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Phase I/II Study of SLAMF7 FPBMC/CS-1 FPBMC in Relapsed/Refractory Multiple Myeloma (MM FPBMC)

Primary Purpose

Multiple Myeloma

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SLAMF7 FPBMC
Sponsored by
University of Virginia
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, Fresh Peripheral Blood Mononuclear Cells (FPBMC), Bispecific antibodies

Eligibility Criteria

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

Inclusion Criteria:

  1. Must have received ≥ 2 consecutive cycles of treatment which include an immunomodulatory drug, a proteasome inhibitor, and an anti-CD38 monoclonal antibody either used individually or in combination
  2. Documented refractory or relapsed myeloma

    • Refractory is defined as progression while on treatment or within 60 days of last treatment
  3. Measurable disease based on at least one of the following lab results within 28 days of enrollment

    • Serum IgG, IgA, or IgM M-protein ≥ 1.0 g/dL
    • Urine M-protein ≥ 200 mg excreted in a 24-hr collection sample
    • Involved serum free light chain (FLC) ≥ 100 mg/L provided the FLC ratio is abnormal
  4. ECOG Performance Status 0 -2
  5. Left Ventricular Ejection Fraction (LVEF) ≥ 55% at rest (MUGA or Echocardiogram)
  6. Age ≥ 18 years at the time of consent (Written informed consent and HIPAA authorization for release of personal health information)
  7. Females of childbearing potential, and males, must be willing to use an effective method of contraception for the duration of the treatment with study drug plus 90 days (duration of sperm turnover).
  8. Eligible for apheresis
  9. Adequate cardiac function as defined as:

    • No EKG evidence of acute ischemia
    • No EKG evidence of clinically significant conduction system abnormalities in the opinion of the treating investigator
    • No EKG evidence of > Grade 2 (> 480 ms) QTc prolongation
    • No uncontrolled angina or severe ventricular arrhythmias
    • No clinically significant pericardial disease
    • No history of myocardial infarction (MI) in the last 6 months
    • No Class 3 or higher New York Heart Association Congestive Heart Failure
  10. Demonstrate adequate organ function as defined below; all screening labs should be performed within 14 days prior to enrollment.

    • Absolute lymphocyte count ≥ 400/mm3
    • Absolute neutrophil count ≥ 1,000/mm3
    • Platelets ≥ 75,000/mm3
    • Calculated Creatinine Clearance ≥ 30 ml/min
    • Serum total bilirubin ≤ 1.5 x upper limit of normal
    • AST and ALT < 2.5 times normal

Exclusion Criteria:

  1. Known hypersensitivity to elotuzumab (Elo)
  2. Amyloidosis, Waldenstrom's macroglobulinemia, POEMS syndrome, or known central nervous system (CNS) involvement
  3. Receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to enrollment.

    • NOTE: Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  4. Active autoimmune disease that has required systemic treatment in the past 2 years before enrollment (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
  5. Serious non-healing wound, ulcer, bone fracture, major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to enrollment
  6. Active liver disease (such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis)
  7. HIV positive or known active Hepatitis C (e.g., HCV RNA [qualitative] is detected) or Hepatitis B (e.g. HBsAg reactive) virus
  8. Active bleeding or a pathological condition that is associated with a high risk of bleeding (therapeutic anticoagulation is allowed)
  9. Has an active infection requiring systemic therapy
  10. History of active TB (Bacillus Tuberculosis)
  11. Has received a live vaccine within 30 days of enrollment.
  12. Anti-myeloma drug therapy (including radiation therapy) ≤ 14 days prior to apheresis
  13. History of myocardial infarction (within 6 months of enrollment), stable or unstable angina
  14. History of another malignancy within the past 3 years before enrollment. -- Exceptions include:

    • Basal cell carcinoma of the skin or squamous cell carcinoma of the skin,
    • In situ cancers that have undergone potentially curative therapy
  15. Prisoners or patients who are incarcerated
  16. Patients who are compulsorily detained for treatment of either a psychiatric or physical illness
  17. Pregnant or breastfeeding females: Females of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment.

Sites / Locations

  • Ashley DoniheeRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SLAMF7 FPBMC

Arm Description

Participants will undergo apheresis to collect cells to make SLAMF7 fresh peripheral blood mononuclear cells (FPBMC). These cells will be activated in the lab to fight against multiple myeloma. About 3-4 days after apheresis, participants will start receiving infusions of SLAMF7 FPBMC. Throughout treatment, participants will have blood taken for labs, to check disease status and also to look at immune response. Study treatment will stop if the participant has disease progression.

