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Study of Belantamab Mafodotin as Pre- and Post-autologous Stem Cell Transplant and Maintenance for Multiple Myeloma

Primary Purpose

Myeloma

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Belantamab mafodotin
Sponsored by
University of Pennsylvania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects must have started therapy for active multiple myeloma within 12 months of enrollment.
  • Subjects must have an ECOG performance status of 0-2.
  • Have received no more than 2 prior lines of induction therapy (induction regimen not specified by protocol), with no prior progressive disease by International Myeloma Working Group (IMWG) criteria.
  • Must be in at least a partial response (PR) but not in a stringent complete response (sCR) after at least 4 cycles of induction therapy, per IMWG consensus criteria.
  • Eligible by institutional criteria to receive melphalan at a dose of 200 mg/m2.
  • Eligible to receive lenalidomide maintenance therapy post-ASCT.
  • Adequate bone marrow and organ function at enrollment

Exclusion Criteria:

  • Participant must not have used an investigational drug or approved systemic anti-myeloma therapy (including systemic steroids) within 14 days or five half-lives, whichever is shorter, preceding the first dose of study drug.
  • Participant must not have received treatment with a monoclonal antibody within 28 days of receiving the first dose of study drug
  • Participant must not be simultaneously enrolled in any interventional clinical trial
  • Participant must not have amyloidosis or POEMS syndrome.
  • Participants must not be pregnant or lactating.
  • Participant must not have current unstable liver or biliary disease defined by the presence of ascites, encephalopathy, coagulopathy, severe hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis. Note: Stable non-cirrhotic chronic liver disease (including Gilbert's syndrome or asymptomatic gallstones) or hepatobiliary involvement of malignancy is acceptable if otherwise meets entry criteria
  • Participant must not have any evidence of active mucosal or internal bleeding
  • History of an active renal condition (infection, requirement for dialysis or any other condition that could affect subject's safety). Subjects with isolated proteinuria resulting from MM are eligible, provided they fulfill criteria given in Section 6.1.
  • Participant must not have evidence of cardiovascular risk
  • Participants must not have any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions (including lab abnormalities) that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures.
  • Participant must not have invasive malignancies other than disease under study, unless the second malignancy has been definitively treated or has been medically stable for at least 2 years and, in the opinion of the principal investigator, will not affect the evaluation of the effects of clinical trial treatment.
  • Participants must not have an active infection requiring antibiotic treatment.
  • Any major surgery within the last 4 weeks prior to enrollment.
  • Participant must not have current corneal epithelial disease except mild changes in corneal epithelium
  • Participant must not have known immediate or delayed hypersensitivity reaction or idiosyncratic reactions to belantamab mafodotin or drugs chemically related to belantamab mafodotin, or any of the components of the study treatment
  • Participant must not have evidence for active hepatitis B infection (i.e. positive hepatitis B surface antigen or nucleic acid-based testing) at screening or within 3 months prior to first dose of belantamab mafodotin. Subjects with positive testing for hepatitis B core antibody but no evidence for active infection by nucleic acid-based testing may enroll if they agree to hepatitis B prophylactic therapy and monitoring for HBV re-activation for the duration of the study.
  • Participant must not have positive hepatitis C antibody test result or positive hepatitis C RNA test result at screening or within 3 months prior to first dose of study treatment. NOTE: Participants with positive hepatitis C antibody due to prior resolved disease can be enrolled, only if a confirmatory negative hepatitis C RNA test is obtained.
  • Participant must not have evidence of active HIV infection. Participants with positive HIV serologies who are on stable active anti-retroviral therapy, have CD4 count > 200 cells/µL, and have no detectable HIV virus by nucleic acid-based testing at screening or within 3 months prior to first dose of study drug may be eligible after discussion with medical director and/or principal investigator.

Sites / Locations

  • University of PennsylvaniaRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Belantamab mafodotin

Arm Description

Patients receive Belantamab mafodotin 2.5 mg/kg by intravenous infusion on day -42 relative to autologous stem cell infusion (day 0), on day +60, and every 90 days thereafter, for up to 2 years following ASCT.

Outcomes

Primary Outcome Measures

MRD (minimal residual disease) negativity rate
Percentage of participants who have achieved minimal residual disease (MRD) negativity by next-generation sequencing (NGS) at 12 months post-autologous stem cell transplant (ASCT)

