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Multi-center, Open-label, Phase 1b Study in Patients With Relapsed/Refractory Multiple Myeloma (RRMM)

Primary Purpose

Multiple Myeloma

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
isatuximab SAR650984 IV
pomalidomide
dexamethasone
isatuximab SAR650984 SC
Investigational injector device
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Anti-CD38 monoclonal antibody

Eligibility Criteria

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

Inclusion criteria:

  • Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in the protocol.
  • Participant must be above 18 years of age or country's legal age of majority if the legal age is >18 years old, at the time of signing the informed consent.
  • Participant has been previously diagnosed with multiple myeloma (MM) based on standard criteria and currently requires treatment because MM has relapsed following a response, according to International Myeloma Working Group (IMWG) criteria.
  • Participant has received at least two previous therapies including lenalidomide and a proteasome inhibitor and has demonstrated disease progression on last therapy or after completion of the last therapy.
  • Participants with measurable disease defined as at least one of the following:
  • Serum M protein ≥ 0.5 g/dL (≥5 g/L).
  • Urine M protein ≥ 200 mg/24 hours.
  • Serum free light chain (FLC) assay: Involved FLC assay ≥ 10 mg/dL (≥ 100 mg/L) and an abnormal serum FLC ratio (<0.26 or >1.65).
  • Male or female: Contraceptive use by men or women

Exclusion criteria:

  • Malignancy within 3 years prior to enrollment.
  • Eastern Cooperative Oncology Group (ECOG) performance status score >2.
  • Inadequate hematological, liver or renal function.
  • Serum calcium (corrected for albumin) level above the upper limit of normal (ULN) range.
  • Patients with prior anti-CD38 treatment are excluded if:

    • Refractory to anti-CD38 treatment defined as progression on or within 60 days of the last dose of the anti-CD38 or,
    • Intolerant to the anti-CD38 previously received or,
    • Progression after initial response on anti-CD38 therapy with a washout period inferior to 9 months before the first dose of isatuximab SC or IV.
  • Participant did not achieve a minimal response or better to at least one of the previous lines of treatment (ie, primary refractory disease is not eligible).
  • Received any investigational drug within 14 days or 5 half-lives of the investigational drug, whichever is longer.
  • Prior anti-cancer therapy within 14 days.
  • Any >Grade 1 adverse reaction unresolved from previous treatments according to the NCI-CTCAE v5.0. The presence of alopecia or peripheral neuropathy ≤ Grade 2 without pain is allowed.
  • Previous allogeneic stem cell transplantation with active Graft Versus Host Disease or being under immunosuppressive therapy in the last 2 months previously to the inclusion in the trial.
  • Daily requirement for corticosteroids.
  • Known to be HIV+ or to have hepatitis A or uncontrolled or active hepatitis B virus (HBV) infection (patients with positive HBsAg [HBsAg] and/or HBV DNA) or active HCV (HCV) infection (positive HCV RNA and negative anti-HCV).
  • Active tuberculosis and severe infections requiring treatment with antibiotic parenteral administration.
  • Any clinically significant, uncontrolled medical conditions that, in the Investigator's opinion, would expose excessive risk to the patient or may interfere with compliance or interpretation of the study results.
  • History of erythema multiforme or severe hypersensitivity to prior immunomodulatory drugs (IMiDs).
  • Hypersensitivity or history of intolerance to immunomodulatory drugs (IMiDs), dexamethasone, mannitol, pregelatinized starch, sodium stearyl fumarate, histidine (as base and hydrochloride salt), arginine hydrochloride, poloxamer 188, sucrose or any of the other components of study therapy that are not amenable to premedication with steroids and histamine H2 blockers or would prohibit further treatment with these agents.
  • Inability to tolerate thromboprophylaxis.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Investigational Site Number :8400005
  • Investigational Site Number :8400002
  • Investigational Site Number :8400001
  • Investigational Site Number :0360002
  • Investigational Site Number :0360001
  • Investigational Site Number :0360004
  • Investigational Site Number :0360003
  • Investigational Site Number :0560001
  • Investigational Site Number :2500001
  • Investigational Site Number :2500002
  • Investigational Site Number :3920002
  • Investigational Site Number :3920001
  • Investigational Site Number :7240001
  • Investigational Site Number :7240002
  • Investigational Site Number :7240003

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose regimen 1

Dose regimen 2

Dose regimen 3

Dose regimen 4

Dose regimen 5

Arm Description

Isatuximab SC administration dose level 1 once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle

Isatuximab SC administration dose level 2 once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle

Isatuximab SC administration dose level 3 using the investigational injector device once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle

