Clinical trial • Phase II • Oncology

ELRANATAMAB for Smoldering multiple myeloma | High-risk smoldering multiple myeloma

Phase II trial of ELRANATAMAB for Smoldering multiple myeloma | High-risk smoldering multiple myeloma. open-label. 105 participants.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Smoldering multiple myeloma | High-risk smoldering multiple myeloma
Trial Stage
Phase II
Drug Modality
Other antibody | Small molecule | Monoclonal antibody
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
11-10-2023
First CTIS Authorization Date
13-02-2024

Trial design

open-label Phase II trial in Greece, Finland, Italy and others.

Open Label
Yes
Target Sample Size
105

Eligibility

Recruits 105 No vulnerable populations selected for inclusion. Persons under guardianship/trusteeship or deprived of freedom are explicitly excluded. Consent must be provided by the subject or a legally acceptable representative as stated in the ICF..

Pregnancy Exclusion
Female subject who is pregnant or breast-feeding.
Vulnerable Population
No vulnerable populations selected for inclusion. Persons under guardianship/trusteeship or deprived of freedom are explicitly excluded. Consent must be provided by the subject or a legally acceptable representative as stated in the ICF.

Inclusion criteria

  • {"criterion_text":"- ≥ 18 years of age"}
  • {"criterion_text":"- Diagnosis of SMM for ≤5 years with measurable disease, defined as serum M protein: ≥1g/dL or urine M protein ≥200 mg/24 hours or involved serum FLC ≥100 mg/Land abnormal serum FLC ratio."}
  • {"criterion_text":"- BMPCs ≥10% and <60%"}
  • {"criterion_text":"- Presence of at least 2 high risk factors, including a. Serum M protein ≥2 g/dL, b. BMPC >20% c. Serum involved/uninvolved FLC ratio > 20"}
  • {"criterion_text":"- ECOG performance status score of 0 or 1"}
  • {"criterion_text":"- Subjects must meet the following laboratory parameters, per laboratory reference range (performed at most 15 days before cycle 1 day 1) a. Absolute neutrophil count ≥1.0 x 10^9 /L (ie, ≥1000/μL) b. Platelet count ≥75 x 10^9 /L c. Aspartate aminotransferase (AST) ≤2.5 x upper limit of normal (ULN) d. Alanine aminotransferase (ALT) ≤2.5 x ULN e. Total bilirubin ≤1.5 x ULN, except in subjects with congenital bilirubinemia,such as Gilbert syndrome (in which case direct bilirubin ≤2.0 x ULN is required)"}
  • {"criterion_text":"- Subject must sign an informed consent form (ICF) or their legally acceptable representative must sign indicating that he or she understands the purpose of, and procedures required for the study and is willing to participate in the study."}
  • {"criterion_text":"- Women of childbearing potential must have a negative serum or urine pregnancy test at screening and before starting study drug. They must commit to continued abstinence from heterosexual intercourse or begin 2 acceptable methods of birth control (One highly effective method and one additional effective method) used at the same time, and continuing for at least 5 months after the last dose of Elranatamab. Women must also agree to notify pregnancy during the study."}

