Clinical trial • Phase II • Oncology

Daratumumab for Multiple myeloma (relapsed and/or refractory)|Multiple myeloma with del(17p)

Phase II trial of Daratumumab for Multiple myeloma (relapsed and/or refractory)|Multiple myeloma with del(17p). open-label. 45 participants.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Multiple myeloma (relapsed and/or refractory)|Multiple myeloma with del(17p)
Trial Stage
Phase II
Drug Modality
Monoclonal antibody|Small molecule
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
22-01-2024
First CTIS Authorization Date
26-02-2024

Trial design

open-label Phase II trial across 13 sites in Italy.

Open Label
Yes
Biomarker Stratified
True, biomarker: del(17p) by FISH in ≥10% of bone marrow plasma cells
Target Sample Size
45

Eligibility

Recruits 45 Subjects must give voluntary written informed consent; trial enrolment limited to adults (≥18 years). The record indicates 'isVulnerablePopulationSelected' = true, but no further specifics on assent/parental consent handling are provided in the available data..

Vulnerable Population
Subjects must give voluntary written informed consent; trial enrolment limited to adults (≥18 years). The record indicates 'isVulnerablePopulationSelected' = true, but no further specifics on assent/parental consent handling are provided in the available data.

Inclusion criteria

  • {"criterion_text":"- Patient has given voluntary written informed consent."}
  • {"criterion_text":"- Subject must have an ECOG Performance Status score of 0, 1, or 2."}
  • {"criterion_text":"- Subject must have the following laboratory values: a)Platelet count ≥50 x 109/L (≥30 x 109 /L if myeloma involvement in the bone marrow is > 50%) within 14 days prior to drug administration); b) Absolute neutrophil count (ANC) ≥ 1 x 109/L without the use of growth factors; c) Corrected serum calcium ≤14 mg/dL (3.5 mmol/L); d) Alanine transaminase (ALT): ≤ 3 x the upper limit normal (ULN); e) Total bilirubin: ≤ 2 x the ULN; f) Calculated or measured creatinine clearance: ≥ 15 mL/minute."}
  • {"criterion_text":"- Females of childbearing potential (FBCP) must follow the Pregnancy Prevention Plan and use a highly effective and an additional barrier contraception method simultaneously for 28 days before starting pomalidomide, during treatment and dose interruptions, for at least 28 days after the last dose of pomalidomide and 3 months after the last dose of daratumumab. Males must use an effective barrier method of contraception if sexually active with FCBP for at least 28 days before starting pomalidomide, during the treatment and dose interruptions, for at least 28 days after the last dose of pomalidomide and 3 months after the last dose of daratumumab. Male subjects must agree to refrain from sperm donation for at least 3 months after the last dose of daratumumab."}
  • {"criterion_text":"- Subject must be at least 18 years of age."}
  • {"criterion_text":"- Subject must have documented MM."}
  • {"criterion_text":"- Subject must have del(17p) observed by FISH in at least 10% of bone marrow plasma cells at any time of MM history."}
  • {"criterion_text":"- Subject must have serum monoclonal paraprotein (M-protein) level ≥0.5 g/dL or urine M-protein, level ≥200 mg/24 hours, or light chain MM, or serum immunoglobulin free light chain ≥10 mg/dL and abnormal serum immunoglobulin kappa lambda free light chain ratio."}
  • {"criterion_text":"- Subject must have received at least 1 and no more than 3 prior lines of therapy for MM."}
  • {"criterion_text":"- Subject must have received at least 2 consecutive cycles of lenalidomide in a previous line of therapy."}
  • {"criterion_text":"- Subject must have achieved a response (PR or better) to at least one prior regimen."}
  • {"criterion_text":"- Subjects must have either refractory or relapsed and refractory disease defined as documented disease progression during or within 60 days of completing their last myeloma therapy."}

