A Study of Modakafusp Alfa on Adult Participants With Relapsed/Refractory Multiple Myeloma (iinnovate-1)
Multiple Myeloma
About this trial
This is an interventional treatment trial for Multiple Myeloma focused on measuring Drug Therapy
Eligibility Criteria
Inclusion Criteria:
For Parts 1 and 2:
1. Has MM defined by the IMWG criteria with evidence of disease progression and:
- In need of additional myeloma therapy as determined by the investigator.
- Has previously received at least 3 lines of myeloma therapy (for example, containing an Immunomodulatory imide drug [IMiD], a proteasome inhibitor [PI], an alkylating agent, and/or an anti-CD38 as single agents or in combination).
- Is either refractory to or intolerant of at least 1 PI and a least 1 IMiD.
For Part 3:
Has MM defined by the IMWG criteria with evidence of disease progression and:
- In need of additional myeloma therapy as determined by the investigator.
- Has previously received at least 3 lines of myeloma therapy.
- Is refractory to at least 1 IMiD (ie, lenalidomide or pomalidomide [thalidomide excluded]), at least 1 PI (ie, bortezomib, ixazomib, or carfilzomib), and refractory to at least 1 anti-CD38 antibody (ie, daratumumab or isatuximab) and has demonstrated disease progression with the last therapy. Participants who are primary refractory, meaning they never achieved at least a MR with any previous treatment line, are not eligible.
For participants in Part 2 and 3 only: Measurable disease is defined as :
- Serum M-protein ≥500 mg/dL (≥5 g/L)
- Urine M-protein ≥200 mg/24 hours.
- Serum free light chain (FLC) assay, with involved FLC level ≥10 mg/dL (≥100 mg/L) provided serum FLC ratio is abnormal.
- During Part 1 only, participants not meeting the above criteria for measurable disease should, at least, have measurable bone marrow plasmacytosis (greater than or equal to [≥ ] 10 percent [%]) and/or plasmacytoma (≥1 centimeter [cm] in diameter) detected by physical examination or imaging.
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤2.
Exclusion Criteria:
For Parts 1 and 2:
- Has polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome, monoclonal gammopathy of unknown significance, smoldering myeloma, solitary plasmacytoma, amyloidosis, Waldenstrom macroglobulinemia or immunoglobulin M (IgM) myeloma, or lymphoplasmacytic lymphoma (LPL).
- Who have received autologous stem cell transplant (SCT) 60 days before first infusion of modakafusp alfa or participants who have received allogeneic SCT 6 months before first infusion. Graft-versus-host disease that is active or requires ongoing systemic immunosuppression.
- Has not recovered from adverse reactions to prior myeloma treatment or procedures (chemotherapy, immunotherapy, radiation therapy) to NCI CTCAE less than or equal to (≤) Grade 1 or baseline, except for sensory or motor neuropathy which should have recovered to ≤ Grade 2 or baseline.
- Has clinical signs of central nervous system involvement of MM.
For Part 3:
- Hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Seropositive for hepatitis B (defined by a positive test for hepatitis B surface antigen [HBsAg]. Participants with resolved infection (that is, participants who are HBsAg negative but positive for antibodies to hepatitis B core antigen [anti-HBc] and/or antibodies to hepatitis B surface antigen [anti-HBs]) must be screened using real-time polymerase chain reaction (PCR) measurement of HBV DNA levels. Those who are PCR positive will be excluded.
- In addition to the above criteria, participants must not have plasma cell leukemia or have had primary refractory MM, current central nervous system involvement of MM, myelodysplastic syndrome, myeloproliferative syndrome, or have had a second malignancy within the previous 3 years, except treated basal cell or localized squamous skin carcinomas, localized prostate cancer, cervical carcinoma in situ, resected colorectal adenomatous polyps, breast cancer in situ, or other malignancy for which the participant is not on active anticancer therapy.
