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临床试验/NCT03993912
NCT03993912进行中(未招募)3 期

A Phase III Study Comparing Lenalidomide and Subcutaneous Daratumumab (R-Dara SC) vs Lenalidomide and Dexamethasone (Rd) in Frail Subjects With Previously Untreated Multiple Myeloma Who Are Ineligible for High Dose Therapy

University Hospital, Lille23 个研究点 分布在 1 个国家目标入组 294 人开始时间: 2019年10月17日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
状态
进行中(未招募)
发起方
入组人数
294
试验地点
23
主要终点
Comparison of the efficacy of Daratumumab SC injection when combined with Lenalidomide (R-Dara SC) vs Lenalidomide and Dexamethasone (Rd): PFS

研究概览

简要总结

This is a Phase 3, randomized (study drug assigned by chance), open-label (participants and researchers are aware about the treatment, participants are receiving), active-controlled (study in which the experimental treatment or procedure is compared to a standard treatment or procedure), parallel-group (each group of participants will be treated at the same time), and multicenter (when more than one hospital team work on a medical research study) study in participants with newly diagnosed multiple myeloma (a blood cancer of plasma cells) and who are not candidates for high dose chemotherapy (treatment of disease, usually cancer, by chemical agents) and autologous stem cell transplant (ASCT). The primary hypothesis of this study is that subcutaneous Daratumumab in combination with Lenalidomide will prolong progression-free survival and likely induce less toxicity as compared with Lenalidomide and dexamethasone, in elderly frail subjects with newly diagnosed Multiple myeloma who are ineligible for high dose chemotherapy and ASCT

详细描述

The primary hypothesis of this study is that subcutaneous Daratumumab in combination with Lenalidomide will prolong progression-free survival and likely induce less toxicity as compared with Lenalidomide and dexamethasone, in elderly frail subjects with newly diagnosed Multiple myeloma who are ineligible for high dose chemotherapy and ASCT

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
65 Years 至 —(Older Adult)
性别
All
接受健康志愿者

入选标准

  • Subject must be at least 65 years of age.
  • Subject must have documented multiple myeloma satisfying the CRAB criteria and measurable disease.
  • Newly diagnosed and not considered candidate for high-dose chemotherapy with SCT.
  • Subject must have a Frailty Score ≥ 2
  • Subject must have within 5 days prior to first drug intake (C1D1) pretreatment clinical laboratory values meeting the following criteria during the Screening Phase:
  • hemoglobin ≥7.5 g/dL
  • absolute neutrophil count ≥1.0 x 109/L
  • platelet count ≥70 x 109/L
  • aspartate aminotransferase (AST) ≤2.5 x upper limit of normal (ULN)
  • alanine aminotransferase (ALT) ≤2.5 x ULN
  • total bilirubin ≤2.0 x ULN
  • creatinine clearance≥30mL/min
  • Measurable ISS with β2-microglobulin and albumin values for randomization
  • A man who is sexually active with a woman of childbearing potential must agree to use a latex or synthetic condom, even if they had a successful vasectomy. All men must also not donate sperm during the study, for 4 weeks after the last dose of lenalidomide, and for 4 months after the last dose of daratumumab. Women participating in this study must be postmenopausal.
  • Each subject must sign an informed consent form (ICF) indicating that he or she understands the purpose of and procedures required for the study and are willing to participate in the study. Subject must be willing and able to adhere to the prohibitions and restrictions specified in this protocol, as referenced in the ICF.
  • Subjects affiliated with an appropriate social security system.

