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Safety and Efficacy of ALLO-715 BCMA Allogenic CAR T Cells in in Adults With Relapsed or Refractory Multiple Myeloma (UNIVERSAL) (UNIVERSAL)

Primary Purpose

Relapsed/Refractory Multiple Myeloma

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ALLO-715
ALLO-647
Fludarabine
Cyclophosphamide
Nirogacestat
Sponsored by
Allogene Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed/Refractory Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Documented diagnosis of relapsed/refractory multiple myeloma (MM) with measurable disease (serum, urine, or free light chain [FLC]) per International Myeloma Working Group (IMWG) criteria
  • At least 3 prior lines of MM therapy, including a proteasome inhibitor, immunomodulatory agent, and anti-CD38 antibody (unless contraindicated), and refractory to the last treatment line.
  • Eastern Cooperative Oncology Group (ECOG) 0 or 1
  • Absence of donor (product)-specific anti-HLA antibodies
  • Adequate hematologic, renal, hepatic, pulmonary, and cardiac function

Exclusion Criteria:

  • Current or history of Central Nervous System (CNS) involvement of myeloma or plasma cell leukemia
  • Clinically significant CNS disorder
  • Current or history of thyroid disorder
  • Autologous stem cell transplant within the last 6 weeks, or any allogeneic stem cell transplant
  • Prior treatment with anti-BCMA therapy, any gene therapy, any genetically modified cell therapy, or adoptive T cell therapy
  • History of HIV infection or acute or chronic active hepatitis B or C infection
  • Patients unwilling to participate in an extended safety monitoring period

Additional Exclusion Criteria for Nirogacestat plus ALLO-715 Cohorts

  • Inability to swallow tablets
  • Subject has known malabsorption syndrome or preexisting gastrointestinal conditions that may impair absorption of nirogacestat
  • Use of strong/moderate CYP3A4 inhibitors, and strong CYP3A4 inducers within 14 days before starting nirogacestat.
  • Use of concomitant medications that are known to prolong the QT/QTcF interval

Sites / Locations

  • Banner MD Anderson Cancer Center
  • City of Hope
  • Stanford Cancer Institute
  • Sarah Cannon/Colorado Blood Cancer Institute
  • Mayo Clinic
  • Memorial Sloan Kettering Cancer Center
  • Cleveland Clinic Taussig Cancer Center
  • Vanderbilt-Ingram Cancer Center
  • St. David's South Austin Medical Center
  • Texas Transplant Institute
  • Medical College of Wisconsin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ALLO-647, ALLO-715, Nirogacestat

Arm Description

Outcomes

Primary Outcome Measures

Proportion of subjects experiencing Dose Limiting Toxicities at increasing doses of ALLO-715
Dose limiting toxicities are defined as ALLO-715-related adverse events with onset within 28 days following infusion of ALLO-715.
To assess the overall safety profile and tolerability of ALLO-647 in combination with Fludarabine and/or cyclophosphamide or ALLO-647 alone, prior to ALLO-715 to confirm the dose of ALLO-647.
The proportion of subjects in a dose cohort with DLTs of ALLO-647
To assess the overall safety profile and tolerability of nirogacestat given concomitantly with ALLO-715 following lymphodepletion with Flu/ Cy/ ALLO-647.
Dose limiting toxicities are defined as ALLO-715-related adverse events with onset within 28 days following infusion of ALLO-715.

