A Study of Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Ciltacabtagene Autoleucel Versus Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Autologous Stem Cell Transplant (ASCT) in Participants With Newly Diagnosed Multiple Myeloma (CARTITUDE-6)
Multiple Myeloma
About this trial
This is an interventional treatment trial for Multiple Myeloma focused on measuring Cellular Therapy, CAR-T Therapy, BCMA CAR-T, Newly Diagnosed Multiple Myeloma
Eligibility Criteria
Inclusion Criteria:
- Participants with documented NDMM according to IMWG diagnostic criteria, for whom high-dose therapy and ASCT are part of the intended initial treatment plan.
Measurable disease, as assessed by central laboratory, at screening as defined by any of the following:
- Serum monoclonal paraprotein (M-protein) level ≥1.0 g/dL or urine M-protein level ≥200 mg/24 hours; or
- Light chain MM without measurable disease in serum or urine: serum Ig free-light chain (FLC) ≥10 mg/dL and abnormal serum Ig kappa lambda FLC ratio.
- ECOG performance status of grade 0 or 1
- Clinical laboratory values within prespecified range.
Exclusion Criteria:
- Prior treatment with CAR-T therapy directed at any target.
- Any prior BCMA target therapy.
- Any prior therapy for MM or smoldering myeloma other than a short course of corticosteroids
- Received a strong cytochrome P450 (CYP)3A4 inducer within 5 half-lives prior to randomization
- Received or plans to receive any live, attenuated vaccine (except for COVID-19 vaccines) within 4 weeks prior to randomization.
- Known active, or prior history of central nervous system (CNS) involvement or clinical signs of meningeal involvement of MM
- Stroke or seizure within 6 months of signing Informed Consent Form (ICF)
Sites / Locations
- Royal Adelaide Hospital
- Princess Alexandra Hospital
- Royal Prince Alfred Hospital
- Royal Brisbane and Womens Hospital
- Alfred Health
- Austin Hospital
- Peter MacCallum Cancer Centre
- St. Vincent's Hospital
- Fiona Stanley Hospital
- Calvary Mater Newcastle Hospital
- Westmead Hospital
- UZA
- UZ Gent
- UZ Leuven
- Tom Baker Cancer Center
- Cross Cancer Institute
- McMaster University
- Hopital Maisonneuve-Rosemont
- Mcgill University Health Centre
- Ottawa Hospital Research Institute
- (CHU) Centre Hospitalier Universitaire de Quebec Laval
- Princess Margaret Cancer Centre
- Vancouver General Hospital
- Fakultni nemocnice Brno
- Fakultni nemocnice Hradec Kralove
- Fakutni nemocnice Ostrava
- Fakultni nemocnice Plzen
- Vseobecna fakultni nemocnice v Prague
- CHRU de Lille - Hopital Claude Huriez
- Hospices Civils De Lyon
- CHU De Nantes - Hématologie Clinique
- Aphp Direction
- CHU Poitiers - Pôle régional de Cancérologie
- Hopital Saint Louis - Aphp Hôpitaux Universitaires Saint-Louis
- CHU de Toulouse
- University Hospital of Cologne
- Dresden
- Universitätsklinikum Hamburg - Eppendorf
- Nationales Centrum für Tumorerkrankungen (NCT) Abt. Medizinische Onkologie
- University Hospital of Leipzig
- Tübingen
- University Hospital of Würzburg
- Attikon University General Hospital of AtticaRecruiting
- 'G. Papanikolaou' Hospital of Thessaloniki
- Hadassah University Hospita - Ein Kerem
- Sheba Medical Center
- Tel Aviv Sourasky Medical Center
- Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi Di Ancona
- Policlinico S Orsola Malpighi
- A.O.U. Policlinico S. Martino - Ematologia
- ASST Grande Ospedale Metropolitano Niguarda
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
- Fondazione Policlinico Universitario Agostino Gemelli
- A.O.U. Citta della Salute e della Scienza di Torino - Presidio Molinette, Turin
- Juntendo University Hospital
