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A Phase IIa Study of Sotatercept on Bone Mass and Turnover in Patients With Multiple Myeloma

Primary Purpose

Multiple Myeloma

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Sotatercept
Placebo
Sponsored by
Rebecca Silbermann
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Multiple Myeloma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age > 18 years at the time of signing the informed consent form.
  2. Documented diagnosis of Multiple Myeloma, currently with complete response (CR) or very good partial response (VGPR) (as defined by IMWG criteria), at least two years after induction therapy or autologous stem cell transplant.
  3. Patients must not be receiving anti-Myeloma therapy (including maintenance therapy).
  4. Disease response must be confirmed with repeat laboratory studies at least 30 days apart.
  5. Radiologic evidence of at least 1 measurable lytic lesion in the arm, pelvis or leg. Completion of two years monthly zoledronic acid therapy.
  6. Eastern Cooperative Group (ECOG) performance status 0- 2
  7. Creatinine ≤1.5 x upper limit of normal (ULN) or ≥40 mL/min
  8. Total bilirubin ≤ 3.0 mg/dL (bilirubin ≤1.5 x upper limit normal)
  9. AST (SGOT) and ALT (SGPT) ≤ 3.0 x ULN and ≤ 5.0 ULN for subjects with liver metastases
  10. Hemoglobin ≥ 7.5 g/dL and ≤ 13 g/dL
  11. Absolute neutrophil count ≥1500/uL
  12. Platelet count ≥ 75,000/ uL (>72 hours since prior platelet transfusion)
  13. Corrected calcium within normal limits, previous hypercalcemia allowed
  14. Females of childbearing potential must use a highly effective method of birth control for at least 28 days before starting study, during participation and at least 112 days following last dose of sotatercept.
  15. Males must use latex condom or non-latex condom not made of (animal) membrane during any sexual contact with female of childbearing potential while participating in the study and for at least 112 days following the last dose of sotatercept, even if he has undergone successful vasectomy.

Exclusion Criteria:

  1. History of thrombosis, deep vein thrombosis, pulmonary emboli, or embolic stroke AND have not been stable on anticoagulants within the past 6 months. Local central line thrombosis is allowed.
  2. History of polycythemia
  3. Uncontrolled hypertension (systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg.)
  4. History of severe allergic or anaphylactic reaction or hypersensitivity to recombinant proteins or excipients in investigational product.
  5. Current use of anti-cancer cytotoxic chemotherapeutic agents.
  6. Major surgery within 30 days of Day 1 of trial.
  7. Incomplete recovery or incomplete healing of wounds from previous surgery, as determined by treating Investigator.
  8. Subjects with classification of 3 or higher heart failure as classified by the New York Heart Association (NYHA). Please see Appendix IV.
  9. Women who are pregnant or breastfeeding or planning to become pregnant or breastfeed during the period of treatment and for 112 days following the last dose of sotatercept.
  10. Treatment with another investigational drug or device within 28 days prior to Day 1, or if the half-life of the previous product is known, within 5 times the half-life of the investigational drug prior to dosing, whichever is longer.
  11. Prior exposure to sotatercept.
  12. Any significant medical condition, laboratory abnormality, or psychiatric illness that, as determined by the treating Investigator, would prevent the subject from participating in the study or providing written informed consent.
  13. Any condition including the presence of laboratory abnormality that, as determined by the treating Investigator, places the subject at unacceptable risk if he/she were to participate in the study.
  14. Known positive for human immunodeficiency virus (HIV)
  15. Known positive for infectious hepatitis type C or active infectious hepatitis type B.
  16. Any condition that, as determined by the treating Investigator, confounds the interpretation of data from the study.

Sites / Locations

  • Indiana University Simon Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Sotatercept

Placebo

Arm Description

Sotatercept 0.2 mg/kg will be administered every 21 days for 12 doses subcutaneously into the upper arm, abdomen or thigh.

0.2 mg/kg of normal saline will be administered subcutaneously in the upper arm, abdomen or thigh for 21 days for 12 doses.

Outcomes

Primary Outcome Measures

Presence of biochemical bone turnover
The presence of change in biochemical markers of bone turnover during treatment with sotatercept will be examined.

Secondary Outcome Measures

Number of Adverse Events related to sotatercept
Bone marrow density
Change in bone mineral density of the femoral neck, forearm and spine.
Change in biochemical myeloma markers
The change in myeloma markers will be determined by quantifying immunoglobulins, SPEP, UPEP and free light chains.
Size of target bone lesions
Measure the change in size of target bone lesions using x-ray of target skeletal lesions.

