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A Study to Determine Dose and Regimen of Durvalumab as Monotherapy or in Combination With Pomalidomide With or Without Dexamethasone in Subjects With Relapsed and Refractory Multiple Myeloma

Primary Purpose

Multiple Myeloma

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Durvalumab
Pomalidomide
Dexamethasone
Sponsored by
Celgene
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Multiple Myeloma, Relapsed, Refractory, MEDI4736, Durvalumab, Pomalidomide (POM), Dexamethasone (DEX), PD-L1

Eligibility Criteria

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

Inclusion Criteria:

  • Has a confirmed diagnosis of active multiple myeloma and measurable disease.
  • Must have undergone prior treatment with ≥2 treatment lines of anti-myeloma therapy
  • Must have failed last line of treatment (refractory to last line of treatment).
  • Must have achieved at least a stable disease (SD) for at least 1 cycle of treatment to at least 1 prior anti-myeloma regimen before developing Progressive disease (PD) (relapsed)
  • Prior anti-myeloma treatments must have included a lenalidomide AND proteasome inhibitor alone or in combination.
  • Has performance status of 0, 1, or 2 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale.
  • The extramedullary plasmacytoma (EMP) sub-group, must have radiologically measurable EMP disease (soft tissue or bone related) that is amenable to biopsy and does not need to have measurable disease.

Exclusion Criteria:

  • Has non-secretory or oligosecretory multiple myeloma
  • Has had prior anti-myeloma therapy within 2 weeks prior to study Day 1
  • Has undergone prior organ or allogeneic hematopoetic stem cell transplantation
  • Has received previous therapy with pomalidomide and did not achieve at least a stable disease
  • Has received prior therapy with an anti-programmed cell death 1 receptor (anti-PD-1), antiprogrammed death-ligand 1 (anti-PD-L1), antiprogrammed death-ligand 2 (anti-PD-L2), anti-CD137, or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways).
  • Has received prior treatment with a monoclonal antibody within 5 half-lives of Study Day 1
  • Has received investigational agents within 28 days or 5 half-lives (whichever is longer) of Study Day 1
  • Has received live, attenuated vaccine within 30 days prior to Study Day 1
  • Had rash ≥ Grade 3 during prior thalidomide, lenalidomide, or pomalidomide therapy
  • Has a history of anaphylaxis or hypersensitivity to thalidomide, lenalidomide, POM, or dex
  • Has peripheral neuropathy ≥ Grade 2
  • Has a known additional malignancy that is progressing or requires active treatment (except for basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy).
  • Is positive for human immunodeficiency virus (HIV), chronic or active hepatitis B or active hepatitis A or C
  • Has a prior history of malignancies, other than MM, unless the subject has been free of the disease for ≥ 5 years (with the exception Basal cell carcinoma of the skin, Squamous cell carcinoma of the skin, Carcinoma in situ of the cervix, Carcinoma in situ of the breast, Incidental histologic finding of prostate cancer [T1a or T1b] or prostate cancer that is curative)
  • Has clinical evidence of central nervous system (CNS) or pulmonary leukostasis, disseminated intravascular coagulation, or CNS multiple myeloma
  • Has clinically significant cardiac disease
  • Is a female who is pregnant, nursing, or breastfeeding, or who intends to become pregnant during the participation in the study
  • Is a current smoker

Sites / Locations

  • Johns Hopkins Oncology Center
  • Dana-Farber Partners Cancer Care, Inc.
  • Weill Medical College Of Cornell University
  • Levine Cancer Institute
  • Cleveland Clinic
  • Froedtert Hospital BMT Medical College of Wisconsin
  • Local Institution - 201
  • Local Institution - 601
  • Local Institution - 602
  • Local Institution - 603
  • Local Institution - 301
  • Local Institution - 403
  • Local Institution - 405
  • Local Institution - 401
  • Local Institution - 702
  • Local Institution - 701
  • Local Institution - 501
  • Local Institution - 504
  • Local Institution - 502
  • Local Institution - 505

