MedPath

A Study of Modakafusp Alfa on Adult Participants With Relapsed/Refractory Multiple Myeloma

Phase 1
Completed
Conditions
Multiple Myeloma
Interventions
Registration Number
NCT03215030
Lead Sponsor
Takeda
Brief Summary

The main aims of this 3-part study are as follows:

Part 1: To determine any side effects from modakafusp alfa single treatment and how often they occur. The dose of modakafusp alfa will be increased a little at a time until the highest dose that does not cause harmful side effects is found.

Part 2: To assess clinical activity of one or more dosing schedules of modakafusp alfa alone in participants with relapsed/refractory multiple myeloma. Dexamethasone standard dose will be administered with one or more selected dose of modakafusp alfa in selected group of participants.

Part 3: To find the optimal dose with the more favorable risk-benefit profile of modakafusp alfa.

Participants will receive modakafusp alfa at one of two doses which will be given through a vein.

Detailed Description

The drug being tested in this study, and which will be given through a vein, is called modakafusp alfa (TAK-573 ) as single agent or in combination with dexamethasone. The study will determine the safety, tolerability, and efficacy of modakafusp alfa as single agent and in combination with dexamethasone in participants with relapsed/refractory multiple myeloma (RRMM). The study consists of 3 Parts:

Part 1: Dose Escalation, Part 2: Dose Expansion, Part 3: Dose Extension

The study will enroll approximately 65 participants in Part 1, 35 in Part 2, and 236 in Part 3. Participants will be assigned to one of the following treatment groups in Parts 1 and 2 of the study. Participants will be randomly assigned in Part 3 of the study as given below:

* Part 1 (Dose Escalation) Schedule A: Modakafusp alfa 0.001 Up to 14 mg/kg

* Part 1 (Dose Escalation) Schedule B: Modakafusp alfa TBD

* Part 1 (Dose Escalation) Schedule C: Modakafusp alfa TBD

* Part 1 (Dose Escalation) Schedule D: Modakafusp alfa TBD

* Part 2 (Dose Expansion): Modakafusp alfa TBD + Dexamethasone 40 mg

* Part 3 (Dose Extension): Modakafusp alfa 120 mg

* Part 3 (Dose Extension): Modakafusp alfa 240 mg

The Part 1 (Dose Escalation) portion of the study will follow a 3+3 dose escalation design to evaluate once-weekly up to 4 different schedules of administration of modakafusp alfa starting at 0.001 mg/kg for dose limiting toxicity (DLT) evaluation and to determine the maximum tolerated dose (MTD) or an optimal biological dose (OBD) for assessments in Part 2.

The Part 2 (Dose Expansion) will further assess the safety profile of modakafusp alfa and its efficacy at MTD or OBD.

For Part 3 (Dose Extension) participants will be randomized 1:1 to receive single-agent modakafusp alfa 120 mg or 240 mg Q4W.

Parts 1 and 2 will be conducted at multiple centers in the United States. Part 3 will be conducted worldwide. The maximum treatment duration in this study is up to 12 months (Parts 1 and 2) or until disease progression (Part 3) and overall time to participate in the study is approximately up to 90 months. Participants with clinical benefit may continue treatment after sponsor approval.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
272
Inclusion Criteria

For Parts 1 and 2:

  1. Has MM defined by the IMWG criteria with evidence of disease progression and:
  • In need of additional myeloma therapy as determined by the investigator.
  • Has previously received at least 3 lines of myeloma therapy (for example, containing an Immunomodulatory imide drug [IMiD], a proteasome inhibitor [PI], an alkylating agent, and/or an anti-CD38 as single agents or in combination).
  • Is either refractory to or intolerant of at least 1 PI and a least 1 IMiD.

For Part 3:

  1. Has MM defined by the IMWG criteria with evidence of disease progression and:

    • In need of additional myeloma therapy as determined by the investigator.
    • Has previously received at least 3 lines of myeloma therapy.
    • Is refractory to at least 1 IMiD (ie, lenalidomide or pomalidomide [thalidomide excluded]), at least 1 PI (ie, bortezomib, ixazomib, or carfilzomib), and refractory to at least 1 anti-CD38 antibody (ie, daratumumab or isatuximab) and has demonstrated disease progression with the last therapy. Participants who are primary refractory, meaning they never achieved at least a MR with any previous treatment line, are not eligible.
  2. For participants in Part 2 and 3 only: Measurable disease is defined as :

    1. Serum M-protein ≥500 mg/dL (≥5 g/L)
    2. Urine M-protein ≥200 mg/24 hours.
    3. Serum free light chain (FLC) assay, with involved FLC level ≥10 mg/dL (≥100 mg/L) provided serum FLC ratio is abnormal.
  3. During Part 1 only, participants not meeting the above criteria for measurable disease should, at least, have measurable bone marrow plasmacytosis (greater than or equal to [≥ ] 10 percent [%]) and/or plasmacytoma (≥1 centimeter [cm] in diameter) detected by physical examination or imaging.

