ISKPD-IFM2018-03-Multicenter Open label Phase 2 study of Isatuximab plus Pomalidomide and Dexamethasone with Carfilzomib in Relapsed or Refractory Multiple Myeloma

Phase 2

Recruiting

• Conditions: Multiple Myeloma

• Registration Number: 2024-516670-29-00
• Lead Sponsor: Centre Hospitalier Universitaire De Poitiers

Brief Summary

The primary objective is to determine the efficacy of IsPd + K in early Relapse Refractory Multiple Myeloma according to IMWG*.

Detailed Description

Not available

Study Timeline

• Study First Posted: 2024-08-19
• Last Update Posted: 2025-06-02

Recruitment & Eligibility

• Status: Ongoing, recruiting
• Sex: Not specified
• Target Recruitment: 90

Inclusion Criteria

1)Must be able to understand and voluntarily sign an informed consent form

10. Adequate organ function defined as: o Serum total bilirubin < 2x upper limit of normal (ULN), o Clearance creatinine ≥ 30ml/min, o Serum SGOT/AST or SGPT/ALT < 3x upper limit of normal (ULN).

11. Patients affiliated to an appropriate social security system.

12. A man who is sexually active with a pregnant female or a FCBP* must agree to use a barrier method of birth control eg, condom with spermicidal foam/gel/film/cream/suppository, even if he has had a vasectomy. All men must also not donate sperm, spermatozoa during the study, for 5 months following treatment discontinuation.

13. A woman FCBP* must understand and agree to use 2 reliable effective methods (a very effective method and an effective additional method) of contraception simultaneously without interruption: o For at least 28 days before starting experimental treatments o Throughout the entire duration of experimental treatments, o During dose interruptions, o And for at least 5 months after the last dose of experimental treatments.

14. All patients must agree to not donate blood during the treatment period, interruptions of treatment and at least 5 months after the last dose of treatment

15. All patients must understand and accept to comply with the conditions of the Pomalidomide pregnancy prevention plan (Appendix of the protocol).

2)Must be able to adhere to the study visit schedule and other protocol requirements

3)Male or female, age 18 years or older

4)Life expectancy of > 6 months.

5. Must be in R1 (Line 2) and R2 (Line 3) relapse Multiple Myeloma with a measurable disease o Have had 1 to maximum 2 lines of therapy prior to study entry o Relapse Refractory or primary refractory or relapse o Must have received prior treatment with a Lenalidomide-containing regimen for at least 2 consecutive cycles

6. Must have measurable disease as defined by the following: must have a clearly detectable and quantifiable monoclonal M-component value in the serum and/or urine. o IgG/IgA (serum M-component > 5g/l), o Light chain (serum M-component >1g/l or Bence Jones > 200mg/24H), o Serum FLC assay (including for IgD isotypes): involved FLC level > 10 mg/dl provided serum. FLC ratio is abnormal for patients not measurable on any of the 3 above criteria.

7. Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2

8. Wash out period without MM treatment must be of 28 days minimum before C1D1, except for anti CD-38 (See exclusion criteria#10).

9. Adequate bone marrow function, documented within 72 hours and without transfusion 72 hours prior to the first intake of investigational product (C1J1) with no growth factor support (one week), defined as: o Absolute neutrophils ≥ 1 x109/L, o Untransfused Platelet count ≥ 75 x109/L, o Hemoglobin ≥ 8.5 g/dL.

Exclusion Criteria

1. Any other uncontrolled medical condition or comorbidity that might interfere with subject’s participation, including simultaneous participation to another interventional clinical study.

2. Refractory to prior anti CD38. Patients can be exposed to anti CD38 (any), BUT the wash out period for patient pre-treated with an anti CD38 antibody must be of 4,5 months minimum between last dose of previous anti-CD38 antibody and the first dose of isatuximab.