Isatuximab IV administration once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle

Isatuximab IV administration once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle

Outcomes

Primary Outcome Measures

Assessment of adverse events (AEs)
Number of participants with adverse events
Pharmacokinetic (PK) assessment: Ceoi
Concentration observed at the end of infusion (Ceoi)
PK assessment: Cmax
Maximum concentration observed after the first infusion (Cmax)
PK assessment: tmax
Time to reach Cmax (tmax)
PK assessment: Clast
Last concentration observed above the lower limit of quantification after the first infusion (Clast)
PK assessment: tlast
Time of Clast (tlast)
PK assessment: Ctrough
Concentration observed just before treatment administration during repeated dosing (Ctrough)
PK assessment: AUClast
Area under the plasma concentration versus time curve calculated using the trapezoidal method from time zero to time of the last concentration observed above the lower limit of quantification (ie, Clast) (AUClast)
PK assessment: AUC0 T
Area under the plasma concentration versus time curve calculated over the dosing interval T (168h or 336h) (AUC0 T)

Secondary Outcome Measures

Estimation of absolute bioavailability of isatuximab
Absolute bioavailability of isatuximab SC, expressed as a percentage, estimated from AUC0-168h obtained after intravenous (IV) and extravascular (EV) administration
Overall response rate (ORR)
ORR is the proportion of patients with stringent complete response (sCR), complete response (CR), very good partial response (VGPR), and partial response (PR) using the IMWG response criteria
Duration of response (DOR)
Time from the date of the first response to the date of first progressive disease (PD) or death, whichever happens first
Time to response (TTR)
Time from the date of first study treatment to the first response
Time to progression (TTP)
Time from date of first study treatment to date of first documentation of progressive disease
Overall survival (OS)
Time from the date of first study treatment to date of death from any cause
Clinical benefit rate (CBR)
Proportion of patients with sCR, CR, VGPR, PR or minimal response (MR) according to IMWG criteria
Progression free survival (PFS)
Time from date of first study treatment to date of first documentation of progressive disease or death
Comparison of patient expectations and satisfaction: Patient Expectations and Satisfaction Questionnaires
Comparison of patient expectations and satisfaction will be assessed using Patient Expectations and Satisfaction Questionnaires before and after subcutaneous (SC) administration, where a score of 1 = not satisfied and a score of 5 = extremely satisfied
Immunogenicity: Anti drug antibody levels
Incidence of patients with anti drug antibodies against isatuximab
Biomarker: Change in CD38 receptor occupancy
Change in CD38 receptor occupancy from baseline

Full Information

First Posted
August 2, 2019
Last Updated
September 27, 2023
Sponsor
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT04045795
Brief Title
Multi-center, Open-label, Phase 1b Study in Patients With Relapsed/Refractory Multiple Myeloma (RRMM)
Official Title
A Multi-center, Open-label, Phase 1b Study to Assess the Pharmacokinetics, Safety, and Efficacy of Subcutaneous and Intravenous Isatuximab (SAR650984) in Combination With Pomalidomide and Dexamethasone, in Patients With Relapsed/Refractory Multiple Myeloma (RRMM)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 6, 2019 (Actual)
Primary Completion Date
February 15, 2024 (Anticipated)
Study Completion Date
February 15, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary Objectives: To evaluate the safety and tolerability of isatuximab administered subcutaneously (SC) versus intravenously (IV) To assess the safety and tolerability (including local injection site tolerability) of isatuximab using the (investigational) isatuximab injector device To evaluate the pharmacokinetics (PK) of SC and IV isatuximab Secondary Objectives: To estimate absolute bioavailability of SC and IV isatuximab To measure receptor occupancy (RO) after isatuximab SC versus IV administration To assess efficacy of isatuximab after SC and IV administration To assess patient expectations prior to and patient experience and satisfaction after SC administration To evaluate potential immunogenicity of SC or IV isatuximab
Detailed Description
Total study duration is variable depending on treatment and follow-up periods, including 21 days of screening, and treatment period until disease progression, unacceptable adverse reaction or other reason for discontinuation. End of treatment will be 30 days after last administration of investigational medicinal product, or before further anti-myeloma therapy, whichever comes first; approximately 14 months after first study treatment administration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Anti-CD38 monoclonal antibody

