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A Study to Assess the Safety and Anti-Tumor Activity of REGN7945 in Combination With Linvoseltamab in Adult Participants With Relapsed/Refractory Multiple Myeloma

Phase 1
Recruiting
Conditions
Relapsed/Refractory Multiple Myeloma
Interventions
Drug: REGN7945+Linvoseltamab
Registration Number
NCT06669247
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

This study is researching an experimental drug called REGN7945 in combination with another experimental drug called linvoseltamab, (also known as REGN5458) (each individually called a "study drug" or "study drugs" when combined).

This study is the first time REGN7945 will be tested in humans. Linvoseltamab has previously been studied by itself (without other cancer drugs) in participants who had advanced multiple myeloma that returned and needed to be treated again after several other therapies had failed.

The aim of the study is to see how safe, tolerable, and effective REGN7945 is when given in combination with linvoseltamab, compared with linvoseltamab alone.

The study is looking at several other research questions, including:

* What side effects may happen from taking the study drug(s)

* How many people treated with REGN7945 and linvoseltamab compared to linvoseltamab alone have improvement of their multiple myeloma and by how much

* How long people benefit from receiving REGN7945 in combination with linvoseltamab compared with linvoseltamab alone

* How much study drug(s) is in the blood at different times

* Whether the body makes antibodies against the study drugs(s) (which could make the study drug(s) less effective or could lead to side effects)

* If there is any change in pain and cancer-related symptoms, how well people are able to function, and their quality of life when taking the study drug(s)

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
186
Inclusion Criteria
  1. Eastern Cooperative Oncology Group (ECOG) performance status ≤1 as described in the protocol
  2. Received at least 3 lines of therapy including exposure to at least 1 anti-CD38 antibody, 1 immunomodulatory imide drug (IMiD), and 1 proteasome inhibitor (PI) and have demonstrated disease progression on or after the last therapy, as defined in the protocol. Prior treatment with other BCMA directed immunotherapies, including BCMA CAR-T cells and BCMA antibody-drug conjugates (Phase 1 and 2), and with BCMA x CD3 bispecific antibodies (Phase 1 only), is allowed
  3. Participants must have the measurable disease for response assessment as described in the protocol
  4. Adequate hematologic, hepatic, and renal function as described in the protocol

Key

Exclusion Criteria
  1. Diagnosis of plasma cell leukemia, primary systemic light-chain amyloidosis (including myeloma associated amyloidosis), Waldenström macroglobulinemia (lymphoplasmacytic lymphoma), or POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
  2. Treatment with any systemic anti-cancer therapy within 5 half-lives or within 28 days before first administration of study drug, whichever is shorter
  3. History of allogeneic stem cell transplantation within 6 months, or autologous stem cell transplantation within 12 weeks of the start of study treatment
  4. Treatment with systemic corticosteroid treatment with more than 10 mg per day of prednisone or steroid equivalent within 72 hours of start of study drug
  5. Participants who have known central nervous system (CNS) involvement with MM or known or suspected progressive multifocal leukoencephalopathy (PML), history of a neurocognitive condition or CNS disorder, or history of seizure within 12 months prior to study enrollment
  6. Live or live attenuated vaccination within 28 days before first study drug administration with a vector that has replicative potential
  7. Has received a COVID-19 vaccination within 1 week of planned start of study medication as described in the protocol
  8. Myelodysplastic syndrome or another malignancy in the past 3 years, except for nonmelanoma skin cancer, in situ carcinoma, thyroid cancer, or low-risk early stage prostate adenocarcinoma, as described in the protocol
  9. Significant cardiovascular disease as described in the protocol
  10. Uncontrolled infection with HIV, Hep B or Hep C infection, or other uncontrolled infection, such as CMV, as described in the protocol
  11. Known hypersensitivity to both allopurinol and rasburicase

Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
REGN7945+LinvoseltamabREGN7945+LinvoseltamabPhase 1 Phase 2
LinvoseltamabLinvoseltamabPhase 2
LinvoseltamabREGN7945+LinvoseltamabPhase 2
Primary Outcome Measures
NameTimeMethod
Incidence of dose limiting toxicities (DLTs) from the first dose of REGN7945 in combination with linvoseltamabUp to 21 days

Phase 1

Incidence of treatment emergent adverse events (TEAEs) during the treatment period with REGN7945 in combination with linvoseltamabUp to 5 years

Phase 1

Severity of TEAEs during the treatment period with REGN7945 in combination with linvoseltamabUp to 5 years

Phase 1

Very Good Partial Response (VGPR) or better as determined by the investigator using the International Myeloma Working Group (IMWG) response criteria in patients receiving combination therapyWithin 12 weeks of starting cycle 1

Phase 2

VGPR or better as determined by the investigator using the IMWG response criteria in patients receiving linvoseltamab monotherapyWithin 12 weeks of starting cycle 1

Phase 2

Partial Response (PR) or better as determined by the investigator using the IMWG response criteria in patients receiving combination therapyWithin 12 weeks of starting cycle 1

Phase 2

PR or better as determined by the investigator using the IMWG response criteria in patients receiving linvoseltamab monotherapyWithin 12 weeks of starting cycle 1