Full Information

First Posted
August 19, 2014
Last Updated
August 30, 2016
Sponsor
Rebecca Silbermann
Collaborators
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT02230917
Brief Title
A Phase IIa Study of Sotatercept on Bone Mass and Turnover in Patients With Multiple Myeloma
Official Title
A Phase IIa Study of Sotatercept on Bone Mass and Turnover in Patients With Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Withdrawn
Study Start Date
October 2014 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Rebecca Silbermann
Collaborators
Celgene

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Lytic bone disease continues to be one of the most devastating complications of multiple myeloma (MM) despite recent and dramatic advancements in MM management, and bone lesions persist and can continue to significantly impact a patient's morbidity, even when an individual's myeloma is otherwise under good control. To date, no agent has been shown to have a prolonged bone anabolic response in myeloma. Preliminary studies treating healthy postmenopausal women with a single dose of sotatercept demonstrated a rapid and sustained increase in serum biochemical markers of bone formation and a decrease in markers of bone resorption. Similarly, the murine analog to sotatercept, RAP-011, increases bone mineral density and strength in murine studies of both normal animals and models of bone loss. We hypothesize that sotatercept will provide an anabolic response for bone in myeloma patients with bone disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sotatercept
Arm Type
Experimental
Arm Description
Sotatercept 0.2 mg/kg will be administered every 21 days for 12 doses subcutaneously into the upper arm, abdomen or thigh.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
0.2 mg/kg of normal saline will be administered subcutaneously in the upper arm, abdomen or thigh for 21 days for 12 doses.
Intervention Type
Drug
Intervention Name(s)
Sotatercept
Other Intervention Name(s)
ACE-011
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Normal Saline
Primary Outcome Measure Information:
Title
Presence of biochemical bone turnover
Description
The presence of change in biochemical markers of bone turnover during treatment with sotatercept will be examined.
Time Frame
Average of 3 months
Secondary Outcome Measure Information:
Title
Number of Adverse Events related to sotatercept
Time Frame
Average of 21 days
Title
Bone marrow density
Description
Change in bone mineral density of the femoral neck, forearm and spine.
Time Frame
Average of 12 months
Title
Change in biochemical myeloma markers
Description
The change in myeloma markers will be determined by quantifying immunoglobulins, SPEP, UPEP and free light chains.
Time Frame
Average of 3 months
Title
Size of target bone lesions
Description
Measure the change in size of target bone lesions using x-ray of target skeletal lesions.
Time Frame
Average of 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 years at the time of signing the informed consent form. Documented diagnosis of Multiple Myeloma, currently with complete response (CR) or very good partial response (VGPR) (as defined by IMWG criteria), at least two years after induction therapy or autologous stem cell transplant. Patients must not be receiving anti-Myeloma therapy (including maintenance therapy). Disease response must be confirmed with repeat laboratory studies at least 30 days apart. Radiologic evidence of at least 1 measurable lytic lesion in the arm, pelvis or leg. Completion of two years monthly zoledronic acid therapy. Eastern Cooperative Group (ECOG) performance status 0- 2 Creatinine ≤1.5 x upper limit of normal (ULN) or ≥40 mL/min Total bilirubin ≤ 3.0 mg/dL (bilirubin ≤1.5 x upper limit normal) AST (SGOT) and ALT (SGPT) ≤ 3.0 x ULN and ≤ 5.0 ULN for subjects with liver metastases Hemoglobin ≥ 7.5 g/dL and ≤ 13 g/dL Absolute neutrophil count ≥1500/uL Platelet count ≥ 75,000/ uL (>72 hours since prior platelet transfusion) Corrected calcium within normal limits, previous hypercalcemia allowed Females of childbearing potential must use a highly effective method of birth control for at least 28 days before starting study, during participation and at least 112 days following last dose of sotatercept. Males must use latex condom or non-latex condom not made of (animal) membrane during any sexual contact with female of childbearing potential while participating in the study and for at least 112 days following the last dose of sotatercept, even if he has undergone successful vasectomy. Exclusion Criteria: History of thrombosis, deep vein thrombosis, pulmonary emboli, or embolic stroke AND have not been stable on anticoagulants within the past 6 months. Local central line thrombosis is allowed. History of polycythemia Uncontrolled hypertension (systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg.) History of severe allergic or anaphylactic reaction or hypersensitivity to recombinant proteins or excipients in investigational product. Current use of anti-cancer cytotoxic chemotherapeutic agents. Major surgery within 30 days of Day 1 of trial. Incomplete recovery or incomplete healing of wounds from previous surgery, as determined by treating Investigator. Subjects with classification of 3 or higher heart failure as classified by the New York Heart Association (NYHA). Please see Appendix IV. Women who are pregnant or breastfeeding or planning to become pregnant or breastfeed during the period of treatment and for 112 days following the last dose of sotatercept. Treatment with another investigational drug or device within 28 days prior to Day 1, or if the half-life of the previous product is known, within 5 times the half-life of the investigational drug prior to dosing, whichever is longer. Prior exposure to sotatercept. Any significant medical condition, laboratory abnormality, or psychiatric illness that, as determined by the treating Investigator, would prevent the subject from participating in the study or providing written informed consent. Any condition including the presence of laboratory abnormality that, as determined by the treating Investigator, places the subject at unacceptable risk if he/she were to participate in the study. Known positive for human immunodeficiency virus (HIV) Known positive for infectious hepatitis type C or active infectious hepatitis type B. Any condition that, as determined by the treating Investigator, confounds the interpretation of data from the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rebecca Silbermann, M.D.
Organizational Affiliation
Indiana University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Indiana University Simon Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States

12. IPD Sharing Statement

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A Phase IIa Study of Sotatercept on Bone Mass and Turnover in Patients With Multiple Myeloma

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