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Durvalumab monotherapy

Durvalumab + pomalidomide (POM)

Durvalumab + pomalidomide (POM) + dexamethasone (dex)

Arm Description

Intravenous (IV) durvalumab at assigned dose level (750, 1500, 2250, or 3000 mg) over 1 hour on day 1 of a 28-day cycle

IV durvalumab at assigned dose level (750, 1500, 2250, or 3000 mg) over 1 hour on day 1 of a 28-day cycle and Oral POM 4 mg/day on Days 1 to 21 of each 28-day treatment cycle

IV durvalumab at assigned dose level (750, 1500, 2250, or 3000 mg) over 1 hour on day 1 of a 28-day cycle with Oral POM 4 mg/day on Days 1 to 21 of each 28-day treatment cycle and Oral dex 40 mg/day (≤ 75 years old) or 20 mg/day (> 75 years old) on Days 1, 8, 15, and 22 of a 28-day cycle

Outcomes

Primary Outcome Measures

Dose-limiting Toxicities (DLTs)
Number of participants with DLTs in the first cycle of treatment

Secondary Outcome Measures

Adverse Events (AEs)
Number of participants with adverse events
Overall response rate (ORR)
Tumor response, including progressive disease (PD) according to the International Myeloma Working Group (IMWG) Uniform Response Criteria
Time to response (TTR)
Time from first dose to the first documentation of response (Partial Response [PR] or greater)
Duration of response (DOR)
Is defined as time from the earliest date of documented response (partial response (PR) or better) to the earliest date when disease progression was confirmed
Pharmacokinetics- Cmax
Maximum observed concentration
Pharmacokinetics- AUC
Area under the concentration-time curve
Pharmacokinetics- Tmax
Time to maximum concentration
Pharmacokinetics- t1/2
Terminal elimination half-life
Pharmacokinetics- CL/F
Apparent total body clearance
Pharmacokinetics- Vz/F
Volume of distribution

Full Information

First Posted
November 25, 2015
Last Updated
June 8, 2023
Sponsor
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT02616640
Brief Title
A Study to Determine Dose and Regimen of Durvalumab as Monotherapy or in Combination With Pomalidomide With or Without Dexamethasone in Subjects With Relapsed and Refractory Multiple Myeloma
Official Title
A Phase IB Multicenter, Open-label Study To Determine The Recommended Dose And Regimen Of Durvalumab (MEDI4736) Either As Monotherapy or In Combination With Pomalidomide (POM) With Or Without Low-Dose Dexamethasone (DEX) In Subjects With Relapsed And Refractory Multiple Myeloma (RRMM)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 11, 2016 (Actual)
Primary Completion Date
January 10, 2017 (Actual)
Study Completion Date
February 5, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Celgene

