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Testing JNJ-42756493 In Combination With Dexamethasone in Multiple Myeloma That Came Back After a Period of Improvement

Primary Purpose

Multiple Myeloma, Relapsed/Refractory

Status
Terminated
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
JNJ-42756493
Dexamethasone
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • A diagnosis of MM and documentation of at least 1 prior line of therapy including proteasome and immunomodulatory agents.
  • Documented lab results confirming FGFR3 expression and mutational status determined by a clinical grade, next generation sequencing platform approved by the Sponsor-Investigator, the results of which must be obtained prior to registration.
  • Patients with measurable disease by laboratory studies for determining eligibility must be obtained within 28 days prior to start of study drug):
  • Must have an Eastern Cooperative Oncology Group (ECOG) performance status score 0, 1, or 2.
  • Negative pregnancy status in women of childbearing potential must be confirmed within 7 days prior to start of study drug. Participants must use medically acceptable methods of birth control before the study entry, during the study, and until 3 months after taking the last dose of the study drug.
  • Patient must sign the informed consent documents indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study.
  • Life Expectancy of โ‰ฅ 3 months.
  • Able to take oral medications.
  • Acceptable laboratory results must be met within 7 days of first study drug administration.

Exclusion Criteria:

  • Patients in whom FGFR3 expression or mutational status cannot be determined.
  • Chemotherapy, limited palliative radiotherapy or other anti-myeloma therapy within 14 days prior to the first dose of study drug. In addition, any treatment related toxicity should have recovered < Grade 1 unless deemed to be irreversible.
  • Patients who are receiving any other investigational agent.
  • Patients with known CNS involvement, plasma cell leukemia or amyloidosis.
  • Use of an investigational drug within 21 days or five-half-lives, whichever is shorter but not less than 14 days, preceding the first dose of study drug.
  • History of allogeneic stem cell transplant.
  • Autologous, peripheral stem cell transplant within 12 weeks of the first dose of study drug.
  • Prior major surgical procedure or extensive radiation therapy within 4 weeks of the first dose of study treatment.
  • Current use of corticosteroids, with the exception of inhaled or topical steroids.
  • Previous or concurrent malignancies are allowed if it is clear that the patient is not symptomatic from the other tumor. The subject must not be receiving active therapy for the other tumor and the other tumor must be considered medically stable.
  • Has a history of or current uncontrolled cardiovascular disease.
  • Patients with evidence of mucosal or internal bleeding and/or platelet transfusion refractory. Patients cannot use growth factors within 7 days of start of study drug, or transfusion of blood or platelets within 7 days of start of study drug.
  • Has impaired wound healing capacity defined as skin/decubitus ulcers, chronic leg ulcers, known gastric ulcers, or unhealed incisions.
  • Serious psychiatric illness, active alcoholism, or drug addiction that may hinder or confuse follow-up evaluations.
  • Any other condition that, in the Investigator's opinion, would contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures.
  • Received prior FGFR inhibitor treatment or if the subject has known allergies, hypersensitivity, or intolerance to JNJ-42756493 or its excipients.
  • Pregnant, breast feeding, or planning to become pregnant within 3 months after the last dose of study drug and males who plan to father a child while enrolled in this study or within 5 months after the last dose of study drug.
  • Known HIV or active hepatitis B or C viral infection.
  • History of cerebrovascular accident (CVA) within 6 months prior to registration.
  • Gastrointestinal abnormalities, including bowel obstruction, inability to take oral medication, requirement for intravenous (IV) alimentation, active peptic ulcer or prior surgical procedures or bowel resection affecting absorption.
  • Peripheral neuropathy โ‰ฅ Grade 2.
  • Has persistent phosphate level >ULN during screening (within 14 days of treatment and prior to Cycle 1 Day 1) despite medical management.
  • Any corneal or retinal abnormality likely to increase the risk of eye toxicity.
  • Patients that require the following prohibited therapy:

    1. Medicines known to have a risk of causing QTc prolongation and Torsades de Pointes
    2. Medications known to increase serum levels of phosphate and calcium
    3. Medications or substances known to be strong inhibitors or strong inducers of CYP3A4 or CYP2C9 before the recommended 5 half-life washout period

Sites / Locations

  • Princess Margaret Cancer Centre

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

FGFR3 wild-type

FGFR3 mutated

Arm Description

JNJ-42756493: For the first cycle, 8 mg orally (by mouth), once each day for 14 days of each 28-day periods called cycles. Then dose of JNJ-42756493 may then be increased to 9 mg taken orally if no significant side effects related to JNJ-42756493 are seen during the first 14 days. Dexamethasone: 40 mg, orally, on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly). Patients over the age of 75 will take a reduced dose of dexamethasone of 20 mg on starting cycle 1 on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly).