  4. Eastern Cooperative Oncology Group (ECOG) performance status of ≤2.

Exclusion Criteria

For Parts 1 and 2:

  1. Has polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome, monoclonal gammopathy of unknown significance, smoldering myeloma, solitary plasmacytoma, amyloidosis, Waldenstrom macroglobulinemia or immunoglobulin M (IgM) myeloma, or lymphoplasmacytic lymphoma (LPL).
  2. Who have received autologous stem cell transplant (SCT) 60 days before first infusion of modakafusp alfa or participants who have received allogeneic SCT 6 months before first infusion. Graft-versus-host disease that is active or requires ongoing systemic immunosuppression.
  3. Has not recovered from adverse reactions to prior myeloma treatment or procedures (chemotherapy, immunotherapy, radiation therapy) to NCI CTCAE less than or equal to (≤) Grade 1 or baseline, except for sensory or motor neuropathy which should have recovered to ≤ Grade 2 or baseline.
  4. Has clinical signs of central nervous system involvement of MM.

For Part 3:

  • Hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Seropositive for hepatitis B (defined by a positive test for hepatitis B surface antigen [HBsAg]. Participants with resolved infection (that is, participants who are HBsAg negative but positive for antibodies to hepatitis B core antigen [anti-HBc] and/or antibodies to hepatitis B surface antigen [anti-HBs]) must be screened using real-time polymerase chain reaction (PCR) measurement of HBV DNA levels. Those who are PCR positive will be excluded.
  • In addition to the above criteria, participants must not have plasma cell leukemia or have had primary refractory MM, current central nervous system involvement of MM, myelodysplastic syndrome, myeloproliferative syndrome, or have had a second malignancy within the previous 3 years, except treated basal cell or localized squamous skin carcinomas, localized prostate cancer, cervical carcinoma in situ, resected colorectal adenomatous polyps, breast cancer in situ, or other malignancy for which the participant is not on active anticancer therapy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Part 1 (Dose Escalation) Schedule A: Modakafusp alfa 0.001 Up to 14 mg/kgModakafusp alfaModakafusp alfa 0.001 up to 14 milligram per kilogram (mg/kg), infusion, intravenously (IV), once every week (Q1W) on Days 1, 8, 15 and 22 of each 28-day treatment cycle up to 2 cycles, followed by once on Days 1 and 15 of each 28-day treatment cycle up to 4 cycles, followed by once on Day 1 of each 28-day treatment cycle until treatment discontinuation.
Part 1 (Dose Escalation) Schedule B: Modakafusp alfa TBDModakafusp alfaModakafusp alfa TBD, infusion, IV, once every 2 weeks (Q2W) on Days 1 and 15 of each 28-day treatment cycle until treatment discontinuation. The starting dose will be decided by the investigators and sponsor representatives based on all available clinical information.
Part 1 (Dose Escalation) Schedule C: Modakafusp alfa TBDModakafusp alfaModakafusp alfa TBD, infusion, IV, once every 3 weeks (Q3W) on Day 1 of each 21-day treatment cycle until treatment discontinuation. The starting dose will be decided by the investigators and sponsor representatives based on all available clinical information.
Part 1 (Dose Escalation) Schedule D: Modakafusp alfa TBDModakafusp alfaModakafusp alfa TBD, infusion, IV, once every 4 weeks (Q4W) on Day 1 of each 28-day treatment cycle until treatment discontinuation. The starting dose will be decided by the investigators and sponsor representatives based on all available clinical information.
Part 2 (Dose Expansion): Modakafusp alfa TBD + Dexamethasone 40 mgModakafusp alfaDose(s) for Phase 2 will be based on safety and tolerability results from the preceding Phase 1 dose escalation cohorts. Participants in Phase 2 cohorts will receive modakafusp alfa TBD as a single agent. Participants in at least 1 cohort will receive modakafusp alfa TBD and modakafusp alfa TBD and dexamethasone 40 mg, orally, once weekly of each 28-day treatment cycle until treatment discontinuation.
Part 2 (Dose Expansion): Modakafusp alfa TBD + Dexamethasone 40 mgDexamethasoneDose(s) for Phase 2 will be based on safety and tolerability results from the preceding Phase 1 dose escalation cohorts. Participants in Phase 2 cohorts will receive modakafusp alfa TBD as a single agent. Participants in at least 1 cohort will receive modakafusp alfa TBD and modakafusp alfa TBD and dexamethasone 40 mg, orally, once weekly of each 28-day treatment cycle until treatment discontinuation.
Part 3 (Dose Extension): Modakafusp alfa 120 mgModakafusp alfaParticipants will receive modakafusp alfa 120 mg, infusion, IV, Q4W, for each 28-day treatment cycle until disease progression or treatment discontinuation.
Part 3 (Dose Extension): Modakafusp alfa 240 mgModakafusp alfaParticipants will receive modakafusp alfa 240 mg, infusion, IV, Q4W, for each 28-day treatment cycle until disease progression or treatment discontinuation.
Primary Outcome Measures
NameTimeMethod
Part 1: Percentage of Participants Reporting one or More Grade 3 TEAEsUp to approximately 90 months

