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CID-103 (Anti-CD38 Antibody) in Previously Treated Relapsed or Refractory Multiple Myeloma

Primary Purpose

Multiple Myeloma

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
CID-103
Sponsored by
CASI Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring multiple myeloma, CID-103, anti-CD38 antibody

Eligibility Criteria

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

Inclusion Criteria:

  1. Able and willing to sign the ICF and comply with the protocol
  2. Male or female ≥ 18 years of age
  3. Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  4. Agrees to bone marrow aspirates
  5. Must have pathologically confirmed multiple myeloma
  6. Has relapsed or refractory myeloma
  7. At least 2 prior systemic anti-cancer therapies for relapsed or refractory multiple myeloma, including an immunomodulatory agent and a proteasome inhibitor
  8. Meets all IMWG 2014 criteria at diagnosis or at time of current relapse
  9. Measurable disease
  10. If female, must be of non-childbearing potential, or have a negative pregnancy test at screening and use highly adequate contraception throughout study until 90 days after last dose
  11. If male with partner of childbearing potential, be vasectomized or female partner must use highly adequate contraception throughout study until 180 days after last dose
  12. All previous therapy-related adverse events should have resolved, prior to Day 1, to Grade 1 or baseline value with the exception of alopecia (includes effects of radiotherapy)
  13. Adequate organ function as indicated by neutrophils, platelets, hemoglobin, eGFR, serum total and direct bilirubin, AST, ALT, INR, aPTT

Exclusion Criteria:

  1. Received small molecule or tyrosine kinase inhibitor within two weeks or five half-lives (whichever is longer) prior to the first dose of study drug; chemotherapy or biological cell-based cancer therapy within four weeks prior to the first dose of study drug; nitrosourea or radioisotope within six weeks prior to first dose of study drug, non-recovery to the CTCAE v5 Grade 1 or better from the adverse events due to cancer therapeutics administered more than four weeks earlier.
  2. Received an anti-CD38 therapy within four months from first dose of study drug
  3. Inability to perform study baseline RBC type and cross-match, phenotype, genotype (if applicable) or lack of available baseline data on RBC phenotype or genotype (if applicable)
  4. Receiving other concurrent investigational therapies or have received investigational therapies within four weeks of the first dose of study drug or five half-lives, if known, whichever is shorter
  5. Currently receiving systemic steroids unless equivalent to 10 mg/day of prednisone or less for adrenal replacement only. At least two weeks since last dose of steroid therapy intended for the treatment of myeloma and the first dose of study drug.
  6. Non-secretory myeloma unless measurable plasmacytoma
  7. Known hypersensitivity to CID-103 excipients or prior severe hypersensitivity to a monoclonal antibody
  8. Baseline interval between Q and T wave on electrocardiogram > 480 msec using Fridericia's formula (QTcF)
  9. Requires renal dialysis
  10. Sensory or motor neuropathy ≥ Grade 3
  11. Known/clinically significant amyloidosis
  12. Known active central nervous system disease or leptomeningeal plasmacytoma.
  13. Presence of any other active malignancy requiring systemic therapy other than the disease under study
  14. Active infection requiring systemic therapy
  15. Active infection with human immunodeficiency virus and CD4+ T-cell count < 350/μL
  16. Active infection with hepatitis B (surface antigen); or infection with hepatitis C in absence of sustained virologic response
  17. Therapeutic anticoagulation, meaning any thromboembolic event within the last six months prior to first dose of study drug or anticoagulation with therapeutic (non-prophylactic) intent
  18. A history or evidence of cardiovascular risk
  19. History or clinical evidence of any surgical or medical condition which the investigator judges as likely to interfere with the results of the study or pose an additional risk in participating, particularly any pre-existing condition that would put the patient at additional risk should they experience an infusion-related reaction
  20. At the time of signing informed consent is a regular user (including "recreational/medical use") of any illicit drugs or had a recent history (within the last year) of substance abuse (including alcohol)

Sites / Locations

  • CHU de Nantes - Hôpital Hôtel-Dieu
  • CHU Rennes - Pontchaillou
  • Gustave Roussy Cancer Center
  • Sarah Cannon

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Dose escalation cohort

Dose expansion cohort - pretreated

Dose expansion cohort - Naïve

Arm Description

Monotherapy CID-103. Priming dose will be given for first dose. Dose and duration of infusion dependent on dose cohort and tolerability.