Exclusion criteria

  • {"criterion_text":"- Previous therapy with any systemic therapy for multiple myeloma."}
  • {"criterion_text":"- Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical, breast or prostate cancer free of disease for 5 years."}
  • {"criterion_text":"- Female subject who is pregnant or breast-feeding."}
  • {"criterion_text":"- Serious medical or psychiatric illness likely to interfere with participation in study."}
  • {"criterion_text":"- Uncontrolled diabetes mellitus"}
  • {"criterion_text":"- Known HIV infection; Known active hepatitis B or C viral infection; known active COVID-19/SARS-CoV-2 infection."}
  • {"criterion_text":"- Live attenuated vaccine administered within 4 weeks of the first dose of study intervention."}
  • {"criterion_text":"- Ongoing treatment with corticosteroids : dose >10mg prednisone"}
  • {"criterion_text":"- Person under guardianship, trusteeship or deprived of freedom by a judicial or administrative decision."}
  • {"criterion_text":"- Evidence of any of the following calcium, renal failure, anemia, bone lesions (CRAB) criteria or Myeloma Defining Events (SLiM CRAB) detailed below (attributable to the participants SMM involvement): a. Increased calcium levels: Corrected serum calcium >1 mg/dL above the ULN or >11 mg/dL b. Renal insufficiency: Determined by glomerular filtration rate (GFR) <40 mL/min/1.73 m² (Modification of Diet in Renal Disease [MDRD] Formula) or serum creatinine >2 mg/dL c. Anemia (hemoglobin 2 g/dL below lower limit of normal or <10 g/dL or both) transfusion support or concurrent treatment with erythropoietin stimulating agents is not permitted d. ≥ 1 bone lytic lesion e. BMPCs ≥60% f. Serum involved/uninvolved FLC ratio ≥100 and an involved FLC ≥100mg/L g. Whole body magnetic resonance imaging (WB-MRI) or positron emission tomography-computed tomography (PET-CT) with more than 1 bone focal lesion (≥5 mm in diameter)"}
  • {"criterion_text":"- Diagnosis of primary amyloidosis, POEMS syndrome, monoclonal gammopathy of undetermined significance, symptomatic multiple myeloma, or solitary plasmacytoma."}
  • {"criterion_text":"- Subject has a diagnosis of Waldenström’s macroglobulinemia, or other conditions in which IgM Mprotein is present in theabsence of a clonal plasma cell infiltration with lytic bone lesions."}
  • {"criterion_text":"- Subject has had plasmapheresis within 14 days of C1D1."}
  • {"criterion_text":"- Myocardial infarction within 6 months prior to enrolment according to NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities."}
  • {"criterion_text":"- Ongoing Grade 2 or higher peripheral sensory/motor peripheral neuropathy (PN), history of GBS or GBS variants, or history of grade 3 or higher peripheral motor polyneuropathy."}
  • {"criterion_text":"- Subject has had major surgery within 2 weeks before eligibility confirmation or will not have fully recovered from surgery, or has surgery planned during the time the subject is expected to participate in the study."}
  • {"criterion_text":"- Clinically relevant active infection or serious co-morbid medical conditions."}
  • {"criterion_text":"- Participants with known or suspected hypersensitivity to the study interventions or any of their excipients"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Complete remission rate at the end of cycle 6, assessed by International Myeloma Working Group [IMWG] criteria.","definition_or_measurement_approach":"Assessed by International Myeloma Working Group (IMWG) criteria"}
  • {"endpoint_text":"- Rate of grade >3-4 non hematologic adverse events, assessed according to CTCAE 5.0.","definition_or_measurement_approach":"Assessed according to CTCAE 5.0"}

Recruitment

Planned Sample Size
105
Recruitment Window Months
91
Consent Approach
Subjects must sign an informed consent form (ICF) or their legally acceptable representative must sign. Country-specific ICF documents are provided (country-language ICFs available in English, Finnish, Greek, Italian, French, Dutch, Norwegian as per uploaded country ICF documents). Women of childbearing potential must have a negative pregnancy test at screening and before starting study drug and agree to contraception/abstinence conditions and to notify pregnancy.

Geography

Total Number Of Sites
24
Total Number Of Participants
105

Greece

Latest Decision Or Authorization Date
14-08-2025
Number Of Sites
1
Number Of Participants
7

Sites

Site Name
Alexandra Hospital
Department Name
04-001:Clinical Therapeutics
Contact Person Name
Evangelos Terpos
Contact Person Email
eterpos@med.uoa.gr

Finland

Latest Decision Or Authorization Date
13-08-2025
Number Of Sites
1
Number Of Participants
2

Sites

Site Name
Helsinki University Central Hospital
Department Name
19-002:Department of hematoligy
Contact Person Name
Juha Lievonen
Contact Person Email
uha.lievonen@hus.fi

Italy

Latest Decision Or Authorization Date
02-02-2026
Number Of Sites
12
Number Of Participants
36

