Phase 3 Study Comparing Daratumumab, Lenalidomide, and Dexamethasone (DRd) vs Lenalidomide and Dexamethasone (Rd) in Subjects With Relapsed or Refractory Multiple Myeloma
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 569
- 主要终点
- Progression-free Survival (PFS)
研究概览
简要总结
The purpose of this study is to compare the effectiveness of daratumumab when combined with lenalidomide and dexamethasone (DRd) to that of lenalidomide and dexamethasone (Rd), in terms of progression-free survival in participants with relapsed or refractory multiple myeloma.
详细描述
This is a randomized (participants will be assigned by chance to study treatments), open-label (all participants and study personnel will know the identity of the study treatments), active-controlled (none of the study treatments are placebo), parallel-group (both treatment arms will run at the same time), multicenter study. In this study, daratumumab, lenalidomide, and low-dose dexamethasone (DRd) will be compared with lenalidomide and low dose dexamethasone (Rd) in participants with relapsed or refractory multiple myeloma. Participants will be randomized in a 1:1 ratio to receive either DRd or Rd. The study will include a Screening Phase, a Treatment Phase (involving treatment cycles of approximately 28 days in length), and a Follow-up Phase. The Treatment Phase will extend from the administration of the first dose of study medication until disease progression or unacceptable toxicity. Participants will also discontinue study treatment if: they become pregnant; have their dose held for more than 28 days (or if 3 consecutive planned doses of daratumumab are missed for reasons other than toxicity); or for safety reasons (for example, adverse event). The Follow-up Phase will begin at the end of treatment and will continue until death, loss to follow-up, consent withdrawal for study participation, or the final overall survival (OS) analysis, whichever occurs first. Eligible participants from Rd group who have had sponsor confirmed disease progression will be offered the option for treatment with daratumumab monotherapy (of 28 days cycle). The primary endpoint will be progression-free survival (PFS). Analysis of the primary endpoint was performed at a pre-specified point determined by PFS events with a clinical cutoff of March 7, 2016 when 169 events of death or progression had occurred. The end of study is anticipated at approximately 6 years after the last participant is randomized. Blood and urine samples will be obtained at time points during the study, together with bone marrow aspirates/biopsies and skeletal surveys. Participant safety will be assessed throughout the study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Must have documented multiple myeloma and measurable disease
- •Must have received at least 1 prior line of therapy for multiple myeloma and achieved a response (partial response or better) to at least one prior regimen
- •Must have documented evidence of progressive disease as defined by the International Myeloma Working Group criteria on or after their last regimen
- •Must have an Eastern Cooperative Oncology Group Performance Status score of 0, 1, or 2
- •If a participant has received subsequent anticancer therapy (salvage therapy), the participant must have a "wash-out period" defined as 2 weeks or 5 pharmacokinetic half-lives of the treatment, whichever is longer, before the planned start date of daratumumab monotherapy. The only exception is the emergency use of a short course of corticosteroids (equivalent of dexamethasone 40 milligram per day for a maximum of 4 days) before Daratumumab monotherapy
排除标准
- •Has received any of the following therapies: daratumumab or other anti-CD38 therapies
- •Has received anti-myeloma treatment within 2 weeks or 5 pharmacokinetic half-lives of the treatment
- •Disease shows evidence of refractoriness or intolerance to lenalidomide or if previously treated with a lenalidomide-containing regimen the participant is excluded if he or she discontinued due to any adverse event related to prior lenalidomide treatment
- •Has received autologous stem cell transplantation within 12 weeks before the date of randomization, or previously received an allogenic stem cell transplant (regardless of timing), or planning to undergo a stem cell transplant prior to progression of disease
- •History of malignancy (other than multiple myeloma) within 5 years before the first dose of daratumumab monotherapy (exceptions are squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix, or breast, or other non-invasive lesion, that in the opinion of the investigator, with concurrence with the sponsor's medical monitor, is considered cured with minimal risk of recurrence within 5 years)
研究组 & 干预措施
Daratumumab + lenalidomide + dexamethasone
During each 28-day treatment cycle, participants will receive daratumumab, lenalidomide, and dexamethasone.
干预措施: Daratumumab (Drug)
Daratumumab + lenalidomide + dexamethasone
During each 28-day treatment cycle, participants will receive daratumumab, lenalidomide, and dexamethasone.
干预措施: Lenalidomide (Drug)
Daratumumab + lenalidomide + dexamethasone
During each 28-day treatment cycle, participants will receive daratumumab, lenalidomide, and dexamethasone.
干预措施: Dexamethasone (Drug)
Lenalidomide + dexamethasone
During each 28-day treatment cycle, participants will receive lenalidomide and dexamethasone.
干预措施: Lenalidomide (Drug)
Lenalidomide + dexamethasone
During each 28-day treatment cycle, participants will receive lenalidomide and dexamethasone.
干预措施: Dexamethasone (Drug)
结局指标
主要结局
Progression-free Survival (PFS)
时间窗: From randomization to either disease progression or death whichever occurs first (up to 21 months)
PFS: duration from date of randomization to either progressive disease (PD)/death, whichever occurred first. PD: defined as meeting any 1 of following criteria: Increase of greater than equal to (\>=)25 percent(%) in level of serum M-protein from lowest response value and absolute increase must be \>=0.5 gram per deciliter (g/dL); Increase of \>=25% in 24-hours(h) urinary light chain excretion (urine M-protein) from lowest response value and absolute increase must be \>=200 mg/24h; Only in participants without measurable serum and urine M-protein levels: increase of \>=25% in difference between involved and uninvolved free light chain (FLC) levels from lowest response value and absolute increase must be \>10 mg/dL; Definite increase in size of existing bone lesions or soft tissue plasmacytomas; Definite development of new bone lesions or soft tissue plasmacytomas; Development of hypercalcemia (corrected serum calcium \>11.5 mg/dL) attributed solely to plasma cell (PC) proliferative disorder.
次要结局
- Time to Disease Progression (TTP)(From randomization to disease progression (up to 21 months))
- Percentage of Participants Who Achieved Very Good Partial Response (VGPR) or Better(From randomization to disease progression (up to 21 months))
- Percentage of Participants With Negative Minimal Residual Disease (MRD)(From randomization to the date of first documented evidence of PD (up to 87.5 months))
- Overall Response Rate(From randomization to disease progression (up to 21 months))
- Overall Survival (OS)(From randomization to date of death due to any cause (up to 87.5 months))
- Time to Response(From randomization up to first documented CR or PR (up to 21 months))
- Duration of Response (DOR)(From randomization to the date of first documented evidence of PD (up to 21 months))
- Time to Subsequent Anticancer Treatment(From randomization to date of start of subsequent anticancer treatment or death due to PD, whichever occured first (up to 87.5 months))