Clinical trial • Phase III • Oncology|Haematology

IBERDOMIDE for Multiple myeloma

Phase III trial of IBERDOMIDE for Multiple myeloma.

Overview

Trial Therapeutic Area
Oncology|Haematology
Trial Disease
Multiple myeloma
Trial Stage
Phase III
Drug Modality
Small molecule|Monoclonal antibody

Key dates

Initial CTIS Submission Date
23-10-2023
First CTIS Authorization Date
16-02-2024

Trial design

Randomised, open-label, arm a (standard, iberdomide): iberdomide po 1.0 mg, days 1-21 of a 28-day cycle; dexamethasone po 20 mg (cycle 1 only: days 1, 8, 15, 22). treatment repeats every 28 days for up to 36 months (up to 39 cycles). arm b (experimental, iberdomide plus isatuximab): iberdomide po 1.0 mg, days 1-21 of a 28-day cycle; isatuximab sc 1400 mg administered via obds (cycle 1: days 1, 8, 15, 22; cycles 2-3: days 1, 15; from cycle 4: day 1); dexamethasone iv or po 20 mg (cycle 1 only: days 1,8,15,22). treatment repeats every 28 days for up to 36 months (up to 39 cycles).-controlled Phase III trial in Germany, Austria.

Randomised
Yes
Open Label
Yes
Comparator
Arm A (standard, iberdomide): Iberdomide PO 1.0 mg, days 1-21 of a 28-day cycle; Dexamethasone PO 20 mg (cycle 1 only: days 1, 8, 15, 22). Treatment repeats every 28 days for up to 36 months (up to 39 cycles). Arm B (experimental, iberdomide plus isatuximab): Iberdomide PO 1.0 mg, days 1-21 of a 28-day cycle; Isatuximab SC 1400 mg administered via OBDS (cycle 1: days 1, 8, 15, 22; cycles 2-3: days 1, 15; from cycle 4: day 1); Dexamethasone IV or PO 20 mg (cycle 1 only: days 1,8,15,22). Treatment repeats every 28 days for up to 36 months (up to 39 cycles).
Biomarker Stratified
True, biomarker: minimal residual disease (MRD) in bone marrow (NGF); strata: MRD negativity vs MRD positivity
Target Sample Size
451
Trial Duration For Participant
1080

Stratification factors

  • Minimal residual disease (bone marrow) negativity status
  • Single vs. tandem high-dose melphalan therapy/autologous stem cell transplantation (HDM/ASCT)

Eligibility

Recruits 451 No vulnerable populations selected. All participants are adults (age ≥18). Written informed consent is required prior to enrolment..

Pregnancy Exclusion
Pregnancy and lactation
Vulnerable Population
No vulnerable populations selected. All participants are adults (age ≥18). Written informed consent is required prior to enrolment.

Inclusion criteria

  • {"criterion_text":"- Patients meeting all of the following criteria will be considered for admission to the trial: Prior inclusion and treatment within the GMMG-HD8/DSMM XIX trial (including confirmation of diagnosis of MM with myeloma-defining events [end-organ damage or biomarker of malignancy] and measurable disease prior to initiation of induction therapy as outlined in the IMWG criteria)"}
  • {"criterion_text":"- All patients must agree to abstain from donating blood while taking study treatment and for 28 days following discontinuation of study treatment"}
  • {"criterion_text":"- Ability of patient to understand character and individual consequences of the clinical trial"}
  • {"criterion_text":"- Written informed consent (must be available before enrolment in the trial)"}
  • {"criterion_text":"- Received at least one cycle high dose melphalan therapy (HDM) and autologous stem cell transplantation (ASCT)"}
  • {"criterion_text":"- At least Partial Response (PR) according to IMWG criteria at inclusion in the trial"}
  • {"criterion_text":"- Age of 18 years or higher at trial inclusion"}
  • {"criterion_text":"- WHO performance status of 0, 1, or 2 (see Appendix II)"}
  • {"criterion_text":"- A female of childbearing potential (FCBP) is a female who: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy, or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (ie, has had menses at any time in the preceding 24 consecutive months) and must: a) Have two negative serum or urine pregnancy tests as verified by the Investigator prior to starting study treatment. She must agree to ongoing pregnancy testing during the course of the study, and after end of study treatment. This applies even if the subject practices true abstinence from heterosexual contact. b) Either commit to true abstinence from heterosexual contact (which must be reviewed on a monthly basis and source documented) or agree to use, and be able to comply with two forms of contraception: one highly effective, and one additional effective (barrier) measure of contraception without interruption 28 days prior to starting investigational product, during the study treatment (including dose interruptions), and for at least 28 days after the last dose of iberdomide."}
  • {"criterion_text":"- Male subjects must practice complete abstinence (True abstinence is acceptable when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence [e.g. calendar, ovulation, symptothermal or post-ovulation methods] and withdrawal are not acceptable methods of contraception) or agree to use a condom during sexual contact with a pregnant female or a FCBP while taking iberdomide, during dose interruptions and for at least 28 days following the last dose of iberdomide even if he has undergone a successful vasectomy."}
  • {"criterion_text":"- Males must agree to refrain from donating sperm while on study treatment, during dose interruptions and for at least 28 days following last dose of study treatment."}
  • {"criterion_text":"- All male and female subjects must follow all requirements defined in the Pregnancy Prevention Program (see section 7.1.7 and Appendix IV)."}

