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A Study of Daratumumab in Patients With Relapsed or Refractory Waldenström Macroglobulinemia

Primary Purpose

Waldenström Macroglobulinemia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Daratumumab
Sponsored by
Dana-Farber Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Waldenström Macroglobulinemia focused on measuring Waldenström Macroglobulinemia

Eligibility Criteria

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

Inclusion Criteria:

  • Clinicopathological diagnosis of Waldenström Macroglobulinemia (Owen et al. 2003), and meeting criteria for treatment using consensus panel criteria from the Second International Workshop on Waldenström macroglobulinemia (Kyle et al. 2003)
  • At least one previous treatment for WM with either documented disease progression or no response (stable disease) to the most recent treatment regimen
  • Measurable disease, defined as presence of serum immunoglobulin M (IgM) with a minimum IgM level of >2 times the upper limit of normal of each institution is required
  • Participants with symptomatic hyperviscosity or serum IgM >5,000 mg/dL to undergo plasmapheresis prior to treatment initiation
  • Age ≥18 years
  • ECOG performance status ≤2 (see Appendix A)
  • Participants must have preserved organ and marrow function as defined below:

    • Absolute neutrophil count ≥ 1,000/mcL
    • Platelets ≥ 50,000/mcL
    • Hemoglobin ≥ 8 g/dL
    • Total bilirubin ≤ 1.5 mg/dL or < 2 mg/dL if attributable to hepatic infiltration by neoplastic disease
    • AST/ALT ≤ 2.5 × institutional upper limit of normal
    • EGFR ≥ 30 ml/min
  • Not on any active therapy for other malignancies with the exception of topical therapies for basal cell or squamous cell cancers of the skin.
  • Females of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or have or will have complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) while participating in the study; and 2) for at least 90 days after discontinuation from the study. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. FCBP must be referred to a qualified provider of contraceptive methods if needed. FCBP must have a negative serum pregnancy test at screening.
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Any serious medical condition, laboratory abnormality, uncontrolled intercurrent illness, or psychiatric illness/social condition that would prevent study participation.
  • Concurrent use of any other anti-cancer agents or treatments or any other investigational agents.
  • Any condition, including the presence of laboratory abnormalities, which places the participant at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Known CNS lymphoma.
  • New York Heart Association classification III or IV heart failure.
  • Known history of Human Immunodeficiency Virus (HIV), active infection with Hepatitis B Virus (HBV), and/or Hepatitis C Virus (HCV).
  • Lactating or pregnant women.
  • Grade >2 toxicity (other than alopecia) continuing from prior anti-cancer therapy.
  • History of non-compliance to medical regimens.

Sites / Locations

  • Massachusetts General Hospital
  • Dana Farber Cancer Institute
  • Mayo Clinic
  • Memorial Sloan-Kettering Cancer Center
  • University of Washington

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Daratumumab

Arm Description

Daratumumab will be administered in three phases: Induction, consolidation and maintenance During induction, participants will receive daratumumab on days 1, 8, 15 and 22 of each 28-day During consolidation, daratumumab will be administered on days 1 and 15 of each 28-day cycle During maintenance, daratumumab will be administered on day 1 of each 28-day cycle

Outcomes

Primary Outcome Measures

Overall Response Rate
Overall Response Rate= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

Secondary Outcome Measures

Progression Free Survival
Amount of time following daratumumab administration until >25% increase in serum IgM
Number of Participants With Complete Response
A complete response is defined as having resolution of WM related symptoms, normalization of serum IgM levels with complete disappearance of IgM paraprotein by immunofixation, and resolution of any adenopathy or splenomegaly.
Number of Participants With Partial Response
Partial response (PR) is defined as achieving a ≥50% reduction in serum IgM levels.
Number of Participants With Very Good Partial Response
Very Good Partial Response (VGPR): is defined as ≥90% reduction in serum IgM levels, or normalization of serum IgM levels.
Number of Participants With Minor Response
Minor Response (MR): A minor response (MR) is defined 25-49% reduction in serum IgM levels.

Full Information

First Posted
June 13, 2017
Last Updated
November 21, 2022
Sponsor
Dana-Farber Cancer Institute
Collaborators
Janssen, LP
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1. Study Identification

Unique Protocol Identification Number
NCT03187262
Brief Title
A Study of Daratumumab in Patients With Relapsed or Refractory Waldenström Macroglobulinemia
Official Title
A Phase 2 Study of Daratumumab in Patients With Relapsed or Refractory Waldenström Macroglobulinemia
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Completed
Study Start Date
November 27, 2017 (Actual)
Primary Completion Date
January 31, 2021 (Actual)
Study Completion Date
December 31, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dana-Farber Cancer Institute
Collaborators
Janssen, LP