Secondary Outcome Measures

Cellular kinetics of ALLO-715
Levels of anti-BCMA CAR T cells in blood
antitumor activity of ALLO-715 in combination with nirogacestat
overall -response rate (ORR)
Cellular kinetics of ALLO-715 in combination with nirogacestat
Levels of anti-BCMA CAR T cells in blood
Pharmacokinetics of ALLO-647
Serum concentration levels of ALLO-647
Pharmacokinetics of nirogacestat
Serum concentration levels of nirogacestat
Incidence of immunogenicity against ALLO-715 and ALLO-647
detection and levels of anti-drug antibodies
Immune monitoring after lymphodepletion regimen
Detection of the following circulating cells: T cell subset, B lymphocytes, and NK cells
Anti-tumor activity of ALLO-715
overall response rate
Anti-tumor activity of ALLO-715
duration of response
Anti-tumor activity of ALLO-715
overall survival
Anti-tumor activity of ALLO-715
minimal residual disease
To evaluate the expression of BCMA in bone marrow plasma cells with and without nirogacestat
Overall response rate of ALLO-715 with and without Nirogacestat

Full Information

First Posted
September 16, 2019
Last Updated
August 9, 2023
Sponsor
Allogene Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT04093596
Brief Title
Safety and Efficacy of ALLO-715 BCMA Allogenic CAR T Cells in in Adults With Relapsed or Refractory Multiple Myeloma (UNIVERSAL)
Acronym
UNIVERSAL
Official Title
A Single-Arm, Open-Label, Phase 1 Study of the Safety, Efficacy, and Cellular Kinetics/Pharmacodynamics of ALLO-715 to Evaluate an Anti-BCMA Allogeneic CAR T Cell Therapy With or Without Nirogacestat in Subjects With Relapsed/Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 23, 2019 (Actual)
Primary Completion Date
September 2027 (Anticipated)
Study Completion Date
September 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Allogene Therapeutics