Sites

Site Name
Azienda Ospedaliero Universitaria Parma
Department Name
01-049:UO Ematologia e Centro Trapianti Midollo Osseo
Contact Person Name
Nicola Giuliani
Contact Person Email
nicola.giuliani@unipr.it
Site Name
University Hospital Consorziale Policlinico
Department Name
01-019:UO EMATOLOGIA CON TRAPIANTO
Contact Person Name
Pellegrino Musto
Contact Person Email
pellegrino.musto@uniba.it
Site Name
Azienda Sanitaria Locale Di Pescara
Department Name
01-053:UOC Ematologia Clinica
Contact Person Name
Carmine Liberatore
Contact Person Email
Liberatore.carmine@hsr.it
Site Name
Istituto Romagnolo Per Lo Studio Dei Tumori Dino Amadori IRST S.r.l.
Department Name
01-036:Oncologia Medica
Contact Person Name
Claudio Cerchione
Contact Person Email
claudio.cerchione@irst.emr.it
Site Name
Fondazione IRCCS Policlinico San Matteo
Department Name
01-051:UOC Ematologia
Contact Person Name
Silvia Mangiacavalli
Contact Person Email
S.Mangiacavalli@smatteo.pv.it
Site Name
Careggi University Hospital
Department Name
01-030:SOD Ematologia
Contact Person Name
Elisabetta Antonioli
Site Name
Azienda Ospedaliero-Universitaria Maggiore Della Carita
Department Name
01-010:SCDU Ematologia
Contact Person Name
Gloria Margiotta-Casaluci
Contact Person Email
gloria.margiotta@med.uniupo.it
Site Name
IRCCS Ospedale Policlinico San Martino
Department Name
01-007:Ematologia e Terapia Cellulari
Contact Person Name
Sara Aquino
Contact Person Email
sara.aquino@hsanmartino.it
Site Name
Azienda Ospedaliera Papa Giovanni XXIII
Department Name
01-003: Medicina Trasfusionale ed Ematologia
Contact Person Name
Monica Galli
Contact Person Email
monicagalli@asst-pg23.it
Site Name
Azienda Ospedaliera Papardo
Department Name
01-037:UOC Ematologia
Contact Person Name
Donato Mannina
Contact Person Email
donamanni@gmail.com
Site Name
Azienda Sanitaria Universitaria Friuli Centrale
Department Name
01-015:Clinica Ematologica
Contact Person Name
Francesca Patriarca
Site Name
Azienda Ospedale-Universita Padova
Department Name
01-011:UOC Ematologia
Contact Person Name
Renato Zambello
Contact Person Email
rani.zambello@gmail.com

Norway

Latest Decision Or Authorization Date
14-06-2024
Number Of Sites
1
Number Of Participants
15

Sites

Site Name
Oslo University Hospital HF
Department Name
23-007:Avd Blodsykdommer
Contact Person Name
Fredrik Schjesvold
Contact Person Email
fredrikschjesvold@gmail.com

France

Latest Decision Or Authorization Date
29-01-2026
Number Of Sites
6
Number Of Participants
33

Sites

Site Name
Centre Hospitalier Regional Universitaire De Tours
Department Name
12-028 Hématologie et thérapie cellulaire
Contact Person Name
Thomas Chalopin
Contact Person Email
t.chalopin@chu-tours.fr
Site Name
Centre Hospitalier Universitaire De Nice
Department Name
12-033 Hématologie Clinique
Contact Person Name
Valentine RICHEZ-OLIVIER
Contact Person Email
richez-olivier.v@chu-nice.fr
Site Name
Centre Hospitalier Universitaire De Poitiers
Department Name
12-022 Hématologie et thérapie cellulaire
Contact Person Name
Xavier Leleu
Contact Person Email
xavier.leleu@chu-poitiers.fr
Site Name
University Hospital Of Montpellier
Department Name
12-015 Hématologie clinique
Contact Person Name
Laure Vincent
Contact Person Email
l-vincent@chu-montpellier.fr
Site Name
Centre Hospitalier Universitaire De Nantes
Department Name
12-016 Hématologie clinique
Contact Person Name
Cyrille Touzeau
Contact Person Email
cyrille.touzeau@chu-nantes.fr
Site Name
Centre Hospitalier Departemental Vendee
Department Name
12-032 Onco-hématologie
Contact Person Name
Komivi Agbestivi
Contact Person Email
komivi.agbetsivi@ght85.fr

Netherlands

Latest Decision Or Authorization Date
13-01-2026
Number Of Sites
3
Number Of Participants
12