Exclusion criteria

  • {"criterion_text":"- Patients presenting with any of the following criteria will not be included in the trial: Subjects with gastrointestinal disease that may significantly alter the absorption of iberdomide"}
  • {"criterion_text":"- Corrected serum calcium > 14 mg/dL (> 3.5 mmol/L)"}
  • {"criterion_text":"- Unable or unwilling to undergo thromboprophylaxis"}
  • {"criterion_text":"- •\tPatient has known hypersensitivity or contraindication to any of the components of study therapy (e.g. known intolerance or hypersensitivity to iberdomide, isatuximab, infused proteins products, sucrose, histidine, and polysorbate 80 as well as intolerance to arginine and Poloxamer 188)"}
  • {"criterion_text":"- Pregnancy and lactation"}
  • {"criterion_text":"- Participant has any concurrent severe and/or uncontrolled medical condition or psychiatric disease 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 or that confounds the ability to interpret data from the study"}
  • {"criterion_text":"- Participation in other interventional clinical trials. This does not include long-term follow-up periods without active drug treatment of previous studies during the last 6 months"}
  • {"criterion_text":"- Systemic AL amyloidosis (except for localized AL amyloidosis limited to the skin or the bone marrow) or plasma cell leukemia (> 2.0 × 109/L circulating plasma cells by standard differential blood count) or polyneuropathy, organomegaly, endocrinopathy, monoclonal-protein and skin abnormalities (POEMS syndrome); or Waldenström macroglobulinemia."}
  • {"criterion_text":"- Previous systemic anti-myeloma treatment other than administered within the GMMG-HD8 / DSMM XIX trial (including up to two cycles cycle high dose melphalan therapy (HDM) and autologous stem cell transplantation (ASCT). Local, consolidative radiotherapy for myeloma disease is permitted unless performed in case of progressive disease (PD) according to IMWG criteria"}
  • {"criterion_text":"- Severe cardiac dysfunction (NYHA classification III-IV; see Appendix II)"}
  • {"criterion_text":"- Significant hepatic dysfunction (ASAT and/or ALAT ≥ 3 times normal level and/or serum bilirubin ≥ 1.5 times normal level if not due to hereditary abnormalities as Gilbert’s disease), unless related to MM or HDM/ASCT"}
  • {"criterion_text":"- Patients with peripheral neuropathy or neuropathic pain, grade 2 or higher (as defined by the NCI Common Terminology Criteria for Adverse Events (NCI CTCAE, version 5.0, see Appendix V)"}
  • {"criterion_text":"- Patients with a history of any active malignancy during the past 5 years with the exception of following malignancies after curative therapy: basal cell carcinoma of the skin, squamous cell skin carcinoma, stage 0 cervical carcinoma or any in situ malignancy. A history of an early stage malignancy during the past 5 years may be acceptable, however, in this case the GMMG or DSMM study office has to be consulted prior to study inclusion"}
  • {"criterion_text":"- Patients with acute diffuse infiltrative pulmonary and/or pericardial disease"}
  • {"criterion_text":"- Autoimmune haemolytic anaemia with positive indirect Coombs test or immune thrombocytopenia"}
  • {"criterion_text":"- Platelet count < 75 x 10^9/L"}
  • {"criterion_text":"- Haemoglobin ≤ 8.0 g/dL, unless related to MM"}
  • {"criterion_text":"- Absolute neutrophil count (ANC) < 1.0 x 10^9/L (the use of colony stimulating factors within 14 days before the test is not allowed)"}
  • {"criterion_text":"- •\tPatients with active or uncontrolled hepatitis B or C or detectable liver disease due to hepatitis B or C. In case of history of hepatitis B or C, it must be clarified whether it has been overcome and negative circulating HBV-DNA or HCV-RNA with sensitive PCR blood tests must be provided. Positive hepatitis B status may only be acceptable in absence of circulating HBV-DNA or signs of chronic or acute infection and if an adequate prophylaxis is being implemented during the course of the study. Prophylaxis for patients with history of hepatitis B or C should be set on a patient individual basis"}
  • {"criterion_text":"- HIV positivity"}
  • {"criterion_text":"- Patients with active, uncontrolled infections"}
  • {"criterion_text":"- •\tPatients with a history of serious allergic reaction to another immunomodulatory agent (thalidomide, lenalidomide, or pomalidomide), as angioedema and severe dermatologic reactions, including Grade 4 rash and exfoliative or bullous rash"}
  • {"criterion_text":"- •\tPatients currently being treated with medically indispensable strong inhibitors or inducers of CYP3A4/5"}
  • {"criterion_text":"- •\tSubjects, who are committed to an institution by virtue of an order issued either by the judicial or the administrative authorities"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Rates of NGF-MRD negativity (sensitivity 2x10-6, from bone marrow aspirate [BMA]) after two years of maintenance therapy.","definition_or_measurement_approach":"Measured by next-generation flow cytometry (NGF) on bone marrow aspirate with sensitivity 2x10^-6; assessed after two years of maintenance therapy."}