Exclusion criteria

  • {"criterion_text":"- Subject has received daratumumab or other anti-CD38 monoclonal antibody previously."}
  • {"criterion_text":"- Subject has clinically significant cardiac disease, including: a) Myocardial infarction within 6 months before Cycle 1, Day 1, or unstable or uncontrolled disease/condition related to or affecting cardiac function (eg, unstable angina, congestive heart failure, New York Heart Association Class IIIIV); b) Cardiac arrhythmia (Common Terminology Criteria for Adverse Events [CTCAE] Version 4 Grade 2 or higher) or clinically significant ECG abnormalities. Screening 12-lead ECG showing a baseline QT interval as corrected by Fridericia’s formula (QTcF) >500 msec."}
  • {"criterion_text":"- Subject’s disease shows evidence of refractoriness or intolerance to pomalidomide. If previously treated with a pomalidomide-containing regimen, the subject is excluded if he or she: a) Discontinued due to any adverse event related to prior pomalidomide treatment, or If, at any time point, the subject was refractory to any dose of pomalidomide. b) Refractory to pomalidomide is defined either: Subjects whose disease progresses within 60 days of pomalidomide; or Subjects whose disease is nonresponsive while on lenalidomide. Nonresponsive disease is defined as either failure to achieve at least an MR or development of PD while on pomalidomide."}
  • {"criterion_text":"- Subject has received anti-myeloma treatment within 2 weeks or 5 pharmacokinetic halflives of the treatment, whichever is longer, before the date of enrollment."}
  • {"criterion_text":"- Subjects who received an allogeneic bone marrow or allogeneic peripheral blood stem cell transplant less than 12 months prior to initiation of study treatment and who have not discontinued immunosuppressive treatment for at least 16 weeks prior to initiation of study treatment and are currently dependent on such treatment."}
  • {"criterion_text":"- Subjects unable or unwilling to undergo antithrombotic prophylactic treatment."}
  • {"criterion_text":"- Subject has a history of malignancy (other than multiple myeloma) within 3 years before the date of enrollment (exceptions are squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix, or malignancy that in the opinion of the investigator, in agreement with the medical monitor, is considered cured with minimal risk of recurrence within 3 years)."}
  • {"criterion_text":"- Subject has known chronic obstructive pulmonary disease (COPD) (defined as a forced expiratory volume in 1 second (FEV1) <60% of predicted normal), asthma, or a history of asthma within the last 2 years. Subjects with known or suspected COPD must have a forced expiratory volume (FEV) test during Screening."}
  • {"criterion_text":"- Subject is known to be seropositive for human immunodeficiency virus (HIV) or hepatitis B (defined by a positive test for hepatitis B surface antigen [HBsAg] or antibodies to hepatitis B surface and core antigens [anti-HBs and anti-HBc, respectively]) or hepatitis C (anti-HCV antibody positive or HCV-RNA quantitation positive)."}
  • {"criterion_text":"- Subject has any concurrent medical condition or disease (eg, active systemic infection) that is likely to interfere with study procedures or results, or that in the opinion of the investigator would constitute a hazard for participating in this study."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary endpoint of the study is efficacy in terms of: Achievement of molecular minimal residual disease (MRD) 10-5 negativity rate assessed by means of nextgeneration sequencing (ClonoSEQ assay) in patients attaining a complete remission in the first year of treatment.","definition_or_measurement_approach":"MRD 10^-5 negativity rate assessed by next-generation sequencing (ClonoSEQ assay) in patients attaining a complete remission within the first year of treatment."}

Secondary endpoints

  • {"endpoint_text":"- PFS will be measured from the start of treatment to the date of first observation of disease progression or death to any cause as an event.","definition_or_measurement_approach":"Measured from start of treatment to date of first documented disease progression or death from any cause."}
  • {"endpoint_text":"- Overall response rate (ORR).","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Progression free survival 2 (PFS2).","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Duration of response (DoR).","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Overall survival (OS).","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Safety.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Time to the next anti-myeloma therapy (TNT).","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Subgroup analyses: MRD negativity rate and prognostic factors.","definition_or_measurement_approach":""}

Recruitment

Planned Sample Size
45
Recruitment Window Months
60
Consent Approach
Voluntary written informed consent is required from subjects; participants must be ≥18 years and provide their own consent. Multiple subject information and informed consent form documents are listed (Italian-language documents are present). No details on assent or parental consent are provided in the available record.