TEAEs Grades will be evaluated as per NCI CTCAE, Version 5.0. Grade 1 scaled as Mild; Grade 2 scaled as Moderate; Grade 3 scaled as severe or medically significant but not immediately life-threatening; Grade 4 scaled as life-threatening consequences; and Grade 5 scaled as death related to AE.

Part 1: Percentage of Participants Reporting one or More Serious Adverse Events (SAEs)Up to approximately 90 months

An SAE is defined as any untoward medical occurrence that: 1) results in death, 2) is life-threatening, 3) requires inpatient hospitalization or prolongation of existing hospitalization, 4) results in persistent or significant disability/incapacity, 5) leads to a congenital anomaly/birth defect in the offspring of the participant or 6) is an medically important event that satisfies any of the following: a) May require intervention to prevent items 1 through 5 above. b) May expose the participant to danger, even though the event is not immediately life threatening or fatal or does not result in hospitalization.

Part 1: Percentage of Participants Reporting one or More Treatment Emergent Adverse Events (TEAEs)Up to approximately 90 months

An adverse event (AE) is defined as any untoward medical occurrence in a participants administered a pharmaceutical product; the untoward medical occurrence does not necessarily have a causal relationship with this treatment. A TEAE is defined as any AE either reported for the first time or worsening of a pre-existing event after first dose of study drug and within 30 days of the last administration of study drug.

Part 1: Percentage of Participants With Dose-limiting Toxicities (DLTs)Up to Cycle 1 (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

DLTs will be evaluated as per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 5.0. Nonhematologic TEAEs of NCI CTCAE Grade ≥3 clearly unrelated to the underlying disease and occurring during the first cycle will be considered DLTs.

Part 1: Percentage of Participants With Dose Modifications: Dose DelayUp to approximately 90 months
Part 3: Overall Response Rate (ORR) Assessed by Independent Review Committee (IRC)Up to approximately 90 months

ORR is defined as the percentage of participants who achieved a PR or better during the study as defined by IMWG Uniform Response Criteria assessed by IRC.

Part 1: Percentage of Participants With Clinically Significant Laboratory ValuesUp to approximately 90 months

Laboratory values will include hematology, chemistry, and urine analysis.

Part 1: Percentage of Participants With Dose Modifications: Dose InterruptionsUp to approximately 90 months
Part 1: Percentage of Participants With Dose Modifications: Dose ReductionsUp to approximately 90 months
Part 1: Percentage of Participants With Clinically Significant Vital Signs MeasurementsUp to approximately 90 months

Vital signs will include temperature, pulse, respiratory rate, oxygen saturation, and blood pressure.

Part 2: Overall Response Rate (ORR)Up to approximately 90 months

ORR is defined as the percentage of participants who achieved a partial response rate (PR) or better during the study as defined by International Myeloma Working Group (IMWG) Uniform Response Criteria.