Outcomes

Primary Outcome Measures

Dose-limiting toxicities (DLTs)
An adverse event that is considered at least possibly related to SLAMF7 FPBMC and meets at least one of the protocol-defined criteria
Adverse event profile
Severity, frequency, category, seriousness and duration of adverse events

Secondary Outcome Measures

Overall response rate (ORR)
As defined by International Myeloma Working Group (IMWG) response criteria (partial response (PR), very good partial response (VGPR), complete response (CR), stringent CR (sCR)
Minimal Residual Disease (MRD) status
Assessed by ClonoSeq, only for patients who achieve stringent CR or CR
Overall Survival (OS)
Duration of time from consent through death or 3 years after first FPBMC infusion
Cellular anti-myeloma responses
IFN-gamma Elispots stimulated by a multiple myeloma cell line
Progression-free survival (PFS)
Duration of time from consent through first progression (or end of follow-up)
Humoral anti-myeloma responses
Anti-SOX2 IgG antibodies in the serum by specific ELISA
Lymphocyte response following infusions of SLAMF7 FPBMC
T cell count and count for T cell subpopulations

Full Information

First Posted
March 30, 2021
Last Updated
August 7, 2023
Sponsor
University of Virginia
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1. Study Identification

Unique Protocol Identification Number
NCT04864522
Brief Title
Phase I/II Study of SLAMF7 FPBMC/CS-1 FPBMC in Relapsed/Refractory Multiple Myeloma
Acronym
MM FPBMC
Official Title
Phase I/II Study of Anti-CD3 x Anti-SLAMF7 (Anti-CS-1) Bispecific Antibody Armed Fresh Peripheral Blood Mononuclear Cells (SLAMF7 FPBMC) in Relapsed/Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 2023 (Anticipated)
Primary Completion Date
May 30, 2027 (Anticipated)
Study Completion Date
May 30, 2030 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Virginia

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
The purpose of this study is to understand the safety and estimate the efficacy of combining anti-CD3 x anti-SLAMF7 bispecific antibody fresh peripheral blood mononuclear cells (SLAMF7 FPBMC/CS1 FPBMC) for patients with relapsed and/or refractory multiple myeloma. Patients receive 8 weekly doses and then 8 more doses every 2 weeks of SLAMF7 FPBMC by intravenous infusion.
Detailed Description
Once subjects are determined eligible, white blood cells (lymphocytes) are collected via leukapheresis procedure. The white blood cells, specifically T cells, are then mixed with two proteins, OKT3 and IL-2, which activate the cells to multiply. The "activated" T cells are coated with the OKT3 and elotuzumab (an anti-SLAMF7 drug) to produce bispecific fresh peripheral blood mononuclear cells (FPBMC). About 72 hours after the leukapheresis procedure, SLAMF7 FPBMC infusions will start. After about 8-9 weeks, participants will have another leukapheresis procedure and then receive doses every 2 weeks for 8 more doses. Before, throughout and following SLAMF7 FPBMC, research blood will be collected to better understand immune response. Disease status will be checked regularly during and after study treatment.

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, Fresh Peripheral Blood Mononuclear Cells (FPBMC), Bispecific antibodies

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
SLAMF7 FPBMC
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SLAMF7 FPBMC
Arm Type
Experimental
Arm Description
Participants will undergo apheresis to collect cells to make SLAMF7 fresh peripheral blood mononuclear cells (FPBMC). These cells will be activated in the lab to fight against multiple myeloma. About 3-4 days after apheresis, participants will start receiving infusions of SLAMF7 FPBMC. Throughout treatment, participants will have blood taken for labs, to check disease status and also to look at immune response. Study treatment will stop if the participant has disease progression.
Intervention Type
Drug
Intervention Name(s)
SLAMF7 FPBMC
Other Intervention Name(s)
CS-1 FPBMC
Intervention Description
Participants will receive 8 weekly infusions of SLAMF7 FPBMC, then 8 additional infusions every 2 weeks.
Primary Outcome Measure Information:
Title
Dose-limiting toxicities (DLTs)
Description
An adverse event that is considered at least possibly related to SLAMF7 FPBMC and meets at least one of the protocol-defined criteria
Time Frame
From time of informed consent through one week following 8th FPBMC infusion
Title
Adverse event profile
Description
Severity, frequency, category, seriousness and duration of adverse events
Time Frame
From time of informed consent through 30 days following last FPBMC infusion
Secondary Outcome Measure Information:
Title
Overall response rate (ORR)
Description
As defined by International Myeloma Working Group (IMWG) response criteria (partial response (PR), very good partial response (VGPR), complete response (CR), stringent CR (sCR)
Time Frame
About once a month during study treatment (for about 6 months), then about every 3 months for 3 years or until first progression
Title
Minimal Residual Disease (MRD) status
Description
Assessed by ClonoSeq, only for patients who achieve stringent CR or CR
Time Frame
Through first progression of disease (maximum of 3 years from first infusion)
Title
Overall Survival (OS)
Description
Duration of time from consent through death or 3 years after first FPBMC infusion
Time Frame
Through 3 years after first FPBMC infusion
Title
Cellular anti-myeloma responses
Description
IFN-gamma Elispots stimulated by a multiple myeloma cell line
Time Frame
Multiple timepoints through 12 months after last FPBMC infusion
Title
Progression-free survival (PFS)
Description
Duration of time from consent through first progression (or end of follow-up)
Time Frame
From informed consent through first progression or 3 years after enrollment
Title
Humoral anti-myeloma responses
Description
Anti-SOX2 IgG antibodies in the serum by specific ELISA
Time Frame
Multiple timepoints through 12 months after last FPBMC infusion
Title
Lymphocyte response following infusions of SLAMF7 FPBMC
Description
T cell count and count for T cell subpopulations
Time Frame
Blood samples collected prior to first infusion and then before the second through fifth infusions