Geography

Total Number Of Sites
13
Total Number Of Participants
45

Italy

Earliest CTIS Part Ii Submission Date
27-06-2023
Latest Decision Or Authorization Date
09-04-2026
Processing Time Days
1017
Number Of Sites
13
Number Of Participants
45

Sites

Site Name
Humanitas Research Hospital
Department Name
UO Ematologia
Principal Investigator Name
Carmelo Carlo-Stella
Principal Investigator Email
carmelo.carlostella@hunimed.eu
Contact Person Name
Carmelo Carlo-Stella
Contact Person Email
carmelo.carlostella@hunimed.eu
Site Name
Azienda Socio Sanitaria Territoriale Degli Spedali Civili Di Brescia
Department Name
U.O.C. Ematologia
Principal Investigator Name
Angelo Belotti
Principal Investigator Email
ange.belotti@gmail.com
Contact Person Name
Angelo Belotti
Contact Person Email
ange.belotti@gmail.com
Site Name
Azienda Ospedaliero-Universitaria Maggiore Della Carita
Department Name
Divisione di Ematologia
Principal Investigator Name
Gloria Margiotta Casaluci
Principal Investigator Email
gloria.margiotta@med.uniupo.it
Contact Person Name
Gloria Margiotta Casaluci
Contact Person Email
gloria.margiotta@med.uniupo.it
Site Name
ASST Grande Ospedale Metropolitano Niguarda
Department Name
Clinical Trial Unit-CTU Ematologia
Principal Investigator Name
Anna Maria Cafro
Principal Investigator Email
annamaria.cafro@ospedaleniguarda.it
Contact Person Name
Anna Maria Cafro
Site Name
Azienda Ospedaliero Universitaria Policlinico G Rodolico San Marco Di Catania
Department Name
U.O. di Ematologia con TMO
Principal Investigator Name
Francesco Di Raimondo
Principal Investigator Email
diraimon@unict.it
Contact Person Name
Francesco Di Raimondo
Contact Person Email
diraimon@unict.it
Site Name
Azienda Universitaria Ospedaliera Consorziale Policlinico Bari
Department Name
U.O. di Ematologia con Trapianto
Principal Investigator Name
Rita Rizzi
Principal Investigator Email
rita.rizzi@uniba.it
Contact Person Name
Rita Rizzi
Contact Person Email
rita.rizzi@uniba.it
Site Name
Azienda Ospedaliero-Universitaria Di Bologna IRCCS Istituto Di Ricerca E Di Cura A Carattere Scientifico
Department Name
Centro Ricerche Cliniche CRC
Principal Investigator Name
Elena Zamagni
Principal Investigator Email
e.zamagni@unibo.it
Contact Person Name
Elena Zamagni
Contact Person Email
e.zamagni@unibo.it
Site Name
Azienda Sanitaria Universitaria Friuli Centrale
Department Name
Clinica Ematologica ed Unita di Terapie Cellulari 'Carlo Melzi'
Principal Investigator Name
Francesca Patriarca
Principal Investigator Email
francesca.patriarca@asufc.sanita.fvg.it
Contact Person Name
Francesca Patriarca
Site Name
Azienda Socio Sanitaria Territoriale Papa Giovanni Xxiii
Department Name
UOC Ematologia
Principal Investigator Name
Alessandro Rambaldi
Principal Investigator Email
arambaldi@asst-pg23.it
Contact Person Name
Alessandro Rambaldi
Contact Person Email
arambaldi@asst-pg23.it
Site Name
Azienda Ospedaliera S Maria Di Terni
Department Name
S.C. Oncoematologia
Principal Investigator Name
Gaetano Vaudo
Principal Investigator Email
vaudogaetano@gmail.com
Contact Person Name
Gaetano Vaudo
Contact Person Email
vaudogaetano@gmail.com
Site Name
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
Department Name
SSD Clinical trials in onco-ematologia e mieloma multiplo
Principal Investigator Name
Roberto Mina
Principal Investigator Email
roberto.mina.rm@gmail.com
Contact Person Name
Roberto Mina
Contact Person Email
roberto.mina.rm@gmail.com
Site Name
Azienda Ospedaliero-Universitaria Policlinico Umberto I
Department Name
Dipartimento di Medicina Traslazionale e di Precisione
Principal Investigator Name
Maria Teresa Petrucci
Principal Investigator Email
petrucci@bce.uniroma1.it
Contact Person Name
Maria Teresa Petrucci
Contact Person Email
petrucci@bce.uniroma1.it
Site Name
Azienda Ospedaliero Universitaria Parma
Department Name
U.O. di Ematologia e CTMO
Principal Investigator Name
Monica Crugnola
Principal Investigator Email
mcrugnola@ao.pr.it
Contact Person Name
Monica Crugnola
Contact Person Email
mcrugnola@ao.pr.it

