finding at Screening. • A prolongation of QT interval on Screening ECG as defined by repeated demonstration of a QTc interval >480 milliseconds (ms) using Fridericia's QT correction formula; a history of or current risk factors for Torsades de Pointe (eg. heart failure, hypokalemia, or a family history of Long QT Syndrome); and concurrent administration of medications that prolong the QT/QTc interval. • Congestive heart failure (New York Heart Association Class III or IV). • Myocardial infarction ≤6 months prior to starting CC-
- •Unstable or poorly controlled angina pectoris, including the Prinzmetal variant of angina pectoris.
- •Concurrent administration of strong CYP3A modulators; concurrent administration of proton-pump inhibitors (eg, omeprazole, esomeprazole, lansoprazole, pantoprazole) ≤ 2 weeks prior to starting CC-92480
- •Subject had prior systemic myeloma treatment with an investigational anti-myeloma agent (eg, anti-PD-1, anti-PD-L1) ≤ 5 halflives prior to starting CC-92480 (not applicable for subjects who had CAR-T as last prior regimen); Subject had prior systemic myeloma treatment with an investigational agent (eg. anti-PD-1, anti-PD-L1) ≤ 5 half-lives prior to starting CC-92480; or subject had prior exposure to approved myeloma therapies (including therapeutic monoclonal antibodies such as anti-CD38 or anti-SLAM-7) ≤5 half-lives or within 4 weeks prior to starting CC-92480 whichever is shorter.
- •Subject had major surgery ≤ 2 weeks prior to starting CC-
- •Note: Subjects must have recovered from any clinically significant effects of recent surgery.
Outcomes
Primary Outcomes
Safety: Type, frequency, seriousness, severity and relationship of AEs to CC- 92480 and dexamethasone; changes from baseline in clinically-relevant physical findings, vital signs, selected laboratory analytes, ECGs and ECHO/MUGA scans.
Safety: Type, frequency, seriousness, severity and relationship of AEs to CC- 92480 and dexamethasone; changes from baseline in clinically-relevant physical findings, vital signs, selected laboratory analytes, ECGs and ECHO/MUGA scans.
PK parameters: Area under the plasma concentration-time curve (AUC), maximal plasma concentration (Cmax), time to Cmax(Tmax), terminal-phase elimination half-life (t1/2),apparent total clearance of the drug from plasma after oral administration (CL/F) and apparent volume of distribution during terminal phase after non-intravenous administration (Vz/F) for CC- 92480 monotherapy and in combination with dexamethasone and the Renantiomer (CC0982796) of CC-92480 (if data allow).
PK parameters: Area under the plasma concentration-time curve (AUC), maximal plasma concentration (Cmax), time to Cmax(Tmax), terminal-phase elimination half-life (t1/2),apparent total clearance of the drug from plasma after oral administration (CL/F) and apparent volume of distribution during terminal phase after non-intravenous administration (Vz/F) for CC- 92480 monotherapy and in combination with dexamethasone and the Renantiomer (CC0982796) of CC-92480 (if data allow).
Recommended Phase 2 Dose: Establish the MTD/RP2D for CC-92480 monotherapy and in combination with dexamethasone at each dosing schedule.
Recommended Phase 2 Dose: Establish the MTD/RP2D for CC-92480 monotherapy and in combination with dexamethasone at each dosing schedule.
Overall Response Rate (ORR) Best response ≥ partial response (PR), according to the IMWG Uniform Response Criteria.
Overall Response Rate (ORR) Best response ≥ partial response (PR), according to the IMWG Uniform Response Criteria.
Secondary Outcomes
- Overall response rate (ORR): Best response ≥ PR, according to the IMWG Uniform Response Criteria.
- Safety: Type, frequency, seriousness, severity and relationship of AEs to CC- 92480 and dexamethasone; changes from baseline in clinically-relevant physical findings, vital signs, selected laboratory analytes, ECGs and ECHO/MUGA scans.
- Time to response (TTR): Time from 1st dose of CC-92480 to the first documentation of response ≥ PR.
- Duration of response (DOR): Time from the first documentation of response ( ≥ PR) to the first documentation of PD or death.
- Progression free survival: Time from 1st dose of CC-92480 to the first occurrence of disease progression or death from any cause.
- Overall survival (OS): Time from first dose of CC-92480 to death due to any cause
Investigators
GSM-CT
Scientific
Celgene Corp.