A Study of Daratumumab-Based Therapies in Participants With Amyloid Light Chain (AL) Amyloidosis (AQUARIUS)
Amyloidosis
About this trial
This is an interventional treatment trial for Amyloidosis
Eligibility Criteria
Inclusion Criteria:
- Cohort 1: Cardiac involvement (amyloid light chain [AL] amyloidosis Mayo Cardiac Stage II and Stage IIIa) with or without other organ(s) involved; Cohort 2: One or more organs impacted by systemic AL amyloidosis according to consensus guidelines
- Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0, 1 or 2
- A female participant of childbearing potential must have a negative serum or urine test at screening and within 72 hours of the first dose of study treatment and must agree to further serum or urine pregnancy tests during the study
- A male participant must agree not to donate sperm for the purpose of reproduction during the study and for a minimum of 6 months after receiving the last dose of cyclophosphamide or 100 days after discontinuation of daratumumab, whichever is longer
- Cohort 2 only: self-identified racial and ethnic minorities, including Black or African American
Exclusion Criteria:
- Prior therapy for systemic AL amyloidosis or multiple myeloma including medications that target cluster of differentiation 38 (CD38), with the exception of 160 milligrams(mg) dexamethasone or equivalent corticosteroid maximum exposure prior to randomization/enrollment
- Previous or current diagnosis of symptomatic multiple myeloma per International Myeloma Working Group (IMWG) Criteria
Participant received any of the following therapies:
- treatment with an investigational drug or used an invasive investigational medical device within 14 days or at least 5 half-lives, whichever is less;
- vaccinated with an investigational vaccine (except for COVID-19) live, attenuated or replicating viral vector vaccines less than (<) 4 weeks prior to randomization/enrollment. Participants who are taking strong Cytochrome P450 3A4(CYP3A4) inducers must discontinue their use at least 5 half-lives prior to the first dose of bortezomib
- Stem cell transplantation -Planned stem cell transplant during the first 9 cycles of protocol therapy are excluded. Stem cell collection during the first 9 cycles of protocol therapy is permitted
- Grade 2 sensory or Grade 1 painful peripheral neuropathy
Sites / Locations
- City of HopeRecruiting
- Moffitt Cancer CenterRecruiting
- Tufts Medical CenterRecruiting
- Boston University Medical CenterRecruiting
- Barbara Ann Karmanos Cancer InstituteRecruiting
- Memorial Sloan KetteringRecruiting
- University Hospital of ClevelandRecruiting
- The Ohio State UniversityRecruiting
- West Penn HospitalRecruiting
- University of WashingtonRecruiting
- Tom Baker Cancer CenterRecruiting
- University Health Network (UHN) Princess Margaret Cancer CentreRecruiting
- Peking University First HospitalRecruiting
- Peking University People's HospitalRecruiting
- West China Hospital, Si Chuan UniversityRecruiting
- First affiliated Hospital of Zhejiang UniversityRecruiting
- Ruijin Hospital, Shanghai Jiao Tong UniversityRecruiting
- CHU de LimogesRecruiting
- Centre hospitalier Lyon-SudRecruiting
- CHU De PoitiersRecruiting
- CHU RangueilRecruiting
- Charite Campus Benjamin FranklinRecruiting
- Universitatsklinikum EssenRecruiting
- Universitaetsklinikum Heidelberg Medizinische Klinik VRecruiting
- Alexandra General Hospital of AthensRecruiting
- Università Degli Studi Di Napoli Federico IiRecruiting
- Fondazione IRCCS Policlinico San MatteoRecruiting
- DIPARTIMENTO DI BIOTECNOLOGIE CELLULARI ED EMATOLOGIA - UNIVERSITà ''LA SAPIENZA''Recruiting
- University Medical Center GroningenRecruiting
- Hospital Maastricht University Medical CenterRecruiting
- UMC UtrechtRecruiting
- Hosp. Univ. Germans Trias I PujolRecruiting
- Hosp. Univ. Vall D HebronRecruiting
- Hosp. Clinic I Provincial de BarcelonaRecruiting
- Clinica Univ. de NavarraRecruiting
- Clinica Univ. de NavarraRecruiting
- Hosp. Clinico Univ. de SalamancaRecruiting
- Leicester Royal Infirmary - HaematologyRecruiting
- University College HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Cohort1 (Arm A): Immediate Daratumumab + Cyclophosphamide, Bortezomib and Dexamethasone (VCd)
Cohort1 (Arm B): Daratumumab + Deferred VCd
Cohort 2: Daratumumab + VCd
Participants with newly diagnosed systemic amyloid light chain (AL) amyloidosis with Mayo Cardiac Stage II and IIIa cardiac involvement will receive daratumumab 1800 milligrams (mg) subcutaneously (SC) starting on Day 1 once weekly (q1w) up to Day 22 for cycles 1-2, on Days 1 and 15 for cycles 3-6, and on Day 1 for cycles 7-24 of a 28-day cycle. Participants will also receive VCd (cyclophosphamide 300 milligrams per meter square [mg/m^2] either orally or intravenously [IV], bortezomib 1.3 mg/m^2 SC, dexamethasone 40 mg weekly either orally or IV) weekly starting at Cycle 1 Day 1 up to Day 22 in every 28-day cycle for a maximum of 6 cycles (Cycle 6 Day 22).
Participants with newly diagnosed systemic AL amyloidosis with Mayo Cardiac Stage II and IIIa cardiac involvement will receive SC daratumumab 1800mg on Day 1 once weekly (q1w) up to Day 22 for cycles 1-2, on Days 1 and 15 for cycles 3-6, and on Day 1 for cycles 7-24 of a 28-day cycle. Participants will also receive VCd (Cyclophosphamide 300 mg/m^2 either orally or IV, Bortezomib 1.3 mg/m^2 SC, Dexamethasone 40 mg weekly either orally or IV) starting at Cycle 4 Day 1, weekly (Days 1, 8, 15, 22) in every 28-day cycle for a maximum of 6 cycles (Cycle 9 Day 22).
Participants with racial and ethnic minorities, including Black or African American participants, with newly diagnosed AL amyloidosis will receive SC injection of daratumumab 1800 mg SC on Day 1 once weekly (q1w) up to Day 22 for cycles 1-2, on Days 1 and 15 for cycles 3-6, and on Day 1 for cycles 7-24 of a 28-day cycle. Participants will also receive VCd (cyclophosphamide 300 milligrams per meter square [mg/m^2] either orally or intravenously [IV], bortezomib 1.3 mg/m^2 SC, dexamethasone 40 mg weekly either orally or IV) weekly starting at Cycle 1 Day 1 up to Day 22 in every 28-day cycle for a maximum of 6 cycles (Cycle 6 Day 22).