Sites / Locations
- Highlands Oncology Group
- Los Angeles Cancer Network - Glendale Adventist Medical Center
- University of California Irvine
- Office of James R. Berenson MD
- Smilow Cancer Hospital at Yale New Haven
- Winship Cancer Institute of Emory University
- Northwestern Medicine - Northwestern Medical Group
- Loyola University Medical Center
- Investigative Clinical Research of Indiana, LLC
- June E. Nylen Cancer Center
- Johns Hopkins Hospital
- Boston Medical Center
- Dana Farber Cancer InstituteRecruiting
- Univeristy of Nebraska Medical CenterRecruiting
- USOR - Comprehensive Cancer Centers of Nevada - Central Valley
- John Theurer Cancer Center
- Montefiore Medical Center
- University of Rochester
- Levine Cancer CenterRecruiting
- Levine Cancer Institute - Concord
- Duke University Medical Center
- Gabrail Cancer Center
- The Ohio State UniversityRecruiting
- Oregon Health and Science University
- University of PennsylvaniaRecruiting
- Baptist Cancer Center - Memphis - Walnut Grove
- Lumi Research
- British Columbia Cancer Agency Vancouver Centre
- Juravinski Cancer Centre
- Centre de Recherche du CHUM
- Sir Mortimer B. Davis Jewish General Hospital
- Peking University People's HospitalRecruiting
- Peking University Third HospitalRecruiting
- Sun Yat-Sen University Cancer CenterRecruiting
- Henan Cancer HospitalRecruiting
- Wuhan Union HospitalRecruiting
- Zhongnan Hospital of Wuhan UniversityRecruiting
- Nanjing Drum Tower HospitalRecruiting
- The First Affiliated Hospital of Soochow University - Suzhou First People's HospitalRecruiting
- Shanghai Fourth People's HospitalRecruiting
- Tianjin Medical University Cancer Institute & HospitalRecruiting
- The First Affiliated Hospital, Zhejiang UniversityRecruiting
- Institut de cancerologie Strasbourg Europe
- Centre Hospitalier Universitaire Henri Mondor
- Hopital Saint-Antoine
- Hopital Necker-Enfants Malades
- Centre Hospitalier Universitaire de Toulouse Hopital Purpan
- Hopital Saint-Vincent de Paul - Lille
- Centre Hospitalier Regional Universitaire de Lille
- Centre Hospitalier Universitaire Nantes - Hotel Dieu
- Centre Hospitalier Universitaire de Poitiers
- Centre Hospitalier d'Argenteuil - Centre Hospitalier Victor Dupouy
- Universitatsklinik Tubingen
- Universitatsklinikum Leipzig
- Evaggelismos General Hospital
- Alexandra General Hospital of Athens
- University Regional General Hospital of Patras
- The Chaim Sheba Medical Center
- Hadassah Medical Center
- Tel Aviv Sourasky Medical Center
- AON SS Antonio e Biagio e Cesare Arrigo
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona
- Azienda Ospedaliero-Universitaria di Bologna - Policlinico Sant'Orsola-Malpighi
- Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele
- Fondazione IRCCS Policlinico San Matteo
- Nagoya City University HospitalRecruiting
- Ogaki Municipal HospitalRecruiting
- University Hospital Kyoto Prefectural University of MedicineRecruiting
- National Hospital Organization Okayama Medical CenterRecruiting
- Japanese Red Cross Medical CenterRecruiting
- Chonnam National University Hwasun Hospital
- Seoul National University Hospital
- The Catholic University of Korea - Seoul St. Mary's Hospital
- Oslo Universitetssykehus-Ulleval Hospital
- Ad-Vance Medical Research
- Hospital Espanol Auxilio Mutuo
- Hospital Universitari Germans Trias i Pujol
- Hospital Universitari Vall d'Hebron
- Hospital Clinic de Barcelona
- Hospital Universitario 12 de Octubre
- Hospital Universitario Virgen de la Arrixaca
- Hospital Universitario de Salamanca
- Hospital Universitario Marques de Valdecilla
- Tri-Service General Hospital
- National Taiwan University Hospital
- Ankara Universitesi
- Ondokuz Mayis Universitesi Tp Fakultesi
- University Hospitals Birmingham NHS Foundation Trust
- Royal Cornwall Hospital NHS Trust
- University College London Hospitals NHS Foundation Trust
- Genesis Care - Milton Keynes
- Oxford University Hospitals NHS Foundation Trust
- The Royal Marsden NHS Foundation Trust
- Genesis Care Windsor - Genesis Care UK Ltd.
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Part 1 (Dose Escalation) Schedule A: Modakafusp alfa 0.001 Up to 14 mg/kg
Part 1 (Dose Escalation) Schedule B: Modakafusp alfa TBD
Part 1 (Dose Escalation) Schedule C: Modakafusp alfa TBD
Part 1 (Dose Escalation) Schedule D: Modakafusp alfa TBD
Part 2 (Dose Expansion): Modakafusp alfa TBD + Dexamethasone 40 mg
Part 3 (Dose Extension): Modakafusp alfa 120 mg
Part 3 (Dose Extension): Modakafusp alfa 240 mg
Modakafusp alfa 0.001 up to 14 milligram per kilogram (mg/kg), infusion, intravenously (IV), once every week (Q1W) on Days 1, 8, 15 and 22 of each 28-day treatment cycle up to 2 cycles, followed by once on Days 1 and 15 of each 28-day treatment cycle up to 4 cycles, followed by once on Day 1 of each 28-day treatment cycle until treatment discontinuation.
Modakafusp alfa TBD, infusion, IV, once every 2 weeks (Q2W) on Days 1 and 15 of each 28-day treatment cycle until treatment discontinuation. The starting dose will be decided by the investigators and sponsor representatives based on all available clinical information.
Modakafusp alfa TBD, infusion, IV, once every 3 weeks (Q3W) on Day 1 of each 21-day treatment cycle until treatment discontinuation. The starting dose will be decided by the investigators and sponsor representatives based on all available clinical information.
Modakafusp alfa TBD, infusion, IV, once every 4 weeks (Q4W) on Day 1 of each 28-day treatment cycle until treatment discontinuation. The starting dose will be decided by the investigators and sponsor representatives based on all available clinical information.
Dose(s) for Phase 2 will be based on safety and tolerability results from the preceding Phase 1 dose escalation cohorts. Participants in Phase 2 cohorts will receive modakafusp alfa TBD as a single agent. Participants in at least 1 cohort will receive modakafusp alfa TBD and modakafusp alfa TBD and dexamethasone 40 mg, orally, once weekly of each 28-day treatment cycle until treatment discontinuation.
Participants will receive modakafusp alfa 120 mg, infusion, IV, Q4W, for each 28-day treatment cycle until disease progression or treatment discontinuation.
Participants will receive modakafusp alfa 240 mg, infusion, IV, Q4W, for each 28-day treatment cycle until disease progression or treatment discontinuation.