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must have received ≥ 2 consecutive cycles of treatment which include an immunomodulatory drug, a proteasome inhibitor, and an anti-CD38 monoclonal antibody either used individually or in combination Documented refractory or relapsed myeloma Refractory is defined as progression while on treatment or within 60 days of last treatment Measurable disease based on at least one of the following lab results within 28 days of enrollment Serum IgG, IgA, or IgM M-protein ≥ 1.0 g/dL Urine M-protein ≥ 200 mg excreted in a 24-hr collection sample Involved serum free light chain (FLC) ≥ 100 mg/L provided the FLC ratio is abnormal ECOG Performance Status 0 -2 Left Ventricular Ejection Fraction (LVEF) ≥ 45% at rest (MUGA or Echocardiogram) Age ≥ 18 years at the time of consent (Written informed consent and HIPAA authorization for release of personal health information) Females of childbearing potential, and males, must be willing to use an effective method of contraception for the duration of the treatment with study drug plus 90 days (duration of sperm turnover). Adequate cardiac function as defined as: No EKG evidence of acute ischemia No EKG evidence of clinically significant conduction system abnormalities in the opinion of the treating investigator No EKG evidence of > Grade 2 (> 480 ms) QTc prolongation No uncontrolled angina or severe ventricular arrhythmias No clinically significant pericardial disease No history of myocardial infarction (MI) in the last 6 months No Class 3 or higher New York Heart Association Congestive Heart Failure Demonstrate adequate organ function as defined below; all screening labs should be performed within 14 days prior to enrollment. Absolute lymphocyte count ≥ 400/mm3 Absolute neutrophil count ≥ 1,000/mm3 Platelets ≥ 75,000/mm3 Calculated Creatinine Clearance ≥ 30 ml/min Serum total bilirubin ≤ 1.5 x upper limit of normal AST and ALT < 2.5 times normal Exclusion Criteria: Known hypersensitivity to elotuzumab (Elo) Amyloidosis, Waldenstrom's macroglobulinemia, POEMS syndrome, or known central nervous system (CNS) involvement Receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to enrollment. NOTE: Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Active autoimmune disease that has required systemic treatment in the past 2 years before enrollment (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Serious non-healing wound, ulcer, bone fracture, major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to enrollment Active liver disease (such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis) HIV positive or known active Hepatitis C (e.g., HCV RNA [qualitative] is detected) or Hepatitis B (e.g. HBsAg reactive) virus Active bleeding or a pathological condition that is associated with a high risk of bleeding (therapeutic anticoagulation is allowed) Has an active infection requiring systemic therapy History of active TB (Bacillus Tuberculosis) Has received a live vaccine within 30 days of enrollment. Anti-myeloma drug therapy (including radiation therapy) ≤ 14 days prior to apheresis History of myocardial infarction (within 6 months of enrollment), stable or unstable angina History of another malignancy within the past 3 years before enrollment. -- Exceptions include: Basal cell carcinoma of the skin or squamous cell carcinoma of the skin, In situ cancers that have undergone potentially curative therapy Prisoners or patients who are incarcerated Patients who are compulsorily detained for treatment of either a psychiatric or physical illness Pregnant or breastfeeding females: Females of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ashley Donihee
Phone
14342436377
Email
zwz6jm@uvahealth.org
First Name & Middle Initial & Last Name or Official Title & Degree
Sara Casana Granell
Phone
4349245254
Email
QNA7WG@uvahealth.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Laahn Foster, MD
Organizational Affiliation
University of Virginia
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ashley Donihee
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ashley Donihee
Phone
434-243-6377
Email
zwz6jm@uvahealth.org
First Name & Middle Initial & Last Name & Degree
Sara Casana Granell
Phone
4349245254
Email
QNA7WG@uvahealth.org
First Name & Middle Initial & Last Name & Degree
Laahn Foster, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase I/II Study of SLAMF7 FPBMC/CS-1 FPBMC in Relapsed/Refractory Multiple Myeloma

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