Phase 2

Secondary Outcome Measures
NameTimeMethod
Time to definitive deterioration in EORTC QLQ-C30 fatigueUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-C30 GHS/QoLUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-C30 PFUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-C30 RFUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-C30 painUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-C30 fatigueUp to 5 years

Phase 1 and Phase 2

Change in EORTC QLQ-C30 painUp to 5 years

Phase 1 and Phase 2

Change in EORTC QLQ-C30 fatigueUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-C30 GHS/QoLUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-C30 PFUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-C30 RFUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-C30 painUp to 5 years

Phase 1 and Phase 2

Incidence of TEAEsUp to 5 years

Phase 1 and Phase 2

Severity of TEAEsUp to 5 years

Phase 1 and Phase 2

Concentrations of REGN7945 in the serumUp to 5 years

Phase 1 and Phase 2

Concentrations of linvoseltamab in the serumUp to 5 years

Phase 1 and Phase 2

Incidence of anti-drug antibodies (ADA) to REGN7945Up to 5 years

Phase 1 and Phase 2

Titer of ADA to REGN7945Up to 5 years

Phase 1 and Phase 2

Incidence of ADA to linvoseltamabUp to 5 years

Phase 1 and Phase 2

Titer of ADA to linvoseltamabUp to 5 years

Phase 1 and Phase 2

Change in European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) Global Health Status / Quality of Life (GHS/QoL)Up to 5 years

Phase 1 and Phase 2 The EORTC QLQ-C30 is a 30-item validated questionnaire developed to measure patient-reported quality of life using one global health status/quality of life (GHS/QoL) scale, 5 functioning scales (physical, role, emotional, cognitive, and social) ranging from from 1 = "very poor" to 5 = "excellent" and 9 symptom scales/items (fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) among patients with cancer, ranging from 1 = "not at all" to 9 = "very much" higher scores indicate higher symptom burden.

Change in EORTC QLQ-C30 Physical Functioning (PF)Up to 5 years

Phase 1 and Phase 2

Change in EORTC QLQ-C30 Role Functioning (RF)Up to 5 years

Phase 1 and Phase 2

Change in EORTC QLQ-Multiple Myeloma Module (MY20) Disease Symptoms (DS)Up to 5 years

Phase 1 and Phase 2 The EORTC QLQ-MY20 is a self -administered instrument to assess QoL in persons with Multiple Myeloma (MM). This 20-item questionnaire measures the following domains: symptom scales, including disease symptoms (6 items) and symptoms related to side effects of treatment (10 items); function scale and future perspective (3 items); and body image (1 item). A high score represents a high level of symptoms or problems.

Change in EORTC QLQ-MY20 Treatment Side Effects (TSE)Up to 5 years

Phase 1 and Phase 2

Change in EORTC QLQ-MY20 Body Image (BI)UP to 5 years

Phase 1 and Phase 2

Change in EORTC QLQ-MY20 Future Perspective (FP)Up to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-MY20 DSUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-MY20 TSEUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-MY20 BIUp to 5 years

Phase 1 and Phase 2

Time to definitive deterioration in EORTC QLQ-MY20 FPUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-MY20 DSUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-MY20 TSEUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-MY20 BIUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EORTC QLQ-MY20 FPUp to 5 years

Phase 1 and Phase 2

Change in EuroQoL-5 Dimensions, 5-level Questionnaire (EQ-5D-5L) Visual Analogue Score (VAS) (EQ-5D-5L VAS)Up to 5 years

Phase 1 and Phase 2 The EQ-5D-5L is a generic questionnaire that measures Health-Related Quality of Life (HRQoL) across 5 dimensions of health (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) across 5 levels (no problems, slight problems, some problems, severe problems and extreme problems) and a visual analogue scale (VAS).

Time to definitive deterioration in EQ-5D-5L VASUp to 5 years

Phase 1 and Phase 2

Time to first improvement in EQ-5D-5L VASUp to 5 days

Phase 1 and Phase 2

Patient-reported overall impact of treatment toxicity measured by Functional Assessment of Cancer Therapy (FACIT)-Item GP5Up to 5 years

Phase 1 and Phase 2 FACIT-Item GP5 will be used to assess the patient-reported impact of treatment toxicity that uses a single item "I am bothered by side effects of treatment" on a 5-point scale (0 = not at all, 1 = a little bit, 2 = somewhat, 3 = quite a bit, 4 = very much).

Objective Response Rate (ORR) as measured by IMWG criteria as determined by the investigatorUp to 5 years

Phase 1

Complete response (CR) rate as measured by IMWG criteria as determined by the investigatorUp to 5 years

Phase 1

Duration of response (DOR) by IMWG criteria as determined by the investigatorUp to 5 years

Phase 1

Progression Free Survival (PFS) as measured by IMWG criteria as determined by the investigatorUp to 5 years

Phase 1

Achievement of Minimal Residual Disease (MRD) negative status (at 10^5) in participants in CR or betterUp to 5 years

Phase 1

Overall survival (OS)Up to 5 years

Phase 1

Trial Locations

Locations (5)

Illawarra Cancer Care Centre

🇦🇺

Wollongong, New South Wales, Australia

Pindara Private Hospital

🇦🇺

Benowa, Queensland, Australia

Royal Adelaide Hospital

🇦🇺

Adelaide, South Australia, Australia

St Vincent's Hospital - Melbourne

🇦🇺

Fitzroy, Victoria, Australia

Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

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