CID-103 monotherapy at the recommended phase 2 dose

CID-103 monotherapy at the recommended phase 2 dose

Outcomes

Primary Outcome Measures

Adverse events
CTCAE v5 coded using the current Medical Dictionary for Regulatory Activities (MedDRA) version

Secondary Outcome Measures

Recommended Phase 2 dose
Based primarily on dose-limiting toxicities
Optimal pre- and post-medication regimens
Type, incidence, severity, timing, seriousness, and relatedness of AEs and laboratory abnormalities will be compared before and after the changes in pre/post medications are made, with specific focus on IRRs and their symptoms
Target engagement assays and ex vivo testing
Extent of RBC binding and cross-match confounding
PK - AUC of CID-103
AUC of CID-103 in serum
PK - Cmax of CID-103
Cmax of CID-103 in serum
PK - t1/2 of CID-103
half-life of CID-103 in serum
PK - Vd of CID-103
volume of distribution of CID-103 in serum
PK - accumulation of CID-103
accumulation of CID-103 in serum
Objective response rate
Based on IMWG
Duration of response
Calculated using a Kaplan-Meier method overall and for appropriate subgroups and cohorts, based on IMWG
Progression-free survival
Calculated using a Kaplan-Meier method overall and for appropriate subgroups and cohorts, based on IMWG
Overall survival
Calculated using a Kaplan-Meier method overall and for appropriate subgroups and cohorts, based on IMWG

Full Information

First Posted
February 8, 2021
Last Updated
March 1, 2023
Sponsor
CASI Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04758767
Brief Title
CID-103 (Anti-CD38 Antibody) in Previously Treated Relapsed or Refractory Multiple Myeloma
Official Title
A Phase 1 Dose Escalation and Expansion Study of CID-103, an Anti-CD38 Antibody, in Patients With Previously Treated Relapsed or Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 22, 2021 (Actual)
Primary Completion Date
September 1, 2023 (Anticipated)
Study Completion Date
September 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CASI Pharmaceuticals, Inc.

4. Oversight

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

5. Study Description

Brief Summary
Patients with relapsed/refractory multiple myeloma will be enrolled in a dose-escalation phase receiving monotherapy CID-103. Once the recommended CID-103 dose and infusion duration is known, additional patients will be enrolled in an expansion phase consisting of two cohorts (anti-CD38 pretreated, and anti-CD38 treatment naïve). Patients will be treated until disease progression or unacceptable toxicities.
Detailed Description
Dose escalation/infusion duration phase: During the CID-103 dose escalation/infusion duration phase, only patients diagnosed with multiple myeloma who have relapsed or are refractory to at least two prior lines of therapy including a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 antibody will be enrolled. Patients will receive monotherapy CID-103. Dose escalation decisions will be based on dose-limiting toxicities; infusion duration decisions will be based on infusion-related reactions. The dose taken forward into the expansion phase will be the RP2D determined in the dose escalation phase. Expansion phase: The expansion phase consists of two specific cohorts of patients with relapsed/refractory multiple myeloma: 1) Pretreated cohort having received previous treatment with an anti-CD38 antibody and 2) Naïve cohort in patients for whom an anti-CD38 antibody is unavailable. Eight patients will be enrolled into each cohort, and if one or more responses is observed, that cohort will be expanded to a total of 14 patients to further assess efficacy. Patients must have had at least two prior systemic therapies (mono or combo), including a proteasome inhibitor and an immunomodulatory agent. Patients will be treated until disease progression or unacceptable toxicities.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
multiple myeloma, CID-103, anti-CD38 antibody

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Single arm dose escalation, followed by dose expansion arm (2 cohorts)
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose escalation cohort
Arm Type
Experimental
Arm Description
Monotherapy CID-103. Priming dose will be given for first dose. Dose and duration of infusion dependent on dose cohort and tolerability.
Arm Title
Dose expansion cohort - pretreated
Arm Type
Experimental
Arm Description
CID-103 monotherapy at the recommended phase 2 dose
Arm Title
Dose expansion cohort - Naïve
Arm Type
Experimental
Arm Description
CID-103 monotherapy at the recommended phase 2 dose
Intervention Type
Drug
Intervention Name(s)
CID-103
Intervention Description
anti-CD38 antibody
Primary Outcome Measure Information:
Title
Adverse events
Description
CTCAE v5 coded using the current Medical Dictionary for Regulatory Activities (MedDRA) version
Time Frame
approximately 18 months after study start
Secondary Outcome Measure Information:
Title
Recommended Phase 2 dose
Description
Based primarily on dose-limiting toxicities
Time Frame
approximately 18 months after study start
Title
Optimal pre- and post-medication regimens
Description
Type, incidence, severity, timing, seriousness, and relatedness of AEs and laboratory abnormalities will be compared before and after the changes in pre/post medications are made, with specific focus on IRRs and their symptoms
Time Frame
approximately 18 months after study start
Title
Target engagement assays and ex vivo testing
Description
Extent of RBC binding and cross-match confounding
Time Frame
approximately 18 months after study start
Title
PK - AUC of CID-103
Description
AUC of CID-103 in serum
Time Frame
approximately 18 months and 3 years after study start
Title
PK - Cmax of CID-103
Description
Cmax of CID-103 in serum
Time Frame
approximately 18 months and 3 years after study start
Title
PK - t1/2 of CID-103
Description
half-life of CID-103 in serum
Time Frame
approximately 18 months and 3 years after study start
Title
PK - Vd of CID-103
Description
volume of distribution of CID-103 in serum
Time Frame
approximately 18 months and 3 years after study start
Title
PK - accumulation of CID-103
Description
accumulation of CID-103 in serum
Time Frame
approximately 18 months and 3 years after study start
Title
Objective response rate
Description
Based on IMWG
Time Frame
approximately 3 years after study start
Title
Duration of response
Description
Calculated using a Kaplan-Meier method overall and for appropriate subgroups and cohorts, based on IMWG
Time Frame
approximately 3 years after study start
Title
Progression-free survival
Description
Calculated using a Kaplan-Meier method overall and for appropriate subgroups and cohorts, based on IMWG
Time Frame
approximately 3 years after study start
Title
Overall survival
Description
Calculated using a Kaplan-Meier method overall and for appropriate subgroups and cohorts, based on IMWG
Time Frame
approximately 3 years after study start
Other Pre-specified Outcome Measures:
Title
Target binding of CID-103
Description
Target binding on different circulating blood cell populations and the potential PD markers
Time Frame
approximately 3 years after study start