Part 1: Percentage of Participants Who Discontinue the Treatment Because of TEAEUp to approximately 90 months

A TEAE is defined as any AE either reported for the first time or worsening of a pre-existing event after first dose of study drug and within 30 days of the last administration of study drug.

Secondary Outcome Measures
NameTimeMethod
Part 1 and 2: Percentage of Participants With Dose-limiting Toxicities (DLTs)- Like EventsUp to approximately 90 months

Percentage of participants with TEAEs meeting DLT definition that occur after phase (P) 1 Cycle (C) 1 will be reported. Toxicity will be evaluated as per the NCI CTCAE, Version 5.0. The hematologic TEAEs of Grade ≥3 clearly unrelated to the underlying disease and occur during the first cycle that is considered DLTs: Grade ≥3 hemolysis; Grade 4 neutropenia for \>7 consecutive days; Grade 4 thrombocytopenia for \>14 consecutive days; Grade 3 thrombocytopenia with clinically significant bleeding; Any other Grade ≥4 hematologic toxicity except for Grade 4 lymphopenia. An incomplete recovery from treatment-related toxicity causing \>2-week delay in the next scheduled infusion before the initiation of C2 will be considered a DLT. Frequencies and other TEAEs occur over the course of extended treatment with study drug, including dose modification, treatment discontinuation, and clinically significant laboratory values and vital signs.

Part 1: Cmax: Maximum Observed Serum Concentration for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: Tmax: Time to Reach the Cmax for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: AUC∞: Area Under the Serum Concentration-time Curve from Time 0 to Infinity for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: AUClast: Area Under the Serum Concentration-time Curve from Time 0 to the Time of the Last Quantifiable Concentration for Modakafusp alfaA Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: λz: Terminal Disposition Rate Constant for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: T1/2: Terminal Elimination Half-life for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: CL: Clearance for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Part 1: Vss: Volume of Distribution at Steady State for Modakafusp alfaSchedule A Cycle(C)1-13,Day(D)1,8,15,22; Schedule B C1-13,D1,15; Schedule C C1-17,D1; Schedule D C1-13,D1: Pre-infusion and at multiple times post-infusion (cycle length is 28 days for Schedule A, B and D; 21 days for Schedule C)

PK blood samples will be collected at the following time points for schedule A: Pre-infusion and at multiple time points (up to 72 hour \[h\]) C1-2 D1, 15; up to 4h C1-2 D8, 22 and C2 D15; up to 24h C3 D1; up to 4h on C3, 4-6 D15, D1, C4-6 and C7-13 D1; Schedule B: Pre-infusion and at multiple time points (up to 24h) on C1-2 D1, 15; up to 24h C3 D1; up to 4h C3 D15 and C4-13 D1; Schedule C: Pre-infusion and at multiple time points (up to 336h) on C1-2 D1; up to 4h on C3-17 D1; Schedule D: Pre-infusion and at multiple time points (up to 504h) C1-2 D1; up to 4h C3-13 D1 post-infusion (Schedule A, B and D cycle is 28 days and schedule C cycle is 21 days).

Parts 1, 2 and 3: Percentage of Participants with Positive Anti-drug Antibodies (ADA)Up to approximately 90 months
Part 1: Objective Response Rate (ORR)Up to approximately 90 months

ORR is defined as the percentage of participants who achieved a PR or better during the study as defined by IMWG Uniform Response Criteria.

Parts 1, 2 and 3: Progression Free Survival (PFS)Up to approximately 90 months

PFS is defined as the time from the date of enrollment until the date of PD or death due to any cause, whichever occurs first as defined by IMWG Criteria.

Parts 1 and 2: Clinical Benefit Rate (CBR)Up to approximately 90 months

CBR is defined as the percentage of participants who achieved MR or better during the study as defined by IMWG Uniform Response Criteria.

Parts 1 and 2: Disease Control Rate (DCR)Up to approximately 90 months

DCR is defined as the percentage of participants who achieved a stable disease (SD) or better during the study as defined by IMWG Uniform Response Criteria.

Parts 1, 2 and 3: Duration of Response (DOR)Up to approximately 90 months

DOR is defined as the time from the date of first documentation of response PR or better to the time of disease progression or death, whichever occurs first.

Parts 1 and 2: Time to ResponseUp to approximately 90 months

Time to response is defined as the time from first dose to the date of first documentation of response (PR or better).