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a multicenter, open-label, Phase 1b study to determine the recommended dose and regimen of durvalumab either as monotherapy or in combination with POM with or without low dose dex in subjects with RRMM. The study will consist of a dose-finding portion as well as a parallel dose-expansion portion to determine the optimal dose and regimen. On 05 Sep 2017, a Partial Clinical Hold was placed on this study by the United States (US) Food and Drug Administration (FDA). The decision by the FDA was based on data related to risks of anti-programmed cell death-1 (PD-1) antibody, pembrolizumab, in combination with IMiDs® immunomodulatory drugs in patients with multiple myeloma. As a result, enrollment into this study has been discontinued. Subjects who are receiving clinical benefit, based on the discretion of the investigator, may remain on study treatment after being reconsented.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Multiple Myeloma, Relapsed, Refractory, MEDI4736, Durvalumab, Pomalidomide (POM), Dexamethasone (DEX), PD-L1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
114 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Durvalumab monotherapy
Arm Type
Experimental
Arm Description
Intravenous (IV) durvalumab at assigned dose level (750, 1500, 2250, or 3000 mg) over 1 hour on day 1 of a 28-day cycle
Arm Title
Durvalumab + pomalidomide (POM)
Arm Type
Experimental
Arm Description
IV durvalumab at assigned dose level (750, 1500, 2250, or 3000 mg) over 1 hour on day 1 of a 28-day cycle and Oral POM 4 mg/day on Days 1 to 21 of each 28-day treatment cycle
Arm Title
Durvalumab + pomalidomide (POM) + dexamethasone (dex)
Arm Type
Experimental
Arm Description
IV durvalumab at assigned dose level (750, 1500, 2250, or 3000 mg) over 1 hour on day 1 of a 28-day cycle with Oral POM 4 mg/day on Days 1 to 21 of each 28-day treatment cycle and Oral dex 40 mg/day (≤ 75 years old) or 20 mg/day (> 75 years old) on Days 1, 8, 15, and 22 of a 28-day cycle
Intervention Type
Drug
Intervention Name(s)
Durvalumab
Other Intervention Name(s)
MEDI4736
Intervention Type
Drug
Intervention Name(s)
Pomalidomide
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Primary Outcome Measure Information:
Title
Dose-limiting Toxicities (DLTs)
Description
Number of participants with DLTs in the first cycle of treatment
Time Frame
Approximately 1 month
Secondary Outcome Measure Information:
Title
Adverse Events (AEs)
Description
Number of participants with adverse events
Time Frame
Up to approximately 2 year
Title
Overall response rate (ORR)
Description
Tumor response, including progressive disease (PD) according to the International Myeloma Working Group (IMWG) Uniform Response Criteria
Time Frame
Up to approximately 2 year
Title
Time to response (TTR)
Description
Time from first dose to the first documentation of response (Partial Response [PR] or greater)
Time Frame
Up to approximately 2 year
Title
Duration of response (DOR)
Description
Is defined as time from the earliest date of documented response (partial response (PR) or better) to the earliest date when disease progression was confirmed
Time Frame
Up to approximately 2 year
Title
Pharmacokinetics- Cmax
Description
Maximum observed concentration
Time Frame
Up to approximately 1 year
Title
Pharmacokinetics- AUC
Description
Area under the concentration-time curve
Time Frame
Up to approximately 1 year
Title
Pharmacokinetics- Tmax
Description
Time to maximum concentration
Time Frame
Up to approximately 1 year
Title
Pharmacokinetics- t1/2
Description
Terminal elimination half-life
Time Frame
Up to approximately 1 year
Title
Pharmacokinetics- CL/F
Description
Apparent total body clearance
Time Frame
Up to approximately 1 year
Title
Pharmacokinetics- Vz/F
Description
Volume of distribution
Time Frame
Up to approximately 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has a confirmed diagnosis of active multiple myeloma and measurable disease. Must have undergone prior treatment with ≥2 treatment lines of anti-myeloma therapy Must have failed last line of treatment (refractory to last line of treatment). Must have achieved at least a stable disease (SD) for at least 1 cycle of treatment to at least 1 prior anti-myeloma regimen before developing Progressive disease (PD) (relapsed) Prior anti-myeloma treatments must have included a lenalidomide AND proteasome inhibitor alone or in combination. Has performance status of 0, 1, or 2 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale. The extramedullary plasmacytoma (EMP) sub-group, must have radiologically measurable EMP disease (soft tissue or bone related) that is amenable to biopsy and does not need to have measurable disease. Exclusion Criteria: Has non-secretory or oligosecretory