Secondary Outcome Measures

Frequency of treatment-related adverse events
Percentage of participants who develop adverse and serious adverse events, including ocular adverse events.
Dose reductions
The percentage of participants who require reduction of the dose of belantamab mafodotin will be assessed
Dose delays
The percentage of participants who require a delay in dosing of belantamab mafodotin will be assessed
MRD Negativity Rate
Percentage of participants who have achieved minimal residual disease (MRD) negativity by next-generation sequencing (NGS) at 3 and 24 months post-autologous stem cell transplant (ASCT)
Overall response rate
Percentage of participants who achieve partial response (PR) or better, as assessed by International Myeloma Working Group (IMWG) criteria.
Very good partial response (VGPR) or better rate
Percentage of participants who achieve VGPR or better, as assessed by IMWG criteria.
Complete response (CR) or better rate
Percentage of participants who achieve CR or stringent CR, as assessed by IMWG criteria.
Progression-free survival
Time from enrollment until progression of disease by IMWG criteria, or death, whichever occurs first
Overall survival
Time from enrollment until death from any cause
Stem cell yield
The number of days required to collect sufficient autologous peripheral blood stem cells to proceed to ASCT will be assessed
Stem cell collection days
: The number of days required to collect sufficient autologous peripheral blood stem cells to proceed to ASCT will be assessed
Hematopoietic reconstitution post-ASCT
The number of days until neutrophil and platelet recovery post-ASCT (defined as absolute neutrophil count >1000 cells/mcl and platelet count >50000 cells/mcl, respectively) will be assessed
Change from Baseline in Health-related quality of life (HRQoL) as assessed by Functional Assessment of Cancer Therapy - Multiple Myeloma (FACT-MM) questionnaire
The FACT-MM questionnaire is a 41 item questionnaire measuring physical, social/family, emotional, and functional well-being, as well as additional concerns

Full Information

First Posted
December 2, 2020
Last Updated
October 10, 2023
Sponsor
University of Pennsylvania
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT04680468
Brief Title
Study of Belantamab Mafodotin as Pre- and Post-autologous Stem Cell Transplant and Maintenance for Multiple Myeloma
Official Title
Phase 2 Study of Belantamab Mafodotin as Pre- and Post-autologous Stem Cell Transplant Consolidation and Maintenance for Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 25, 2021 (Actual)
Primary Completion Date
July 11, 2026 (Anticipated)
Study Completion Date
July 11, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Pennsylvania
Collaborators
GlaxoSmithKline