Sites

Site Name
University Hospital Maastricht
Department Name
02-037:Hematologie
Contact Person Name
Janine van Elssen-Hodenius
Contact Person Email
janine.van.elssen@mumc.nl
Site Name
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Department Name
02-044:Hematologie
Contact Person Name
Annemiek Broijl
Contact Person Email
a.broyl@erasmusmc.nl
Site Name
St. Antonius Ziekenhuis
Department Name
02-038:Hematologie
Contact Person Name
Inger Nijhof
Contact Person Email
i.nijhof@antoniusziekenhuis.nl

Sponsor

Primary sponsor

Full Name
European Myeloma Network B.V.
Organisation Type
Patient organisation/association
Country Of Registered Address
Netherlands

Contract research organisations

Name
Excelya Greece CRO Single Member S.A.
Responsibilities
Start-Up activities; sponsorDuties codes: [1,15]; contact: clinicalRa-greece@excelya.com
Name
PPD Development LP
Responsibilities
sponsorDuties codes: [4]; contact: Lindsay.Turnpin@ppd.com
Name
Parexel International (IRL) Limited
Responsibilities
sponsorDuties codes: [1,11,12,8,9]; contact: Clinicaltrial.Enquiries@parexel.com

Third parties

  • {"country":"Italy","full_name":"Emn Trial Office S.r.l. Impresa Sociale","duties_or_roles":"sponsorDuties codes: [4]; contact: torinocentrallab@emn.org","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Greece","full_name":"Excelya Greece CRO Single Member S.A.","duties_or_roles":"sponsorDuties codes: [1, 15]; value for code 15: Start-Up activities; contact: clinicalRa-greece@excelya.com","organisation_type":"Pharmaceutical company / CRO"}
  • {"country":"Belgium","full_name":"Clinigen Clinical Supplies Management","duties_or_roles":"sponsorDuties codes: [15]; value for code 15: IMP Packaging and labelling; contact: contact@clinigencsm.com","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"PPD Development LP","duties_or_roles":"sponsorDuties codes: [4]; contact: Lindsay.Turnpin@ppd.com","organisation_type":"Pharmaceutical company / CRO"}
  • {"country":"Ireland","full_name":"Parexel International (IRL) Limited","duties_or_roles":"sponsorDuties codes: [1,11,12,8,9]; contact: Clinicaltrial.Enquiries@parexel.com","organisation_type":"Pharmaceutical company / CRO"}
  • {"country":"Netherlands","full_name":"Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)","duties_or_roles":"sponsorDuties codes: [4]; contact: myeloma.hematology@erasmusmc.nl","organisation_type":"Hospital/Clinic/Other health care facility"}

Co-sponsors

  • Emn Trial Office S.r.l. Impresa Sociale

Investigational products

Investigational Product Name
ELRANATAMAB
Active Substance
ELRANATAMAB
Modality
Other antibody
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
prodAuthStatus: 1
Orphan Designation
Yes
Maximum Dose
maxDailyDoseAmount 76 mg; maxTotalDoseAmount 2096 mg
Investigational Product Name
RoActemra 20 mg/mL concentrate for solution for infusion
Active Substance
TOCILIZUMAB
Modality
Monoclonal antibody
Routes Of Administration
INTRAVENOUS USE
Route
Intravenous
Authorisation Status
marketingAuthorisation EU/1/08/492/003 (authorised)
Maximum Dose
maxDailyDoseAmount 800 mg; maxTotalDoseAmount 800 mg
Investigational Product Name
DEXAMETHASONE
Active Substance
DEXAMETHASONE
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Authorisation Status
prodAuthStatus: 2
Maximum Dose
maxDailyDoseAmount 20 mg; maxTotalDoseAmount 60 mg
Investigational Product Name
PARACETAMOL
Active Substance
PARACETAMOL
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Authorisation Status
prodAuthStatus: 2
Maximum Dose
maxDailyDoseAmount 500 mg; maxTotalDoseAmount 1500 mg
Investigational Product Name
DIPHENHYDRAMINE HYDROCHLORIDE
Active Substance
DIPHENHYDRAMINE HYDROCHLORIDE
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Authorisation Status
prodAuthStatus: 2
Maximum Dose
maxDailyDoseAmount 25 mg; maxTotalDoseAmount 75 mg
Combination Treatment
Yes

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