排除标准

  • Subject has a diagnosis of primary amyloidosis, monoclonal gammopathy of undetermined significance, or smoldering multiple myeloma.
  • Subject has a diagnosis of Waldenström's disease, or other conditions in which IgM M-protein is present in the absence of a clonal plasma cell infiltration with lytic bone lesions.
  • Subject has prior or current systemic therapy or SCT for multiple myeloma
  • Subject has a history of malignancy (other than multiple myeloma) within 5 years before the date of randomization
  • Subject has had radiation therapy within 14 days of randomization.
  • Subject has had plasmapheresis within 28 days of randomization.
  • Subject is exhibiting clinical signs of meningeal involvement of multiple myeloma.
  • Subject has known chronic obstructive pulmonary disease (COPD) (defined as a forced expiratory volume [FEV] in 1 second <60% of predicted normal), persistent asthma, or a history of asthma within the last 2 years (intermittent asthma is allowed).
  • Subject is known to be seropositive for history of human immunodeficiency virus (HIV)
  • Seropositive for hepatitis B.
  • (Known to be) seropositive for hepatitis C
  • Subject has any concurrent medical or psychiatric condition or disease that is likely to interfere with the study procedures or results, or that in the opinion of the investigator, would constitute a hazard for participating in this study.
  • Subject has clinically significant cardiac disease, including:
  • myocardial infarction within 1 year before randomization, or an unstable or uncontrolled disease/condition related to or affecting cardiac function
  • uncontrolled cardiac arrhythmia or clinically significant ECG abnormalities
  • screening 12-lead ECG showing a baseline QT interval as corrected by Fridericia's formula (QTcF) >470 msec
  • Subject has known allergies, hypersensitivity, or intolerance to corticosteroids, monoclonal antibodies or human proteins, or their excipients
  • Subject has plasma cell leukemia or POEMS syndrome
  • Subject is known or suspected of not being able to comply with the study protocol. Subject has any condition for which, in the opinion of the investigator, participation would not be in the best interest of the subject or that could prevent, limit, or confound the protocol-specified assessments.
  • Subject has had major surgery within 2 weeks before randomization or has not fully recovered from surgery.
  • Subject has received an investigational drug (including investigational vaccines) or used an invasive investigational medical device within 4 weeks before randomization or is currently enrolled in an interventional investigational study.
  • Refusal to consent or protected by legal regime ( guardianship, trusteeship)
  • Subject has contraindications to required prophylaxis for deep vein thrombosis and pulmonary embolism
  • Incidence of gastrointestinal disease that may significantly alter the absorption of oral drugs.

研究组 & 干预措施

Arm 1: Experimental group

Experimental

Daratumumab SC 1800 mg

  • once every week for 8 weeks
  • then once every other week for 16 weeks
  • thereafter once every 4 weeks, until progression Lenalidomide PO (25mg): days 1 through 21 of each 28-day cycle, until progression Dexamethasone PO (20mg): days 1, 8, 15, 22 of a 28-day cycle, for the first 2 cycles, then discontinued

干预措施: Daratumumab SC in combination with Lenalidomide (Drug)

Arm 1: Experimental group

Experimental

Daratumumab SC 1800 mg

  • once every week for 8 weeks
  • then once every other week for 16 weeks
  • thereafter once every 4 weeks, until progression Lenalidomide PO (25mg): days 1 through 21 of each 28-day cycle, until progression Dexamethasone PO (20mg): days 1, 8, 15, 22 of a 28-day cycle, for the first 2 cycles, then discontinued

干预措施: Lenalidomide PO (25mg) (Drug)

Arm 2: Control group

Sham Comparator

Lenalidomide PO (25mg): days 1 through 21 of each 28-day cycle, until progression Dexamethasone PO (20mg): days 1, 8, 15, 22 of each 28-day cycle, until progression

干预措施: Lenalidomide PO (25mg) (Drug)

结局指标

主要结局

Comparison of the efficacy of Daratumumab SC injection when combined with Lenalidomide (R-Dara SC) vs Lenalidomide and Dexamethasone (Rd): PFS

时间窗: From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months

The primary objective is to compare the efficacy of Daratumumab SC injection when combined with Lenalidomide (R-Dara SC) to that of Lenalidomide and Dexamethasone (Rd), in terms of PFS in frail subjects with newly diagnosed myeloma who are not candidates for high dose chemotherapy and autologous stem cell transplant.

次要结局

  • Evaluation of quality of life based on EORTC C30 questionnaires(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Evaluation of quality of life based on EQ-5D questionnaires(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Minimal residual disease (MRD) negative rate at 12 months.(after 12 months of treatment)
  • Time-to-treatment failure(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Overall response (CR + VGPR + partial response [PR]).(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Occurrence of grade 3 or more side effects.(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Time-to-next treatment(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • PFS2 time(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Overall survival (OS) time(From date of randomization until the date of death from any cause, whichever came first, assessed up to 84months)
  • Complete remission (CR)(From date of randomization until the date of first documented progression whichever came first, assessed up to 84months)
  • Very good partial response (VGPR) or better.(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Safety and tolerability of Daratumumab SC when administered in combination with Revlimid: NCI-CTCAE V5.0.(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Evaluation of quality of life based on MY20 questionnaires(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)
  • Event Free Survival(From date of randomization until the date of first documented progression or date of toxicity or date of death from any cause, whichever came first, assessed up to 84months)

研究者

发起方
University Hospital, Lille
申办方类型
Other
责任方
Sponsor

研究点 (23)

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