Parts 2 and 3: Overall Survival (OS)Up to approximately 90 months
Part 2: Cmax: Maximum Observed Serum Concentration for Modakafusp alfaUp to approximately 90 months
Part 2: AUC∞: Area Under the Serum Concentration-time Curve from Time 0 to Infinity for Modakafusp alfaUp to approximately 90 months
Part 2: AUClast: Area Under the Serum Concentration-time Curve from Time 0 to the Time of the Last Quantifiable Concentration for Modakafusp alfaUp to approximately 90 months
Part 2: λz: Terminal Disposition Rate Constant for Modakafusp alfaUp to approximately 90 months
Part 2: Tmax: Time to Reach the Cmax for Modakafusp alfaUp to approximately 90 months
Part 2: CL: Clearance for Modakafusp alfaUp to approximately 90 months
Part 2: Vss: Volume of Distribution at Steady State for Modakafusp alfaUp to approximately 90 months
Part 2: T1/2z: Terminal Elimination Half-life for Modakafusp alfaUp to approximately 90 months
Part 3: Clinical Benefit Rate (CBR) by IRC and Investigator assessmentUp to approximately 90 months

CBR is defined as the percentage of participants who achieved MR or better during the study as defined by IMWG Uniform Response Criteria.

Part 3: Objective Response Rate (ORR) by Investigator AssessmentUp to approximately 90 months

ORR is defined as the percentage of participants who achieved a PR or better during the study as defined by IMWG Uniform Response Criteria assessed by investigators.

Part 3: Disease Control Rate (DCR) by IRC and Investigator AssessmentUp to approximately 90 months

DCR is defined as the percentage of participants who achieved a stable disease (SD) or better during the study as defined by IMWG Uniform Response Criteria.

Part 3: Percentage of Participants With Neutralizing Antibodies (NAb)Up to approximately 90 months
Part 3: Duration of Clinical BenefitUp to approximately 90 months

Duration of clinical benefit is defined as the time from first documented evidence of confirmed MR or better until the earliest date of a confirmed PD per IMWG, or death among patients who achieve a confirmed MR or better.

Part 3: Duration of Disease ControlUp to approximately 90 months

Duration of disease control is defined as the time from first documented evidence of SD or better until the earliest date of a confirmed PD per IMWG, or death among patients who achieve a SD or better.

Part 3: Time to Progression (TTP) by IRC and Investigator AssessmentUp to approximately 90 months

TTP is defined as the time from the date of the first dose until the earliest date of confirmed PD per IMWG, or death due to PD.

Part 3:Duration of MRD Negativity Status at a Sensitivity of 10^-5 in Participants Achieving CRUp to approximately 90 months

Duration of MRD negativity (10\^-5) is defined as the time from the first MRD negative status (10\^-5) to the earliest date of the MRD positive status (10\^-5), confirmed PD per IMWG or death.

Part 3: Percentage of Participants With Adverse Events (AEs)Up to approximately 90 months

An adverse event (AE) is defined as any untoward medical occurrence in a participants administered a pharmaceutical product; the untoward medical occurrence does not necessarily have a causal relationship with this treatment.

Part 3: Percentage of Participants With Serious Adverse Events (SAEs)Up to approximately 90 months

An SAE is defined as any untoward medical occurrence that: 1) results in death, 2) is life-threatening, 3) requires inpatient hospitalization or prolongation of existing hospitalization, 4) results in persistent or significant disability/incapacity, 5) leads to a congenital anomaly/birth defect in the offspring of the participant or 6) is an medically important event that satisfies any of the following: a) May require intervention to prevent items 1 through 5 above. b) May expose the participant to danger, even though the event is not immediately life threatening or fatal or does not result in hospitalization.

Part 3: Percentage of Participants With Clinically Significant Laboratory ValuesUp to approximately 90 months

Laboratory values will include hematology, chemistry, and urine analysis.

Part 3: Number of Participants With Eastern Cooperative Oncology Group (ECOG) StatusUp to approximately 90 months

ECOG is a grade, where grade 0: Normal activity. Grade 1: Symptoms but ambulatory. Grade 2: In bed \<50% of the time. Grade 3: In bed \>50% of the time. Grade 4: 100% bedridden. Grade 5: Dead.

