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PHE885 CAR-T Therapy in Adult Participants With Relapsed and Refractory Multiple Myeloma

Phase 2
Active, not recruiting
Conditions
Multiple Myeloma
Interventions
Registration Number
NCT05172596
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

This is a Phase II study to determine the efficacy and safety of PHE885, a BCMA-directed CAR-T cell therapy, manufactured with a new process. The CAR-T cell therapy will be investigated as a single agent in relapsed and refractory multiple myeloma

Detailed Description

This clinical trial employs an open label, single arm, multi-center design with primary analysis testing overall response rate ( ORR), including one interim analysis for futility and one interim analysis for efficacy.

The trial population includes adult patients with relapsed and refractory multiple myeloma (MM) after failure of 3 or more lines of therapy, including failing an immunomodulatory drug (IMiD), a proteasome inhibitor (PI) and an anti-CD38 (cluster of differentiation 38) monoclonal antibody (mAb) and who have measurable disease at enrollment per IMWG criteria . In addition, patients must be refractory to the last line of therapy

The trial will enroll 90 efficacy evaluable adult patients with relapsed and refractory MM (efficacy evaluable means participants infused with a PHE885 product at target dose 10e6 that met all release specifications).

Patients will be followed for acute and intermediate safety and efficacy within this trial for a minimum of 2 years before being transferred to the long-term follow-up trial. A long-term post-study follow-up for lentiviral vector safety will be offered under a separate destination protocol for 15 years post injection per health authority guidelines.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
146
Inclusion Criteria
  1. ≥18 years of age at the time of informed consent form (ICF) signature

  2. Adult patients after failure of three or more lines of therapy including an IMiD (e.g., lenalidomide or pomalidomide), a proteasome inhibitor (e.g., bortezomib, carfilzomib), and an approved anti-CD38 antibody (e.g., daratumumab, isatuximab), and who have documented evidence of disease progression (IMWG criteria) 3, Must have received ≥2 consecutive cycles of treatment for at least three prior regimens unless deemed refractory to that regimen (i.e., progressive disease as the best response)

  3. Must be refractory to the last treatment regimen (defined as progressive disease on or within 60 days measured from last dose of last regimen).

  4. Measurable disease at enrollment as defined by the protocol 6. Eastern Cooperative Oncology Group (ECOG) performance status that is either 0 or 1 at screening 7. Must have a leukapheresis material of non-mobilized cells accepted for manufacturing

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Exclusion Criteria

1.Prior administration of a genetically modified cellular product including prior BCMA CAR-T therapy. 2.Participants who have received prior BCMA -directed bi-specific antibodies or anti-BCMA antibody drug conjugate.

  1. Prior autologous SCT within 3 month or allogenic SCT within 6 months prior to signing informed consent.

4.Plasma cell (PC) leukemia and other plasmacytoid disorders, other than MM 5.POEMS syndrome 6.Active central nervous system (CNS) involvement by malignancy 7.Patients with active neurological autoimmune or inflammatory disorders 8.Inadequate cardiac, renal, hepatic or hematologic function as defined in the protocol.

Other protocol-defined Inclusion/Exclusion may apply.

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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
PHE885PHE885Patients will receive PHE885
Primary Outcome Measures
NameTimeMethod
Overall response rate (ORR) per Independent Review Committee (IRC) in Efficacy Analysis Set24 Months

Percentage of patients with best overall response (BOR) of either stringent complete response (sCR), complete response (CR), very good partial response (VGPR), partial response (PR) according to the International Myeloma Working Group (IMWG) criteria'

Secondary Outcome Measures
NameTimeMethod
Transgene of PHE885 concentrations over time in peripheral blood and bone marrow24 Months

As determined by quantitative polymerase chain reaction (qPCR)

Cellular kinetics parameter: AUC24 months

The Area under the curve of the transgene level

Key Secondary End point: MRD Negativity rate in Bone Marrow24 months

Evaluate the efficacy of PHE885 with respect to MRD negativity rate in bone marrow measured by next generation sequencing (NGS)

Time to next anti-myeloma treatment (TTNT)24 Months

Time from PHE885 infusion until start of new anti-myeloma therapy or death due to any cause

Overall Survival (OS)24 Months

Time from PHE885 infusion until death due to any cause

Patient Reported Outcomes (PRO): EORTC-QLQ-MY2024 months

PROs as measured by EORTC-QLQ-MY20 is a 20-item myeloma module intended for use among patients varying in disease stage and treatment modality.

Cellular kinetics parameter: Tmax24 Months

The time to peak transgene level

Complete response rate (CRR)24 Months

Percentage of patients with BOR of sCR or CR according to the IMWG criteria

Progression free survival (PFS)24 Months

Time from PHE885 infusion until progression or death due to any cause

Patient Reported Outcomes (PRO): EORTC-QLQ-C3024 months

PROs as measured by European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC-QLQ-C30) Questionnaire will be used as a measure of health-related quality of life.

Manufacturing turnaround time24 months

Time from pick of cryopreserved material at the clinic or hospital until return to the clinical or hospital

Time to response24 Months

Time form PHE885 infusion to the date of first documented response (PR or better)

Duration of Response (DOR)24 Months

Time from first documented response (PR or better) until relapse or death due to any cause

Durability of Minimal Residual Disease (MRD)negativity24 Months

Time from the start of undetectable MRD to the time of reappearance of detectable MRD

Patient Reported Outcomes (PRO): EQ-5D-5L Health Questionnaire24 months

PROs as measured by EuroQoL Group EQ-5D-5L Health Questionnaire is a standardized measure of health status developed by the EuroQol Group in order to provide a simple, generic measure of health for clinical and economic appraisal.

PHE885 manufacturing success rate24 Months

Percentage of enrolled patients for whom PHE885 product was manufactured that met all release specifications

Immunogenicity to PHE88524 Months

Summary of pre-existing and treatment-induced immunogenicity (cellular and humoral) of PHE885

Cellular kinetics parameter: Cmax24 Months

The maximum transgene level at Tmax

Trial Locations

Locations (7)

Stanford University

🇺🇸

Palo Alto, California, United States

Emory University School of Medicine-Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Oregon Health Sciences University

🇺🇸

Portland, Oregon, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

Fred Hutch Cancer Research

🇺🇸

Seattle, Washington, United States

Novartis Investigative Site

🇬🇧

Glasgow, United Kingdom

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