Sponsor

Primary sponsor

Full Name
Fondazione European Myeloma Network Italy O.N.L.U.S.
Organisation Type
Patient organisation/association
Country Of Registered Address
Italy

Third parties

  • {"country":"United States","full_name":"Adaptive Biotechnologies Corp.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"Italy","full_name":"Mipharm S.p.A.","duties_or_roles":"Drug dispenser","organisation_type":"Pharmaceutical company"}
  • {"country":"Italy","full_name":"Emn Trial Office S.r.l. Impresa Sociale","duties_or_roles":"Shipping samples","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Switzerland","full_name":"Celgene International II S.a.r.l.","duties_or_roles":"Drug supplier","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"Janssen Pharmaceutica","duties_or_roles":"Drug supplier","organisation_type":"Pharmaceutical company"}
  • {"country":"Italy","full_name":"Humanitas Research Hospital","duties_or_roles":"","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Belgium","full_name":"Clinigen Clinical Supplies Management","duties_or_roles":"Drug dispenser","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
DARZALEX 1800 mg solution for injection
Active Substance
Daratumumab
Modality
Monoclonal antibody
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
Authorised (marketing authorisation number: EU/1/16/1101/004)
Orphan Designation
Yes
Starting Dose
1800 mg given by SC administration per protocol schedule (see dosing schedule: cycle 1 and 2 days 1,8,15,22; cycles 3-6 days 1 and 15; from cycle 7 day 1 until progression).
Dose Levels
1800 mg
Frequency
Cycle-dependent schedule: cycle 1 and 2 days 1, 8, 15, 22; cycle 3-6 days 1 and 15; from cycle 7 day 1 until progression.
Maximum Dose
1800 mg
Investigational Product Name
Imnovid 4 mg hard capsules
Active Substance
Pomalidomide
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Authorised (marketing authorisation number: EU/1/13/850/004)
Orphan Designation
Yes
Starting Dose
4 mg once daily on days 1-21 of a 28-day cycle.
Dose Levels
4 mg (other available strengths in study: 1 mg, 2 mg, 3 mg)
Frequency
Once daily on days 1-21 of each 28-day cycle
Maximum Dose
4 mg
Investigational Product Name
Imnovid 1 mg hard capsules
Active Substance
Pomalidomide
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Authorised (marketing authorisation number: EU/1/13/850/001)
Orphan Designation
Yes
Dose Levels
1 mg
Maximum Dose
1 mg
Investigational Product Name
Imnovid 2 mg hard capsules
Active Substance
Pomalidomide
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Authorised (marketing authorisation number: EU/1/13/850/002)
Orphan Designation
Yes
Dose Levels
2 mg
Maximum Dose
2 mg
Investigational Product Name
Imnovid 3 mg hard capsules
Active Substance
Pomalidomide
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Authorised (marketing authorisation number: EU/1/13/850/003)
Orphan Designation
Yes
Dose Levels
3 mg
Maximum Dose
3 mg
Investigational Product Name
SOLDESAM 8 mg/2 ml soluzione iniettabile
Active Substance
Dexamethasone sodium phosphate
Modality
Small molecule
Routes Of Administration
INFUSION
Route
Infusion (injectable) / oral (other product form)
Authorisation Status
Authorised (marketing authorisation number: 019499084)
Starting Dose
Intravenous/oral dexamethasone 40 mg/day (≤75 years) or 20 mg/day (>75 years) on days 1, 8, 15 and 22 as per protocol.
Dose Levels
8 mg/2 ml (injection formulation); other oral formulation available
Frequency
On days 1, 8, 15 and 22 of each 28-day cycle (dose per age as specified).
Maximum Dose
40 mg/day
Investigational Product Name
SOLDESAM 0,2% gocce orali, soluzione
Active Substance
Dexamethasone sodium phosphate
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Authorised (marketing authorisation number: 019499072)
Dose Levels
oral formulation
Maximum Dose
40 mg/day
Combination Treatment
Yes

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