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
56 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose regimen 1
Arm Type
Experimental
Arm Description
Isatuximab SC administration dose level 1 once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle
Arm Title
Dose regimen 2
Arm Type
Experimental
Arm Description
Isatuximab SC administration dose level 2 once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle
Arm Title
Dose regimen 3
Arm Type
Experimental
Arm Description
Isatuximab SC administration dose level 3 using the investigational injector device once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle
Arm Title
Dose regimen 4
Arm Type
Experimental
Arm Description
Isatuximab IV administration once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle
Arm Title
Dose regimen 5
Arm Type
Experimental
Arm Description
Isatuximab IV administration once weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle
Intervention Type
Drug
Intervention Name(s)
isatuximab SAR650984 IV
Other Intervention Name(s)
Sarclisa
Intervention Description
Pharmaceutical form: solution Route of administration: intravenous
Intervention Type
Drug
Intervention Name(s)
pomalidomide
Other Intervention Name(s)
Pomalyst®
Intervention Description
Pharmaceutical form: tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
dexamethasone
Other Intervention Name(s)
Decadron®
Intervention Description
Pharmaceutical form: tablet Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
isatuximab SAR650984 SC
Intervention Description
Pharmaceutical form: solution Route of administration: subcutaneous
Intervention Type
Device
Intervention Name(s)
Investigational injector device
Intervention Description
Subcutaneous administration
Primary Outcome Measure Information:
Title
Assessment of adverse events (AEs)
Description
Number of participants with adverse events
Time Frame
Baseline to 30 days after last study treatment administration (up to approximately 14 months after first study treatment administration)
Title
Pharmacokinetic (PK) assessment: Ceoi
Description
Concentration observed at the end of infusion (Ceoi)
Time Frame
Baseline to end of treatment (EOT) after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: Cmax
Description
Maximum concentration observed after the first infusion (Cmax)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: tmax
Description
Time to reach Cmax (tmax)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: Clast
Description
Last concentration observed above the lower limit of quantification after the first infusion (Clast)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: tlast
Description
Time of Clast (tlast)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: Ctrough
Description
Concentration observed just before treatment administration during repeated dosing (Ctrough)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: AUClast
Description
Area under the plasma concentration versus time curve calculated using the trapezoidal method from time zero to time of the last concentration observed above the lower limit of quantification (ie, Clast) (AUClast)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
PK assessment: AUC0 T
Description
Area under the plasma concentration versus time curve calculated over the dosing interval T (168h or 336h) (AUC0 T)
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Secondary Outcome Measure Information:
Title
Estimation of absolute bioavailability of isatuximab
Description
Absolute bioavailability of isatuximab SC, expressed as a percentage, estimated from AUC0-168h obtained after intravenous (IV) and extravascular (EV) administration
Time Frame
Day 8
Title
Overall response rate (ORR)
Description
ORR is the proportion of patients with stringent complete response (sCR), complete response (CR), very good partial response (VGPR), and partial response (PR) using the IMWG response criteria
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Duration of response (DOR)
Description
Time from the date of the first response to the date of first progressive disease (PD) or death, whichever happens first
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Time to response (TTR)
Description
Time from the date of first study treatment to the first response
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Time to progression (TTP)
Description
Time from date of first study treatment to date of first documentation of progressive disease
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Overall survival (OS)
Description
Time from the date of first study treatment to date of death from any cause
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Clinical benefit rate (CBR)
Description
Proportion of patients with sCR, CR, VGPR, PR or minimal response (MR) according to IMWG criteria
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Progression free survival (PFS)
Description
Time from date of first study treatment to date of first documentation of progressive disease or death
Time Frame
From day -21 to day 60 after last study treatment (up to approximately 14 months after first study treatment administration)
Title
Comparison of patient expectations and satisfaction: Patient Expectations and Satisfaction Questionnaires
Description
Comparison of patient expectations and satisfaction will be assessed using Patient Expectations and Satisfaction Questionnaires before and after subcutaneous (SC) administration, where a score of 1 = not satisfied and a score of 5 = extremely satisfied
Time Frame
Cycles 1 and 2 (28 days per Cycle), and 30 days after last isatuximab administration (up to approximately 14 months after first study treatment administration)
Title
Immunogenicity: Anti drug antibody levels
Description
Incidence of patients with anti drug antibodies against isatuximab