JNJ-42756493: For the first cycle, 8 mg orally (by mouth), once each day for 14 days of each 28-day periods called cycles. Then dose of JNJ-42756493 may then be increased to 9 mg taken orally if no significant side effects related to JNJ-42756493 are seen during the first 14 days. Dexamethasone: 40 mg, orally, on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly). Patients over the age of 75 will take a reduced dose of dexamethasone of 20 mg on starting cycle 1 on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly).

Outcomes

Primary Outcome Measures

Objective response rate (ORR)
Minimal response rate
Stable disease rate

Secondary Outcome Measures

Incidence of toxicities
Progression free survival rate
Duration of response rate

Full Information

First Posted
October 31, 2016
Last Updated
September 15, 2020
Sponsor
University Health Network, Toronto
Collaborators
Multiple Myeloma Research Consortium
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1. Study Identification

Unique Protocol Identification Number
NCT02952573
Brief Title
Testing JNJ-42756493 In Combination With Dexamethasone in Multiple Myeloma That Came Back After a Period of Improvement
Official Title
A Phase II Open Label, Multicenter, Trial of JNJ-42756493 In Combination With Dexamethasone For The Treatment Of FGFR3 Wild-type Or Mutation Positive Relapsed and/or Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Terminated
Why Stopped
Low patient accrual
Study Start Date
June 13, 2017 (Actual)
Primary Completion Date
November 13, 2018 (Actual)
Study Completion Date
November 13, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
Collaborators
Multiple Myeloma Research Consortium