4. Oversight

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

5. Study Description

Brief Summary
This is a single-institution, single-arm, phase 2 study in which belantamab mafodotin (GSK2857916), an antibody-drug conjugate targeting B-cell maturation antigen (BCMA), will be administered to patients with multiple myeloma prior to and following high-dose melphalan and autologous stem cell transplantation (ASCT), in conjunction with standard lenalidomide maintenance. We hypothesize that administration of belantamab mafodotin as part of autologous stem cell transplant consolidation and maintenance will be safe, well tolerated, and efficacious in comparison to historical data.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
47 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Belantamab mafodotin
Arm Type
Experimental
Arm Description
Patients receive Belantamab mafodotin 2.5 mg/kg by intravenous infusion on day -42 relative to autologous stem cell infusion (day 0), on day +60, and every 90 days thereafter, for up to 2 years following ASCT.
Intervention Type
Drug
Intervention Name(s)
Belantamab mafodotin
Other Intervention Name(s)
GSK2857916
Intervention Description
2.5 mg/kg IV
Primary Outcome Measure Information:
Title
MRD (minimal residual disease) negativity rate
Description
Percentage of participants who have achieved minimal residual disease (MRD) negativity by next-generation sequencing (NGS) at 12 months post-autologous stem cell transplant (ASCT)
Time Frame
12 months post-ASCT
Secondary Outcome Measure Information:
Title
Frequency of treatment-related adverse events
Description
Percentage of participants who develop adverse and serious adverse events, including ocular adverse events.
Time Frame
through study completion, approximately 3 years
Title
Dose reductions
Description
The percentage of participants who require reduction of the dose of belantamab mafodotin will be assessed
Time Frame
through study completion, approximately 3 years
Title
Dose delays
Description
The percentage of participants who require a delay in dosing of belantamab mafodotin will be assessed
Time Frame
through study completion, approximately 3 years
Title
MRD Negativity Rate
Description
Percentage of participants who have achieved minimal residual disease (MRD) negativity by next-generation sequencing (NGS) at 3 and 24 months post-autologous stem cell transplant (ASCT)
Time Frame
at 3 and 24 months post-ASCT
Title
Overall response rate
Description
Percentage of participants who achieve partial response (PR) or better, as assessed by International Myeloma Working Group (IMWG) criteria.
Time Frame
through study completion, approximately 3 years
Title
Very good partial response (VGPR) or better rate
Description
Percentage of participants who achieve VGPR or better, as assessed by IMWG criteria.
Time Frame
through study completion, approximately 3 years
Title
Complete response (CR) or better rate
Description
Percentage of participants who achieve CR or stringent CR, as assessed by IMWG criteria.
Time Frame
through study completion, approximately 3 years
Title
Progression-free survival
Description
Time from enrollment until progression of disease by IMWG criteria, or death, whichever occurs first
Time Frame
through study completion, approximately 3 years
Title
Overall survival
Description
Time from enrollment until death from any cause
Time Frame
through study completion, approximately 3 years
Title
Stem cell yield
Description
The number of days required to collect sufficient autologous peripheral blood stem cells to proceed to ASCT will be assessed
Time Frame
Following stem cell mobilization, about 6 weeks after enrollment
Title
Stem cell collection days
Description
: The number of days required to collect sufficient autologous peripheral blood stem cells to proceed to ASCT will be assessed
Time Frame
Following stem cell mobilization, about 6 weeks after enrollment
Title
Hematopoietic reconstitution post-ASCT
Description
The number of days until neutrophil and platelet recovery post-ASCT (defined as absolute neutrophil count >1000 cells/mcl and platelet count >50000 cells/mcl, respectively) will be assessed
Time Frame
up to 30 days post-ASCT
Title
Change from Baseline in Health-related quality of life (HRQoL) as assessed by Functional Assessment of Cancer Therapy - Multiple Myeloma (FACT-MM) questionnaire
Description
The FACT-MM questionnaire is a 41 item questionnaire measuring physical, social/family, emotional, and functional well-being, as well as additional concerns
Time Frame
baseline through study completion, approximately 3 years.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must have started therapy for active multiple myeloma within 12 months of enrollment. Subjects must have an ECOG performance status of 0-2. Have received no more than 2 prior lines of induction therapy (induction regimen not specified by protocol), with no prior progressive disease by International Myeloma Working Group (IMWG) criteria. Must be in at least a partial response (PR) but not in a complete response (CR) or better after at least 4 cycles of induction therapy, per IMWG consensus criteria. Eligible by institutional criteria to receive melphalan at a dose of 200 mg/m2. Eligible to receive lenalidomide maintenance therapy post-ASCT. Adequate bone marrow and organ function at enrollment Exclusion Criteria: Participant must not have used an investigational drug or approved systemic anti-myeloma therapy (including systemic steroids) within 14 days or five half-lives, whichever is shorter, preceding the first dose of study drug. Participant must not have received treatment with a monoclonal antibody within 28 days of receiving the first dose of study drug Participant must not be simultaneously enrolled in any interventional clinical trial Participant must not have amyloidosis or POEMS syndrome. Participants must not be pregnant or lactating. Participant must not have current unstable liver or biliary disease defined by the presence of ascites, encephalopathy, coagulopathy, severe hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis. Note: Stable non-cirrhotic chronic liver disease (including Gilbert's syndrome or asymptomatic gallstones) or hepatobiliary involvement of malignancy is acceptable if otherwise meets entry criteria Participant must not have any evidence of active mucosal or internal bleeding History of an active renal condition (infection, requirement for dialysis or any other condition that could affect subject's safety). Subjects with isolated proteinuria resulting from MM are eligible, provided they fulfill criteria given in Section 6.1. Participant must not have evidence of cardiovascular risk Participants must not have any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions (including lab abnormalities) that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures. Participant must not have invasive malignancies other than disease under study, unless the second malignancy has been definitively treated or has been medically stable for at least 2 years and, in the opinion of the principal investigator, will not affect the evaluation of the effects of clinical trial treatment. Participants must not have an active infection requiring antibiotic treatment. Any major surgery within the last 4 weeks prior to enrollment. Participant must not have current corneal epithelial disease except mild changes in corneal epithelium Participant must not have known immediate or delayed hypersensitivity reaction or idiosyncratic reactions to belantamab mafodotin or drugs chemically related to belantamab mafodotin, or any of the components of the study treatment Participant must not have evidence for active hepatitis B infection (i.e. positive hepatitis B surface antigen or nucleic acid-based testing) at screening or within 3 months prior to first dose of belantamab mafodotin. Subjects with positive testing for hepatitis B core antibody but no evidence for active infection by nucleic acid-based testing may enroll if they agree to hepatitis B prophylactic therapy and monitoring for HBV re-activation for the duration of the study. Participant must not have positive hepatitis C antibody test result or positive hepatitis C RNA test result at screening or within 3 months prior to first dose of study treatment. NOTE: Participants with positive hepatitis C antibody due to prior resolved disease can be enrolled, only if a confirmatory negative hepatitis C RNA test is obtained. Participant must not have evidence of active HIV infection. Participants with positive HIV serologies who are on stable active anti-retroviral therapy, have CD4 count > 200 cells/µL, and have no detectable HIV virus by nucleic acid-based testing at screening or within 3 months prior to first dose of study drug may be eligible after discussion with medical director and/or principal investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sara Whittington, RN
Phone
267-271-1558
Email
Sara.whittington@pennmedicine.upenn.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Adam Cohen, MD
Phone
215-615-7362
Email
adam.cohen@pennmedicine.upenn.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adam Cohen, MD
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of Belantamab Mafodotin as Pre- and Post-autologous Stem Cell Transplant and Maintenance for Multiple Myeloma

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