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to sign the ICF and comply with the protocol Male or female ≥ 18 years of age Eastern Cooperative Oncology Group (ECOG) performance status 0-1 Agrees to bone marrow aspirates Must have pathologically confirmed multiple myeloma Has relapsed or refractory myeloma At least 2 prior systemic anti-cancer therapies for relapsed or refractory multiple myeloma, including an immunomodulatory agent and a proteasome inhibitor Meets all IMWG 2014 criteria at diagnosis or at time of current relapse Measurable disease If female, must be of non-childbearing potential, or have a negative pregnancy test at screening and use highly adequate contraception throughout study until 90 days after last dose If male with partner of childbearing potential, be vasectomized or female partner must use highly adequate contraception throughout study until 180 days after last dose All previous therapy-related adverse events should have resolved, prior to Day 1, to Grade 1 or baseline value with the exception of alopecia (includes effects of radiotherapy) Adequate organ function as indicated by neutrophils, platelets, hemoglobin, eGFR, serum total and direct bilirubin, AST, ALT, INR, aPTT Exclusion Criteria: Received small molecule or tyrosine kinase inhibitor within two weeks or five half-lives (whichever is longer) prior to the first dose of study drug; chemotherapy or biological cell-based cancer therapy within four weeks prior to the first dose of study drug; nitrosourea or radioisotope within six weeks prior to first dose of study drug, non-recovery to the CTCAE v5 Grade 1 or better from the adverse events due to cancer therapeutics administered more than four weeks earlier. Received an anti-CD38 therapy within four months from first dose of study drug Inability to perform study baseline RBC type and cross-match, phenotype, genotype (if applicable) or lack of available baseline data on RBC phenotype or genotype (if applicable) Receiving other concurrent investigational therapies or have received investigational therapies within four weeks of the first dose of study drug or five half-lives, if known, whichever is shorter Currently receiving systemic steroids unless equivalent to 10 mg/day of prednisone or less for adrenal replacement only. At least two weeks since last dose of steroid therapy intended for the treatment of myeloma and the first dose of study drug. Non-secretory myeloma unless measurable plasmacytoma Known hypersensitivity to CID-103 excipients or prior severe hypersensitivity to a monoclonal antibody Baseline interval between Q and T wave on electrocardiogram > 480 msec using Fridericia's formula (QTcF) Requires renal dialysis Sensory or motor neuropathy ≥ Grade 3 Known/clinically significant amyloidosis Known active central nervous system disease or leptomeningeal plasmacytoma. Presence of any other active malignancy requiring systemic therapy other than the disease under study Active infection requiring systemic therapy Active infection with human immunodeficiency virus and CD4+ T-cell count < 350/μL Active infection with hepatitis B (surface antigen); or infection with hepatitis C in absence of sustained virologic response Therapeutic anticoagulation, meaning any thromboembolic event within the last six months prior to first dose of study drug or anticoagulation with therapeutic (non-prophylactic) intent A history or evidence of cardiovascular risk History or clinical evidence of any surgical or medical condition which the investigator judges as likely to interfere with the results of the study or pose an additional risk in participating, particularly any pre-existing condition that would put the patient at additional risk should they experience an infusion-related reaction At the time of signing informed consent is a regular user (including "recreational/medical use") of any illicit drugs or had a recent history (within the last year) of substance abuse (including alcohol)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexander Zukiwski, MD
Organizational Affiliation
CASI Pharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
CHU de Nantes - Hôpital Hôtel-Dieu
City
Nantes
Country
France
Facility Name
CHU Rennes - Pontchaillou
City
Rennes
Country
France
Facility Name
Gustave Roussy Cancer Center
City
Villejuif Cedex
Country
France
Facility Name
Sarah Cannon
City
London
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

CID-103 (Anti-CD38 Antibody) in Previously Treated Relapsed or Refractory Multiple Myeloma

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