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase 2 study to see how effective investigational drug, JNJ-42756493, is when given in combination with dexamethasone in two groups of patients with multiple myeloma (cancer of the plasma cells, a type of white blood cell present in bone marrow) that has relapsed (has come back after a period of improvement) or refractory (did not respond to standard treatment).
Detailed Description
Participants in the study will be assigned to one of two groups: One group of participants will be FGFR3 wild-type (participants whose tumors have no mutations or changes of a gene called FGFR3) and the other group will be FGFR3 mutated (participants whose tumors have mutations of FGFR3). Participants will receive JNJ-42756493 with dexamethasone for as long as their diseases do not progress (worsen) and they do not experience unacceptable side effects for a maximum of 24 cycles (approximately 22 months). While on the study drugs, participants will be asked to visit the clinic about 2 times during Cycles 1 and 2 and once during Cycle 3 and subsequent cycles for tests and procedures.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
FGFR3 wild-type
Arm Type
Experimental
Arm Description
JNJ-42756493: For the first cycle, 8 mg orally (by mouth), once each day for 14 days of each 28-day periods called cycles. Then dose of JNJ-42756493 may then be increased to 9 mg taken orally if no significant side effects related to JNJ-42756493 are seen during the first 14 days. Dexamethasone: 40 mg, orally, on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly). Patients over the age of 75 will take a reduced dose of dexamethasone of 20 mg on starting cycle 1 on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly).
Arm Title
FGFR3 mutated
Arm Type
Experimental
Arm Description
JNJ-42756493: For the first cycle, 8 mg orally (by mouth), once each day for 14 days of each 28-day periods called cycles. Then dose of JNJ-42756493 may then be increased to 9 mg taken orally if no significant side effects related to JNJ-42756493 are seen during the first 14 days. Dexamethasone: 40 mg, orally, on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly). Patients over the age of 75 will take a reduced dose of dexamethasone of 20 mg on starting cycle 1 on days 1-4, 9-12, 17-20 for the first two cycles. Starting cycle 3, dexamethasone will be taken on days 1, 8, 15 and 22 (once weekly).
Intervention Type
Drug
Intervention Name(s)
JNJ-42756493
Other Intervention Name(s)
Erdafitinib
Intervention Description
Once daily dosing
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Other Intervention Name(s)
Apo- Dexamethasone
Intervention Description
Cycle 1 and 2: OD dosing on days 1-4, 9-12, and 17-20;Cycle 3: OD dosing on days 1, 8, 15, 22
Primary Outcome Measure Information:
Title
Objective response rate (ORR)
Time Frame
5 years
Title
Minimal response rate
Time Frame
5 years
Title
Stable disease rate
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Incidence of toxicities
Time Frame
5 years
Title
Progression free survival rate
Time Frame
5 years
Title
Duration of response rate
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A diagnosis of MM and documentation of at least 1 prior line of therapy including proteasome and immunomodulatory agents. Documented lab results confirming FGFR3 expression and mutational status determined by a clinical grade, next generation sequencing platform approved by the Sponsor-Investigator, the results of which must be obtained prior to registration. Patients with measurable disease by laboratory studies for determining eligibility must be obtained within 28 days prior to start of study drug): Must have an Eastern Cooperative Oncology Group (ECOG) performance status score 0, 1, or 2. Negative pregnancy status in women of childbearing potential must be confirmed within 7 days prior to start of study drug. Participants must use medically acceptable methods of birth control before the study entry, during the study, and until 3 months after taking the last dose of the study drug. Patient must sign the informed consent documents indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study. Life Expectancy of โ‰ฅ 3 months. Able to take oral medications. Acceptable laboratory results must be met within 7 days of first study drug administration. Exclusion Criteria: Patients in whom FGFR3 expression or mutational status cannot be determined. Chemotherapy, limited palliative radiotherapy or other anti-myeloma therapy within 14 days prior to the first dose of study drug. In addition, any treatment related toxicity should have recovered < Grade 1 unless deemed to be irreversible. Patients who are receiving any other investigational agent. Patients with known CNS involvement, plasma cell leukemia or amyloidosis. Use of an investigational drug within 21 days or five-half-lives, whichever is shorter but not less than 14 days, preceding the first dose of study drug. History of allogeneic stem cell transplant. Autologous, peripheral stem cell transplant within 12 weeks of the first dose of study drug. Prior major surgical procedure or extensive radiation therapy within 4 weeks of the first dose of study treatment. Current use of corticosteroids, with the exception of inhaled or topical steroids. Previous or concurrent malignancies are allowed if it is clear that the patient is not symptomatic from the other tumor. The subject must not be receiving active therapy for the other tumor and the other tumor must be considered medically stable. Has a history of or current uncontrolled cardiovascular disease. Patients with evidence of mucosal or internal bleeding and/or platelet transfusion refractory. Patients cannot use growth factors within 7 days of start of study drug, or transfusion of blood or platelets within 7 days of start of study drug. Has impaired wound healing capacity defined as skin/decubitus ulcers, chronic leg ulcers, known gastric ulcers, or unhealed incisions. Serious psychiatric illness, active alcoholism, or drug addiction that may hinder or confuse follow-up evaluations. Any other condition that, in the Investigator's opinion, would contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures. Received prior FGFR inhibitor treatment or if the subject has known allergies, hypersensitivity, or intolerance to JNJ-42756493 or its excipients. Pregnant, breast feeding, or planning to become pregnant within 3 months after the last dose of study drug and males who plan to father a child while enrolled in this study or within 5 months after the last dose of study drug. Known HIV or active hepatitis B or C viral infection. History of cerebrovascular accident (CVA) within 6 months prior to registration. Gastrointestinal abnormalities, including bowel obstruction, inability to take oral medication, requirement for intravenous (IV) alimentation, active peptic ulcer or prior surgical procedures or bowel resection affecting absorption. Peripheral neuropathy โ‰ฅ Grade 2. Has persistent phosphate level >ULN during screening (within 14 days of treatment and prior to Cycle 1 Day 1) despite medical management. Any corneal or retinal abnormality likely to increase the risk of eye toxicity. Patients that require the following prohibited therapy: Medicines known to have a risk of causing QTc prolongation and Torsades de Pointes Medications known to increase serum levels of phosphate and calcium Medications or substances known to be strong inhibitors or strong inducers of CYP3A4 or CYP2C9 before the recommended 5 half-life washout period
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Suzanne Trudel, M.D.
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Testing JNJ-42756493 In Combination With Dexamethasone in Multiple Myeloma That Came Back After a Period of Improvement

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