Time Frame
Baseline to EOT after isatuximab SC and to Cycle 10 after IV (28 days per Cycle)
Title
Biomarker: Change in CD38 receptor occupancy
Description
Change in CD38 receptor occupancy from baseline
Time Frame
At screening and at Day 1 of Cycle 2 (28 days per Cycle) (predose); to be stopped once the isatuximab SC dose has been selected.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in the protocol. Participant must be above 18 years of age or country's legal age of majority if the legal age is >18 years old, at the time of signing the informed consent. Participant has been previously diagnosed with multiple myeloma (MM) based on standard criteria and currently requires treatment because MM has relapsed following a response, according to International Myeloma Working Group (IMWG) criteria. Participant has received at least two previous therapies including lenalidomide and a proteasome inhibitor and has demonstrated disease progression on last therapy or after completion of the last therapy. Participants with measurable disease defined as at least one of the following: Serum M protein ≥ 0.5 g/dL (≥5 g/L). Urine M protein ≥ 200 mg/24 hours. Serum free light chain (FLC) assay: Involved FLC assay ≥ 10 mg/dL (≥ 100 mg/L) and an abnormal serum FLC ratio (<0.26 or >1.65). Male or female: Contraceptive use by men or women Exclusion criteria: Malignancy within 3 years prior to enrollment. Eastern Cooperative Oncology Group (ECOG) performance status score >2. Inadequate hematological, liver or renal function. Serum calcium (corrected for albumin) level above the upper limit of normal (ULN) range. Patients with prior anti-CD38 treatment are excluded if: Refractory to anti-CD38 treatment defined as progression on or within 60 days of the last dose of the anti-CD38 or, Intolerant to the anti-CD38 previously received or, Progression after initial response on anti-CD38 therapy with a washout period inferior to 9 months before the first dose of isatuximab SC or IV. Participant did not achieve a minimal response or better to at least one of the previous lines of treatment (ie, primary refractory disease is not eligible). Received any investigational drug within 14 days or 5 half-lives of the investigational drug, whichever is longer. Prior anti-cancer therapy within 14 days. Any >Grade 1 adverse reaction unresolved from previous treatments according to the NCI-CTCAE v5.0. The presence of alopecia or peripheral neuropathy ≤ Grade 2 without pain is allowed. Previous allogeneic stem cell transplantation with active Graft Versus Host Disease or being under immunosuppressive therapy in the last 2 months previously to the inclusion in the trial. Daily requirement for corticosteroids. Known to be HIV+ or to have hepatitis A or uncontrolled or active hepatitis B virus (HBV) infection (patients with positive HBsAg [HBsAg] and/or HBV DNA) or active HCV (HCV) infection (positive HCV RNA and negative anti-HCV). Active tuberculosis and severe infections requiring treatment with antibiotic parenteral administration. Any clinically significant, uncontrolled medical conditions that, in the Investigator's opinion, would expose excessive risk to the patient or may interfere with compliance or interpretation of the study results. History of erythema multiforme or severe hypersensitivity to prior immunomodulatory drugs (IMiDs). Hypersensitivity or history of intolerance to immunomodulatory drugs (IMiDs), dexamethasone, mannitol, pregelatinized starch, sodium stearyl fumarate, histidine (as base and hydrochloride salt), arginine hydrochloride, poloxamer 188, sucrose or any of the other components of study therapy that are not amenable to premedication with steroids and histamine H2 blockers or would prohibit further treatment with these agents. Inability to tolerate thromboprophylaxis. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site Number :8400005
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
Facility Name
Investigational Site Number :8400002
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Investigational Site Number :8400001
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Facility Name
Investigational Site Number :0360002
City
Blacktown
State/Province
New South Wales
ZIP/Postal Code
2148
Country
Australia
Facility Name
Investigational Site Number :0360001
City
Wollongong
State/Province
New South Wales
ZIP/Postal Code
2500
Country
Australia
Facility Name
Investigational Site Number :0360004
City
Fitzroy
State/Province
Victoria
ZIP/Postal Code
3065
Country
Australia
Facility Name
Investigational Site Number :0360003
City
Richmond
State/Province
Victoria
ZIP/Postal Code
3121
Country
Australia
Facility Name
Investigational Site Number :0560001
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Investigational Site Number :2500001
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
Investigational Site Number :2500002
City
TOULOUSE Cedex 9
ZIP/Postal Code
31059
Country
France
Facility Name
Investigational Site Number :3920002
City
Okayama-shi
State/Province
Okayama
ZIP/Postal Code
701-1192
Country
Japan
Facility Name
Investigational Site Number :3920001
City
Shibuya-ku
State/Province
Tokyo
ZIP/Postal Code
150-8935
Country
Japan
Facility Name
Investigational Site Number :7240001
City
Badalona
State/Province
Barcelona [Barcelona]
ZIP/Postal Code
08916
Country
Spain
Facility Name
Investigational Site Number :7240002
City
Santander
State/Province
Cantabria
ZIP/Postal Code
39008
Country
Spain
Facility Name
Investigational Site Number :7240003
City
Salamanca
ZIP/Postal Code
37007
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Learn more about this trial

Multi-center, Open-label, Phase 1b Study in Patients With Relapsed/Refractory Multiple Myeloma (RRMM)

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