4. Oversight

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

5. Study Description

Brief Summary
This research study is studying Daratumumab as a possible treatment for Waldenström Macroglobulinemia.
Detailed Description
This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific disease. "Investigational" means that the drug is being studied. The FDA (the U.S. Food and Drug Administration) has not approved Daratumumab for this specific disease but it has been approved for other uses. Daratumumab is a monoclonal human antibody. An antibody recognizes a specific protein and binds to it. Daratumumab binds to a protein called CD38 located on the surface of B cells like WM. Daratumumab has shown the ability to slow or stop the growth of cells that have CD38 on the cell surface when tested in laboratories. In this research study, the investigators are evaluating the efficacy of Daratumumab as a single agent in participants with WM that has come back or has shown no response to previous treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Waldenström Macroglobulinemia
Keywords
Waldenström Macroglobulinemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Daratumumab
Arm Type
Experimental
Arm Description
Daratumumab will be administered in three phases: Induction, consolidation and maintenance During induction, participants will receive daratumumab on days 1, 8, 15 and 22 of each 28-day During consolidation, daratumumab will be administered on days 1 and 15 of each 28-day cycle During maintenance, daratumumab will be administered on day 1 of each 28-day cycle
Intervention Type
Drug
Intervention Name(s)
Daratumumab
Other Intervention Name(s)
Darzalex
Intervention Description
Daratumumab is a monoclonal human antibody. Daratumumab has shown the ability to slow or stop the growth of cells that have CD38 on the cell surface when tested in laboratories
Primary Outcome Measure Information:
Title
Overall Response Rate
Description
Overall Response Rate= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression Free Survival
Description
Amount of time following daratumumab administration until >25% increase in serum IgM
Time Frame
4 years
Title
Number of Participants With Complete Response
Description
A complete response is defined as having resolution of WM related symptoms, normalization of serum IgM levels with complete disappearance of IgM paraprotein by immunofixation, and resolution of any adenopathy or splenomegaly.
Time Frame
2 years
Title
Number of Participants With Partial Response
Description
Partial response (PR) is defined as achieving a ≥50% reduction in serum IgM levels.
Time Frame
2 years
Title
Number of Participants With Very Good Partial Response
Description
Very Good Partial Response (VGPR): is defined as ≥90% reduction in serum IgM levels, or normalization of serum IgM levels.
Time Frame
2 years
Title
Number of Participants With Minor Response
Description
Minor Response (MR): A minor response (MR) is defined 25-49% reduction in serum IgM levels.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Clinicopathological diagnosis of Waldenström Macroglobulinemia (Owen et al. 2003), and meeting criteria for treatment using consensus panel criteria from the Second International Workshop on Waldenström macroglobulinemia (Kyle et al. 2003) At least one previous treatment for WM with either documented disease progression or no response (stable disease) to the most recent treatment regimen Measurable disease, defined as presence of serum immunoglobulin M (IgM) with a minimum IgM level of >2 times the upper limit of normal of each institution is required Participants with symptomatic hyperviscosity or serum IgM >5,000 mg/dL to undergo plasmapheresis prior to treatment initiation Age ≥18 years ECOG performance status ≤2 (see Appendix A) Participants must have preserved organ and marrow function as defined below: Absolute neutrophil count ≥ 1,000/mcL Platelets ≥ 50,000/mcL Hemoglobin ≥ 8 g/dL Total bilirubin ≤ 1.5 mg/dL or < 2 mg/dL if attributable to hepatic infiltration by neoplastic disease AST/ALT ≤ 2.5 × institutional upper limit of normal EGFR ≥ 30 ml/min Not on any active therapy for other malignancies with the exception of topical therapies for basal cell or squamous cell cancers of the skin. Females of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or have or will have complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) while participating in the study; and 2) for at least 90 days after discontinuation from the study. Men must agree to use a latex condom during sexual contact with a FCBP even if they have had a successful vasectomy. FCBP must be referred to a qualified provider of contraceptive methods if needed. FCBP must have a negative serum pregnancy test at screening. Able to adhere to the study visit schedule and other protocol requirements. Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Any serious medical condition, laboratory abnormality, uncontrolled intercurrent illness, or psychiatric illness/social condition that would prevent study participation. Concurrent use of any other anti-cancer agents or treatments or any other investigational agents. Any condition, including the presence of laboratory abnormalities, which places the participant at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Known CNS lymphoma. New York Heart Association classification III or IV heart failure. Known history of Human Immunodeficiency Virus (HIV), active infection with Hepatitis B Virus (HBV), and/or Hepatitis C Virus (HCV). Lactating or pregnant women. Grade >2 toxicity (other than alopecia) continuing from prior anti-cancer therapy. History of non-compliance to medical regimens.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jorge J Castillo, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02214
Country
United States
Facility Name
Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
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
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of Daratumumab in Patients With Relapsed or Refractory Waldenström Macroglobulinemia

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