Safety and Efficacy of bb2121 (Ide-cel) Combinations in Multiple Myeloma (KarMMa-7)
Multiple Myeloma
About this trial
This is an interventional treatment trial for Multiple Myeloma focused on measuring Relapsed/Refractory Multiple Myeloma, BB2121, ide-cel, CC-220, JSMD194, BMS-986405, DPd, PVd, CAR T, KarMMa-7, Phase I, Phase II, DARA, POM, BTZ
Eligibility Criteria
Inclusion Criteria:
Participants must satisfy the following criteria to be enrolled in the study:
Participant has documented diagnosis of MM and measurable disease, defined as:
- M-protein (serum protein electrophoresis [sPEP] or urine protein electrophoresis [uPEP]): sPEP ≥ 0.5 g/dL or uPEP ≥ 200 mg/24 hours and/or
- Light chain MM without measurable disease in the serum or urine: Serum immunoglobulin free light chain ≥ 10 mg/dL (100 mg/L) and abnormal serum immunoglobulin kappa lambda free light chain ratio
Participant has received:
- at least 3 prior MM regimens for Arm A Cohort 1 and Arm B
- at least 1 but no greater than 3 prior MM regimens for Arm A Cohort 2 and Arm C.
- Arm A Cohort 1 and Arm B: Participant has received prior treatment with an immunomodulatory agent, a proteasome inhibitor and an anti-CD38 antibody-containing regimen for at least 2 consecutive cycles.
- Arm A Cohort 2 and Arm C: Participant has received prior treatment with an immunomodulatory agent for at least 2 consecutive cycles.
- Evidence of PD during or within 6 months (measured from the last dose of any drug within the regimen) of completing treatment with the last antimyeloma regimen before study entry.
- Participant achieved a response (minimal response [MR] or better) to at least 1 prior treatment regimen.
- Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
Exclusion Criteria:
The presence of any of the following will exclude a participant from enrollment:
- Participant has non-secretory MM or has history of or active plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) or amyloidosis.
Participant has any of the following laboratory abnormalities:
- ANC and Platelets count as reported below
- Hemoglobin < 8 g/dL (< 4.9 mmol/L) (transfusion is not permitted within 21 days of screening)
- Creatinine clearance (CrCl) as reported below
- Corrected serum calcium > 13.5 mg/dL (> 3.4 mmol/L)
- Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 ×upper limit of normal (ULN)
- Serum total bilirubin > 1.5 × ULN or > 3.0 mg/dL for participants with documented Gilbert's syndrome
- International normalized ratio (INR) or activated partial thromboplastin time (aPTT) 1.5 × ULN, or history of Grade ≥ 2 hemorrhage within 30 days, or participant requires ongoing treatment with chronic, therapeutic dosing of anticoagulants (eg, warfarin, low molecular weight heparin, Factor Xa inhibitors)
- Participant has inadequate pulmonary function defined as oxygen saturation (SaO2) < 92% on room air.
- Participant has known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1 second (FEV1) 50% of predicted normal.
- Prior exposure to CC-220 (± low-dose dexamethasone) as part of their most recent antimyeloma treatment regimen (Arm A).
- Prior exposure to, BMS-986405 (JSMD194) (Arm B).
- Prior exposure to DARA in combination with POM with or without dexamethasone (DP±d) as part of their most recent antimyeloma treatment regimen (Arm C Cohort 1).
- Prior exposure to POM in combination with BTZ with or without dexamethasone (PV± d as part of their most recent antimyeloma treatment regimen (Arm C Cohort 2).
- Previous history of an allogeneic hematopoietic stem cell transplantation, treatment with any gene therapy-based therapeutic for cancer, investigational cellular therapy for cancer or BCMA targeted therapy.
- Treatment Arm A Cohort 1 and Arm B: participant has received autologous stem cell transplantation (ASCT) within 12 weeks prior to leukapheresis.
- Treatment Arms A Cohort 2 and Arm C: participant has received autologous stem cell transplantation (ASCT) within 12 months prior to leukapheresis.
Sites / Locations
- Local Institution - 117
- Local Institution - 113
- Local Institution - 101
- Local Institution - 104
- Local Institution - 120
- Local Institution - 114
- Local Institution - 108
- Local Institution - 124
- Local Institution - 109
- New York University Langone
- Local Institution - 110
- Local Institution - 111
- Local Institution - 118
- Local Institution - 103
- Local Institution - 107
- Local Institution - 201
- Local Institution - 202
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Arm A- bb2121 in combination with CC-220 (± low-dose dexamethasone)
Arm B- bb2121 in combination with BMS-986405 (JSMD194)
bb2121 will be administered at a target dose of 450 x 10^6 CAR+T cells. The combination agent will be administered at different doses and/ or schedules, depending on dose limiting toxicity (DLT) evaluation.
bb2121 will be administered at a target dose of 450 x 10^6 CAR+T cells. The combination agent will be administered during Month 1 starting from the day of bb2121 infusion Enrollment is closed for this Arm