Part 3: Rate of Minimal Residual Disease (MRD) Negativity Status at a Sensitivity of 10^-5 in Participants Achieving CRUp to approximately 90 months

MRD negativity at a sensitivity of 10\^-5 is defined as patients who are MRD negative at a sensitivity of 10\^-5 in patients achieving suspected complete response (CR). CR is defined as negative immunofixation of serum and urine, disappearance of any soft tissue plasmacytomas, and \<5% plasma cells in bone marrow; in participants for whom only measurable disease is by serum FLC level, normal FLC ratio of 0.26 to 1.65 in addition to CR criteria is required.

Part 3: Health Care Utilization: Length of Hospital StaysUp to approximately 90 months
Part 3: Health Care Utilization: Number of Participants With at Least One Medical EncounterUp to approximately 90 months

Healthcare resources used during medical encounters included hospitalizations, emergency room stays, or outpatient visits.

Part 3: Patient-reported Outcome (PRO): Instrument European Organisation for Research and Treatment of Cancer QLQ Questionnaire Multiple Myeloma Module (EORTC QLQ-MY20)Up to approximately 90 months

The EORTC QLQ-MY20 has 20 items across 4 independent subscales, 2 functional subscales (body image and future perspective), and 2 symptoms scales (disease symptoms and side effects of treatment). The QLQ-MY20 raw scores are converted into scale scores ranging from 0 to 100. For the symptom scales, lower scores represent better functioning. All items in this questionnaire have a recall period of 1 week.

Trial Locations

Locations (94)

Winship Cancer Institute of Emory University

🇺🇸

Atlanta, Georgia, United States

Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Lumi Research

🇺🇸

Houston, Texas, United States

University College London Hospitals NHS Foundation Trust

🇬🇧

London, England, United Kingdom

Oxford University Hospitals NHS Foundation Trust

🇬🇧

Oxford, England, United Kingdom

Royal Cornwall Hospital NHS Trust

🇬🇧

Cornwell, England, United Kingdom

Oslo Universitetssykehus-Ulleval Hospital

🇳🇴

Oslo, Norway

British Columbia Cancer Agency Vancouver Centre

🇨🇦

Vancouver, British Columbia, Canada

Institut de cancerologie Strasbourg Europe

🇫🇷

Strasbourg, Alsace, France

University of Rochester

🇺🇸

Rochester, New York, United States

University Hospitals Birmingham NHS Foundation Trust

🇬🇧

Birmingham, England, United Kingdom

Nanjing Drum Tower Hospital

🇨🇳

Nanjing, Jiangsu, China

Henan Cancer Hospital

🇨🇳

Zhengzhou, Henan, China

Tianjin Medical University Cancer Institute & Hospital

🇨🇳

Tianjin, Tianjin, China

The First Affiliated Hospital, Zhejiang University

🇨🇳

Hangzhou, Zhejiang, China

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Highlands Oncology Group

🇺🇸

Springdale, Arkansas, United States

Gabrail Cancer Center

🇺🇸

Canton, Ohio, United States

The Ohio State University

🇺🇸

Columbus, Ohio, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

Office of James R. Berenson MD

🇺🇸

West Hollywood, California, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Levine Cancer Center

🇺🇸

Charlotte, North Carolina, United States

Baptist Cancer Center - Memphis - Walnut Grove

🇺🇸

Memphis, Tennessee, United States

Sir Mortimer B. Davis Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

Juravinski Cancer Centre

🇨🇦

Hamilton, Ontario, Canada

Sun Yat-Sen University Cancer Center

🇨🇳

Guangzhou, Guangdong, China

Peking University Third Hospital

🇨🇳

Beijing, Beijing, China

Wuhan Union Hospital

🇨🇳

Wuhan, Hubei, China

The First Affiliated Hospital of Soochow University - Suzhou First People's Hospital

🇨🇳

Suzhou, Jiangsu, China

Zhongnan Hospital of Wuhan University

🇨🇳

Wuhan, Hubei, China

Centre Hospitalier Universitaire Henri Mondor

🇫🇷

Creteil Cedex, Ile-de-france, France

Hopital Saint-Antoine

🇫🇷

Paris Cedex 12, Ile-de-france, France

Hopital Necker-Enfants Malades

🇫🇷

Paris, Ile-de-france, France

Centre Hospitalier d'Argenteuil - Centre Hospitalier Victor Dupouy

🇫🇷

Argenteuil Cedex, France

Centre Hospitalier Universitaire de Poitiers

🇫🇷

Poitiers, Poitou-charentes, France

Universitatsklinik Tubingen

🇩🇪

Tuebingen, Baden-wuerttemberg, Germany

Hadassah Medical Center

🇮🇱

Jerusalem, Israel

Universitatsklinikum Leipzig

🇩🇪

Leipzig, Sachsen, Germany

The Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Tel Aviv, Israel

Evaggelismos General Hospital

🇬🇷

Athens, Attica, Greece

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Azienda Ospedaliero-Universitaria di Bologna - Policlinico Sant'Orsola-Malpighi