- Kyushu University Hospital - Hematology/Oncology
- Hokkaido University Hospital-Department of Hematology
- Hyogo College of Medicine
- Kanazawa University Hospital
- Nagoya City University Hospital - Department of Hematology & Oncology
- Okayama University Hospital - Hematology/Oncology
- Osaka metropolitan university hospital
- Japanese Red Cross Medical Center - Hematology
- Keio University Hospital - Hematology
- Tohoku University Hospital - Hematology
- Chonnam National University Hwasun Hospital
- Asan Medical Center
- Samsung Medical Center, Seoul
- Seoul National University Hospital
- Seoul St. Mary's Hospital, The Catholic University of Korea
- Severance Hospital, Yonsei University Health System
- VU Medisch Centrum
- University Medical Center Groningen
- Radboud UMC
- Erasmus MC
- UMC Utrecht
- Oslo University Hospital Ullevål - Oncology
- Hospital Universitario Germans Trias i Pujol
- Hospital Clinic de Barcelona
- Instituto Catalán de Oncología
- Hospital Universitario Ramón y Cajal
- Clinica Universidad de Navarra
- HOSP. UNIV. 12 DE OCTUBRE, Madrid
- Hospital General Universitario Gregorio Marañón
- Hospital Universitario 12 de Octubre
- Ramon y Cajal, Madrid
- CLINICA UNIV. DE NAVARRA, PamplonaRecruiting
- Hospital Universitario de SalamancaRecruiting
- Hospital de Santiago de Compostela
- Hosp. Virgen Del Rocio
- Hospital Universitario Virgen del Rocío
- Hospital Universitario la Fe, Valencia
- Sahlgrenska Universitetssjukhuset
- Landstinget i Ostergotland-Universitetssjukhuset i Linkoping
- Skånes University Hospital Lund
- Akademiska Sjukhuset
- Universitaetsspital Basel - Zentrum fur Hamato-Onkologie
- Bern Inselspital
- Lausanne CHUV Département d'oncologie
- UniversitaetsSpital Zürich
- Queen Elizabeth Medical Centre
- University Hospital of Wales
- Leeds Cancer Centre at St. James's University Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Arm A: DVRd + ASCT+DVRd (Standard Therapy)
Arm B: DVRd followed by Ciltacabtagene Autoleucel
Participants will receive daratumumab, bortezomib, lenalidomide and dexamethasone (DVRd) for 4 induction cycles. Followed by ASCT and 2 cycles of DVRd consolidation, and lenalidomide maintenance therapy for 2 years Daratumumab subcutaneously (SC), 1800 mg on days 1, 8, 15 and 22 of cycle 1 and 2, on days 1 and 15 of cycle 3-6. Bortezomib SC 1.3 mg/m^2 on days 1, 4, 8, and 11 of each cycle 1-6. Lenalidomide orally, 25 mg on days 1 to 21 of each cycle 1-6. Dexamethasone orally, 40 mg once a week on days 1, 8, 15 and 22 of each cycle 1-6. Each cycle will consist 28 days. Lenalidomide maintenance orally 10 to 15 mg on days 1 to 28 (continuously) until confirmed progressive disease or unacceptable toxicity or for a maximum of 2 years
Participants will receive daratumumab, bortezomib, lenalidomide and dexamethasone (DVRd) for 6 induction cycles. Participants will receive a conditioning regimen (cyclophosphamide 300 mg/m^2 intravenous [IV] and fludarabine 30 mg/m^2 IV daily for 3 days) and Cilta-cel infusion 0.75*10^6 chimeric antigen receptor (CAR)-positive viable T cells/kilogram (kg), followed by lenalidomide post CAR-T cell therapy for 2 years Daratumumab subcutaneously (SC), 1800 mg on days 1, 8, 15 and 22 of cycle 1 and 2, on days 1 and 15 of cycle 3-6. Bortezomib SC 1.3 mg/m^2 on days 1, 4, 8, and 11 of each cycle 1-6. Lenalidomide orally, 25 mg on days 1 to 21 of each cycle 1-6. Dexamethasone orally, 40 mg once a week on days 1, 8, 15 and 22 of each cycle 1-6. Each cycle will consist of 28 days. Lenalidomide maintenance orally 10 to 15 mg on days 1 to 28 (continuously) until confirmed progressive disease or unacceptable toxicity or for a maximum of 2 years