4. Oversight

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

5. Study Description

Brief Summary
The purpose of the UNIVERSAL study is to assess the safety, efficacy, cell kinetics, and immunogenicity of ALLO-715 with or without Nirogacestat in adults with relapsed or refractory multiple myeloma after a lymphodepletion regimen of ALLO-647 in combination with fludarabine and/or cyclophosphamide, or ALLO-647 alone.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
132 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ALLO-647, ALLO-715, Nirogacestat
Arm Type
Experimental
Intervention Type
Genetic
Intervention Name(s)
ALLO-715
Intervention Description
ALLO-715 is an allogeneic CAR T cell therapy targeting BCMA
Intervention Type
Biological
Intervention Name(s)
ALLO-647
Intervention Description
ALLO-647 is a monoclonal antibody that recognizes a CD52 antigen
Intervention Type
Drug
Intervention Name(s)
Fludarabine
Intervention Description
Chemotherapy for lymphodepletion
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
Chemotherapy for lymphodepletion
Intervention Type
Drug
Intervention Name(s)
Nirogacestat
Intervention Description
a small molecule, selective, reversible, noncompetitive inhibitor of γsecretase (GSI) that increases BCMA target density on the surface of multiple myeloma cells.
Primary Outcome Measure Information:
Title
Proportion of subjects experiencing Dose Limiting Toxicities at increasing doses of ALLO-715
Description
Dose limiting toxicities are defined as ALLO-715-related adverse events with onset within 28 days following infusion of ALLO-715.
Time Frame
28 Days
Title
To assess the overall safety profile and tolerability of ALLO-647 in combination with Fludarabine and/or cyclophosphamide or ALLO-647 alone, prior to ALLO-715 to confirm the dose of ALLO-647.
Description
The proportion of subjects in a dose cohort with DLTs of ALLO-647
Time Frame
33 days
Title
To assess the overall safety profile and tolerability of nirogacestat given concomitantly with ALLO-715 following lymphodepletion with Flu/ Cy/ ALLO-647.
Description
Dose limiting toxicities are defined as ALLO-715-related adverse events with onset within 28 days following infusion of ALLO-715.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Cellular kinetics of ALLO-715
Description
Levels of anti-BCMA CAR T cells in blood
Time Frame
up to 60 months
Title
antitumor activity of ALLO-715 in combination with nirogacestat
Description
overall -response rate (ORR)
Time Frame
up to 60 months
Title
Cellular kinetics of ALLO-715 in combination with nirogacestat
Description
Levels of anti-BCMA CAR T cells in blood
Time Frame
up to 60 months
Title
Pharmacokinetics of ALLO-647
Description
Serum concentration levels of ALLO-647
Time Frame
up to 60 months
Title
Pharmacokinetics of nirogacestat
Description
Serum concentration levels of nirogacestat
Time Frame
up to 60 months
Title
Incidence of immunogenicity against ALLO-715 and ALLO-647
Description
detection and levels of anti-drug antibodies
Time Frame
up to 60 months
Title
Immune monitoring after lymphodepletion regimen
Description
Detection of the following circulating cells: T cell subset, B lymphocytes, and NK cells
Time Frame
up to 60 months
Title
Anti-tumor activity of ALLO-715
Description
overall response rate
Time Frame
up to 60 months
Title
Anti-tumor activity of ALLO-715
Description
duration of response
Time Frame
up to 60 months
Title
Anti-tumor activity of ALLO-715
Description
overall survival
Time Frame
up to 60 months
Title
Anti-tumor activity of ALLO-715
Description
minimal residual disease
Time Frame
up to 60 months
Title
To evaluate the expression of BCMA in bone marrow plasma cells with and without nirogacestat
Description
Overall response rate of ALLO-715 with and without Nirogacestat
Time Frame
up to 60 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documented diagnosis of relapsed/refractory multiple myeloma (MM) with measurable disease (serum, urine, or free light chain [FLC]) per International Myeloma Working Group (IMWG) criteria At least 3 prior lines of MM therapy, including a proteasome inhibitor, immunomodulatory agent, and anti-CD38 antibody (unless contraindicated), and refractory to the last treatment line. Eastern Cooperative Oncology Group (ECOG) 0 or 1 Absence of donor (product)-specific anti-HLA antibodies Adequate hematologic, renal, hepatic, pulmonary, and cardiac function Exclusion Criteria: Current or history of Central Nervous System (CNS) involvement of myeloma or plasma cell leukemia Clinically significant CNS disorder Current or history of thyroid disorder Autologous stem cell transplant within the last 6 weeks, or any allogeneic stem cell transplant Prior treatment with anti-BCMA therapy, any gene therapy, any genetically modified cell therapy, or adoptive T cell therapy History of HIV infection or acute or chronic active hepatitis B or C infection Patients unwilling to participate in an extended safety monitoring period Additional Exclusion Criteria for Nirogacestat plus ALLO-715 Cohorts Inability to swallow tablets Subject has known malabsorption syndrome or preexisting gastrointestinal conditions that may impair absorption of nirogacestat Use of strong/moderate CYP3A4 inhibitors, and strong CYP3A4 inducers within 14 days before starting nirogacestat. Use of concomitant medications that are known to prolong the QT/QTcF interval
Facility Information:
Facility Name
Banner MD Anderson Cancer Center
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85234
Country
United States
Facility Name
City of Hope
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
Stanford Cancer Institute
City
Palo Alto
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Sarah Cannon/Colorado Blood Cancer Institute
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Cleveland Clinic Taussig Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
St. David's South Austin Medical Center
City
Austin
State/Province
Texas
ZIP/Postal Code
78704
Country
United States
Facility Name
Texas Transplant Institute
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
36690811
Citation
Mailankody S, Matous JV, Chhabra S, Liedtke M, Sidana S, Oluwole OO, Malik S, Nath R, Anwer F, Cruz JC, Htut M, Karski EE, Lovelace W, Dillon M, Butz E, Ying W, Balakumaran A, Kumar SK. Allogeneic BCMA-targeting CAR T cells in relapsed/refractory multiple myeloma: phase 1 UNIVERSAL trial interim results. Nat Med. 2023 Feb;29(2):422-429. doi: 10.1038/s41591-022-02182-7. Epub 2023 Jan 23. Erratum In: Nat Med. 2023 Mar 17;:
Results Reference
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Safety and Efficacy of ALLO-715 BCMA Allogenic CAR T Cells in in Adults With Relapsed or Refractory Multiple Myeloma (UNIVERSAL)

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