Secondary endpoints

  • {"endpoint_text":"- PFS, defined as time from randomization to disease progression or death from any cause, whichever occurs first.","definition_or_measurement_approach":"Progression-free survival measured as time (days) from randomization to documented disease progression (per IMWG criteria) or death from any cause."}

Recruitment

Planned Sample Size
451
Recruitment Window Months
66
Consent Approach
Written informed consent required from each participant prior to enrolment. Participants are adults (≥18). Subject information and informed consent form documents are included in the submission package (ICF/SIS documents listed), but specific languages of ICFs are not specified in the available metadata.

Geography

Total Number Of Participants
451

Germany

Earliest CTIS Part Ii Submission Date
29-01-2024
Latest Decision Or Authorization Date
09-07-2025
Processing Time Days
527
Number Of Participants
411

Austria

Earliest CTIS Part Ii Submission Date
11-09-2024
Latest Decision Or Authorization Date
10-06-2025
Processing Time Days
272
Number Of Sites
6
Number Of Participants
40

Sites

Site Name
SCRI CCCIT Ges.m.b.H.
Department Name
Universitätsklinik für Innere Medizin III
Contact Person Name
Thomas Melchardt
Contact Person Email
t.melchardt@salk.at
Site Name
Klinikum Wels-Grieskirchen GmbH
Department Name
Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin IV
Contact Person Name
Sonja Heibl
Contact Person Email
Sonja.Heibl@klinikum-wegr.at
Site Name
Stadt Wien Wiener Gesundheitsverbund
Department Name
Klinik Ottakring, 1. Medzinische Abteilung, Zentrum für Onkologie und Hämatologie
Contact Person Name
Martin Schreder
Site Name
Universitaetsklinikum Krems
Department Name
Universitätsklinikum Krems, Innere Medizin II Hämato-Onkologie
Contact Person Name
Klaus Podar
Contact Person Email
klaus.podar@krems.lknoe.at
Site Name
Ordensklinikum Linz GmbH
Department Name
Ordensklinikum Linz Elisabethinen Abteilung 1. Interne / Onkologie / Hämatologie)
Contact Person Name
Irene Strassl
Site Name
Noe LGA Gesundheit Region Mitte GmbH
Department Name
Universitätsklinikum St. Pölten, Klinische Abteilung für Innere Medizin 1
Contact Person Name
Petra Pichler-Izmir

Sponsor

Primary sponsor

Full Name
Universitaetsklinikum Heidelberg AöR
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Germany

Third parties

  • {"country":"","full_name":"Bristol Myers Squibb","duties_or_roles":"Source of monetary support / funding","organisation_type":"Pharmaceutical company"}
  • {"country":"","full_name":"Sanofi-Aventis Deutschland GmbH","duties_or_roles":"Source of monetary support / funding","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Iberdomide
Active Substance
IBERDOMIDE
Modality
Small molecule
Routes Of Administration
ORAL
Route
PO
Starting Dose
1.0 mg
Frequency
Days 1-21 of each 28-day cycle
Maximum Dose
Max daily dose 1 mg; max total dose amount 819 mg; treatment up to 36 months
Investigational Product Name
Isatuximab
Active Substance
ISATUXIMAB
Modality
Monoclonal antibody
Routes Of Administration
SUBCUTANEOUS (OBDS)
Route
SC
Starting Dose
1400 mg (SC)
Frequency
Cycle 1: days 1,8,15,22; cycles 2-3: days 1,15; from cycle 4: day 1 (every 28-day cycle)
Maximum Dose
1400 mg per administration; max total dose amount 61600 mg
Investigational Product Name
Dexamethason TAD® 20 mg Tabletten
Active Substance
DEXAMETHASONE
Modality
Small molecule
Routes Of Administration
ORAL
Route
PO
Authorisation Status
Authorised (marketing authorisation number 94251.00.00; authorisationCountryCode: DE)
Starting Dose
20 mg (PO, cycle 1 only: days 1,8,15,22)
Frequency
Cycle 1 only: days 1,8,15,22
Maximum Dose
Max daily dose 20 mg; max total dose amount 80 mg
Combination Treatment
Yes

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