🇮🇹

Bologna, Italy

Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona

🇮🇹

Ancona, Italy

Nagoya City University Hospital

🇯🇵

Nagoya, Aichi, Japan

Chonnam National University Hwasun Hospital

🇰🇷

Hwasun, Jeollanam-do, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Hospital Espanol Auxilio Mutuo

🇵🇷

San Juan, Puerto Rico

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Universitari Germans Trias i Pujol

🇪🇸

Badalona, Barcelona, Spain

Ad-Vance Medical Research

🇵🇷

Ponce, Puerto Rico

Hospital Universitario Virgen de la Arrixaca

🇪🇸

Murcia, Spain

Genesis Care Windsor - Genesis Care UK Ltd.

🇬🇧

Windsor, England, United Kingdom

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

June E. Nylen Cancer Center

🇺🇸

Sioux City, Iowa, United States

Centre Hospitalier Universitaire de Toulouse Hopital Purpan

🇫🇷

Toulouse, Midi-pyrenees, France

Los Angeles Cancer Network - Glendale Adventist Medical Center

🇺🇸

Glendale, California, United States

John Theurer Cancer Center

🇺🇸

Hackensack, New Jersey, United States

Northwestern Medicine - Northwestern Medical Group

🇺🇸

Chicago, Illinois, United States

Investigative Clinical Research of Indiana, LLC

🇺🇸

Noblesville, Indiana, United States

Levine Cancer Institute - Concord

🇺🇸

Concord, North Carolina, United States

Centre de Recherche du CHUM

🇨🇦

Montreal, Quebec, Canada

Peking University People's Hospital

🇨🇳

Beijing, Beijing, China

Shanghai Fourth People's Hospital

🇨🇳

Shanghai, Shanghai, China

Centre Hospitalier Regional Universitaire de Lille

🇫🇷

Lille Cedex, NORD Pas-de-calais, France

Hopital Saint-Vincent de Paul - Lille

🇫🇷

Lille Cedex, NORD Pas-de-calais, France

Centre Hospitalier Universitaire Nantes - Hotel Dieu

🇫🇷

Nantes Cedex 1, PAYS DE LA Loire, France

AON SS Antonio e Biagio e Cesare Arrigo

🇮🇹

Alessandria, Italy

Alexandra General Hospital of Athens

🇬🇷

Athens, Attica, Greece

University Regional General Hospital of Patras

🇬🇷

Patra, Peloponnese, Greece

Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele

🇮🇹

Catania, Italy

Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

Ogaki Municipal Hospital

🇯🇵

Gifu-shi, Gifu, Japan

University Hospital Kyoto Prefectural University of Medicine

🇯🇵

Kyoto-City, Kyoto, Japan

National Hospital Organization Okayama Medical Center

🇯🇵

Okayama-city, Okayama, Japan

Japanese Red Cross Medical Center

🇯🇵

Tokyo, Japan

The Catholic University of Korea - Seoul St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario Marques de Valdecilla

🇪🇸

Santander, Spain

Tri-Service General Hospital

🇨🇳

Taipei, Taipei CITY, Taiwan

Hospital Universitario de Salamanca

🇪🇸

Salamanca, Spain

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Ondokuz Mayis Universitesi Tp Fakultesi

🇹🇷

Samsun, Turkey

Ankara Universitesi

🇹🇷

Yenimahalle, Ankara, Turkey

Genesis Care - Milton Keynes

🇬🇧

Milton Keynes, England, United Kingdom

The Royal Marsden NHS Foundation Trust

🇬🇧

Sutton, England, United Kingdom

Univeristy of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

USOR - Comprehensive Cancer Centers of Nevada - Central Valley

🇺🇸

Las Vegas, Nevada, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Smilow Cancer Hospital at Yale New Haven

🇺🇸

New Haven, Connecticut, United States

University of California Irvine

🇺🇸

Orange, California, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

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