3. Refractory to prior carfilzomib.

4. Known allergy to one of the study product (pomalidomide, isatuximab, carfilzomib) or dexamethasone

Patient with a history of severe allergic reactions to thalidomide or lenalidomide

Previously exposed to pomalidomide

Known intolerance to infused protein products, sucrose, histidine, and polysorbate 80

Contraindications to dexamethasone

Any ongoing non hematological adverse event grade > 2 severity or medical history grade > 2 severity

18. Pregnant or breast-feeding females

Refusal to participate in the study

2. Known positive for HIV or active infectious hepatitis, type B or C.

Persons protected by a legal regime (guardianship, trusteeship)

3. Patients with non-secretory MM and non-measurable MM

4. Patient with terminal renal failure that require dialysis or clearance creatinine < 30 ml/min (calculated with MDRD formula)

5. Any uncontrolled or severe cardiovascular or pulmonary disease determined by the investigator including: o NYHA functional classification III or IV congestive heart failure o LVEF (Left Ventricular Ejection Fraction) < 40% o Uncontrolled angina, hypertension or arrhythmia o Myocardial infarction in the past 6 months

6. Prior history of malignancies, other than multiple myeloma, unless the patients has been free of the disease for ≥ 5 years. Exceptions include the following: o Basal or squamous cell carcinoma of the skin o Carcinoma in situ of the cervix or breast o Incidental histologic finding of prostate cancer (TNM stage of T1a or T1b)

Evidence of central nervous system (CNS) involvement

8. Ongoing active infection or other clinically significant uncontrolled cardiovascular events

9. Unable to comply with IMids regulation to thromboprophylaxis, or teratogenic recommendations.

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
MRD 10-5 incidence rate determined (as the best response obtained at any time point during treatment) as per IMWG criteria by NGS (centrally performed, Pr Avet Loiseau Toulouse Oncopole).		MRD 10-5 incidence rate determined (as the best response obtained at any time point during treatment) as per IMWG criteria by NGS (centrally performed, Pr Avet Loiseau Toulouse Oncopole).

Secondary Outcome Measures

Name	Time	Method
Treatment emergent adverse events of IsPd +K will be evaluated according to CTCAE 5.0.		Treatment emergent adverse events of IsPd +K will be evaluated according to CTCAE 5.0.
To determine Overall Response Rate (ORR, Partial Response and better), Very Good Partial Response (VGPR) + CR rate of IsPd +K as per IMWG criteria and with M protein interference testing. Clinical benefit response rate (CBR, Minor Response (MR) and better) of IsPd +K as per IMWG criteria.		To determine Overall Response Rate (ORR, Partial Response and better), Very Good Partial Response (VGPR) + CR rate of IsPd +K as per IMWG criteria and with M protein interference testing. Clinical benefit response rate (CBR, Minor Response (MR) and better) of IsPd +K as per IMWG criteria.
Time to response and Response duration for responders as per IMWG criteria.		Time to response and Response duration for responders as per IMWG criteria.
Overall Survival (OS), Progression free survival (PFS), Time To Progression (TTP), Time To Next Therapy (TTNT) and Event Free survival (EFS) of IsPd +K will be evaluated as per IMWG criteria.		Overall Survival (OS), Progression free survival (PFS), Time To Progression (TTP), Time To Next Therapy (TTNT) and Event Free survival (EFS) of IsPd +K will be evaluated as per IMWG criteria.

Trial Locations

Locations (17)

Centre Hospitalier Regional Universitaire De Tours; 🇫🇷 Tours, France

Centre Hospitalier Universitaire De Rennes; 🇫🇷 Rennes, France

Centre Hospitalier Universitaire De Bordeaux; 🇫🇷 Pessac, France

Centre Hospitalier Universitaire De Poitiers; 🇫🇷 Poitiers, France

Centre Hospitalier De La Cote Basque; 🇫🇷 Bayonne, France

Centre Hospitalier Universitaire De Lille; 🇫🇷 Lille, France

Assistance Publique Hopitaux De Paris; 🇫🇷 Bobigny Cedex, France

Oncopole Claudius Regaud; 🇫🇷 Toulouse Cedex 9, France

Centre Hospitalier Annecy Genevois; 🇫🇷 Pringy Cedex, France

Centre Hospitalier Regional Universitaire; 🇫🇷 Besancon Cedex, France

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Centre Hospitalier Regional Universitaire De Tours

🇫🇷Tours, France

Thomas CHALOPIN

Site contact

0247473712

t.chalopin@chu-tours.fr