multiple myeloma Has had prior anti-myeloma therapy within 2 weeks prior to study Day 1 Has undergone prior organ or allogeneic hematopoetic stem cell transplantation Has received previous therapy with pomalidomide and did not achieve at least a stable disease Has received prior therapy with an anti-programmed cell death 1 receptor (anti-PD-1), antiprogrammed death-ligand 1 (anti-PD-L1), antiprogrammed death-ligand 2 (anti-PD-L2), anti-CD137, or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways). Has received prior treatment with a monoclonal antibody within 5 half-lives of Study Day 1 Has received investigational agents within 28 days or 5 half-lives (whichever is longer) of Study Day 1 Has received live, attenuated vaccine within 30 days prior to Study Day 1 Had rash ≥ Grade 3 during prior thalidomide, lenalidomide, or pomalidomide therapy Has a history of anaphylaxis or hypersensitivity to thalidomide, lenalidomide, POM, or dex Has peripheral neuropathy ≥ Grade 2 Has a known additional malignancy that is progressing or requires active treatment (except for basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy). Is positive for human immunodeficiency virus (HIV), chronic or active hepatitis B or active hepatitis A or C Has a prior history of malignancies, other than MM, unless the subject has been free of the disease for ≥ 5 years (with the exception Basal cell carcinoma of the skin, Squamous cell carcinoma of the skin, Carcinoma in situ of the cervix, Carcinoma in situ of the breast, Incidental histologic finding of prostate cancer [T1a or T1b] or prostate cancer that is curative) Has clinical evidence of central nervous system (CNS) or pulmonary leukostasis, disseminated intravascular coagulation, or CNS multiple myeloma Has clinically significant cardiac disease Is a female who is pregnant, nursing, or breastfeeding, or who intends to become pregnant during the participation in the study Is a current smoker
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lars Sternas, MD, PhD
Organizational Affiliation
Celgene Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Johns Hopkins Oncology Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Facility Name
Dana-Farber Partners Cancer Care, Inc.
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Weill Medical College Of Cornell University
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Levine Cancer Institute
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Froedtert Hospital BMT Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226-3522
Country
United States
Facility Name
Local Institution - 201
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 4N2
Country
Canada
Facility Name
Local Institution - 601
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Local Institution - 602
City
Poitiers Cedex
ZIP/Postal Code
86021
Country
France
Facility Name
Local Institution - 603
City
Toulouse CEDEX 9
ZIP/Postal Code
31059
Country
France
Facility Name
Local Institution - 301
City
Tuebingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Local Institution - 403
City
Pavia 2
ZIP/Postal Code
27100
Country
Italy
Facility Name
Local Institution - 405
City
Rozzano (MI)
ZIP/Postal Code
20089
Country
Italy
Facility Name
Local Institution - 401
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Local Institution - 702
City
Amsterdam
ZIP/Postal Code
1081 HV
Country
Netherlands
Facility Name
Local Institution - 701
City
Rotterdam
ZIP/Postal Code
3015 CN
Country
Netherlands
Facility Name
Local Institution - 501
City
Barcelona
ZIP/Postal Code
08916
Country
Spain
Facility Name
Local Institution - 504
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Local Institution - 502
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Facility Name
Local Institution - 505
City
Valencia
ZIP/Postal Code
46026
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
34385543
Citation
Young MH, Pietz G, Whalen E, Copeland W, Thompson E, Fox BA, Newhall KJ. Immunomodulation by durvalumab and pomalidomide in patients with relapsed/refractory multiple myeloma. Sci Rep. 2021 Aug 12;11(1):16460. doi: 10.1038/s41598-021-95902-x.
Results Reference
derived
Links:
URL
https://www.bms.com/researchers-and-partners/clinical-trials-and-research.html
Description
BMS Clinical Trial Information
URL
https://www.bmsstudyconnect.com/s/US/English/USenHome
Description
BMS Clinical Trial Patient Recruiting
URL
https://www.fda.gov/Safety/MedWatch/SafetyInformation/default.htm
Description
FDA Safety Alerts and Recalls

Learn more about this trial

A Study to Determine Dose and Regimen of Durvalumab as Monotherapy or in Combination With Pomalidomide With or Without Dexamethasone in Subjects With Relapsed and Refractory Multiple Myeloma

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