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Safety and Efficacy of bb2121 (Ide-cel) Combinations in Multiple Myeloma (KarMMa-7)

Primary Purpose

Multiple Myeloma

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
BB2121
CC-220
BMS-986405
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 Relapsed/Refractory Multiple Myeloma, BB2121, ide-cel, CC-220, JSMD194, BMS-986405, DPd, PVd, CAR T, KarMMa-7, Phase I, Phase II, DARA, POM, BTZ

Eligibility Criteria

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

Inclusion Criteria:

Participants must satisfy the following criteria to be enrolled in the study:

  • Participant has documented diagnosis of MM and measurable disease, defined as:

    1. M-protein (serum protein electrophoresis [sPEP] or urine protein electrophoresis [uPEP]): sPEP ≥ 0.5 g/dL or uPEP ≥ 200 mg/24 hours and/or
    2. Light chain MM without measurable disease in the serum or urine: Serum immunoglobulin free light chain ≥ 10 mg/dL (100 mg/L) and abnormal serum immunoglobulin kappa lambda free light chain ratio
  • Participant has received:

    1. at least 3 prior MM regimens for Arm A Cohort 1 and Arm B
    2. at least 1 but no greater than 3 prior MM regimens for Arm A Cohort 2 and Arm C.
  • Arm A Cohort 1 and Arm B: Participant has received prior treatment with an immunomodulatory agent, a proteasome inhibitor and an anti-CD38 antibody-containing regimen for at least 2 consecutive cycles.
  • Arm A Cohort 2 and Arm C: Participant has received prior treatment with an immunomodulatory agent for at least 2 consecutive cycles.
  • Evidence of PD during or within 6 months (measured from the last dose of any drug within the regimen) of completing treatment with the last antimyeloma regimen before study entry.
  • Participant achieved a response (minimal response [MR] or better) to at least 1 prior treatment regimen.
  • Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

Exclusion Criteria:

The presence of any of the following will exclude a participant from enrollment:

  • Participant has non-secretory MM or has history of or active plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) or amyloidosis.
  • Participant has any of the following laboratory abnormalities:

    1. ANC and Platelets count as reported below
    2. Hemoglobin < 8 g/dL (< 4.9 mmol/L) (transfusion is not permitted within 21 days of screening)
    3. Creatinine clearance (CrCl) as reported below
    4. Corrected serum calcium > 13.5 mg/dL (> 3.4 mmol/L)
    5. Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 ×upper limit of normal (ULN)
    6. Serum total bilirubin > 1.5 × ULN or > 3.0 mg/dL for participants with documented Gilbert's syndrome
    7. International normalized ratio (INR) or activated partial thromboplastin time (aPTT) 1.5 × ULN, or history of Grade ≥ 2 hemorrhage within 30 days, or participant requires ongoing treatment with chronic, therapeutic dosing of anticoagulants (eg, warfarin, low molecular weight heparin, Factor Xa inhibitors)
  • Participant has inadequate pulmonary function defined as oxygen saturation (SaO2) < 92% on room air.
  • Participant has known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1 second (FEV1) 50% of predicted normal.
  • Prior exposure to CC-220 (± low-dose dexamethasone) as part of their most recent antimyeloma treatment regimen (Arm A).
  • Prior exposure to, BMS-986405 (JSMD194) (Arm B).
  • Prior exposure to DARA in combination with POM with or without dexamethasone (DP±d) as part of their most recent antimyeloma treatment regimen (Arm C Cohort 1).
  • Prior exposure to POM in combination with BTZ with or without dexamethasone (PV± d as part of their most recent antimyeloma treatment regimen (Arm C Cohort 2).
  • Previous history of an allogeneic hematopoietic stem cell transplantation, treatment with any gene therapy-based therapeutic for cancer, investigational cellular therapy for cancer or BCMA targeted therapy.
  • Treatment Arm A Cohort 1 and Arm B: participant has received autologous stem cell transplantation (ASCT) within 12 weeks prior to leukapheresis.
  • Treatment Arms A Cohort 2 and Arm C: participant has received autologous stem cell transplantation (ASCT) within 12 months prior to leukapheresis.

Sites / Locations

  • Local Institution - 117
  • Local Institution - 113
  • Local Institution - 101
  • Local Institution - 104
  • Local Institution - 120
  • Local Institution - 114
  • Local Institution - 108
  • Local Institution - 124
  • Local Institution - 109
  • New York University Langone
  • Local Institution - 110
  • Local Institution - 111
  • Local Institution - 118
  • Local Institution - 103
  • Local Institution - 107
  • Local Institution - 201
  • Local Institution - 202

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm A- bb2121 in combination with CC-220 (± low-dose dexamethasone)

Arm B- bb2121 in combination with BMS-986405 (JSMD194)

Arm Description

bb2121 will be administered at a target dose of 450 x 10^6 CAR+T cells. The combination agent will be administered at different doses and/ or schedules, depending on dose limiting toxicity (DLT) evaluation.

bb2121 will be administered at a target dose of 450 x 10^6 CAR+T cells. The combination agent will be administered during Month 1 starting from the day of bb2121 infusion Enrollment is closed for this Arm

Outcomes

Primary Outcome Measures

Does Limiting Toxicity (DLT) rates _Phase 1
Percentage of participants experiencing DLTs
Complete Response Rate (CRR)_ Phase 2
Proportion of participants who achieved CR or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed by investigator's review

Secondary Outcome Measures

Incidence of Adverse Event (AEs)
An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a participant during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values, regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) should be considered an AE.
Overall Response Rate (ORR)
Proportion of participants who achieved PR or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed investigator's review
Progression-free Survival (PFS)
Time from first study treatment (whichever is given earlier) start date to the date of either first observation of progressive disease or death due to any cause
Overall Survival (OS)
Time from first study treatment (whichever is given earlier) start date to death due to any cause
Time to response (TTR)
Time from first study treatment start date to the first date of documented response (PR or better)
Duration of Response (DoR)
Time from first documentation of response (PR or better) to first documentation of PD or death due to any cause
Time to next antimyeloma treatment (TTNT)
Time from first study treatment (whichever is given earlier) start date to first day when participant receives another antimyeloma treatment
Progression-free survival after next antimyeloma therapy (PFS2)
Time from first study treatment (whichever is given earlier) start date to documentation of PD on the next-line treatment or death from any cause, whichever is first.
Feasibility of maintenance therapy in combination with bb2121
Cumulative incidence of the maintenance therapy starting from bb2121 infusion with death as the competing risk
Pharmacokinetics - Cmax_Phase 1 and 2
Maximum transgene level
Pharmacokinetics - Tmax_Phase 1 and 2
Time to maximum observed transgene level
Pharmacokinetics - AUC_Phase 1 and 2
Area under the curve of transgene level
Pharmacokinetics - AUC0-28days _Phase 1 and 2
Area under the curve of transgene level from time 0 to 28 days
Pharmacokinetics - Tlast _Phase 1 and 2
Time of last measurable transgene level

Full Information

First Posted
April 19, 2021
Last Updated
September 27, 2023
Sponsor
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT04855136
Brief Title
Safety and Efficacy of bb2121 (Ide-cel) Combinations in Multiple Myeloma
Acronym
KarMMa-7
Official Title
An Exploratory Phase 1/2 Trial to Determine Recommended Phase 2 Dose (RP2D), Safety and Preliminary Efficacy of bb2121 (Ide-cel) Combinations in Subjects With Relapsed/Refractory Multiple Myeloma (KarMMa-7)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 1, 2021 (Actual)
Primary Completion Date
December 23, 2024 (Anticipated)
Study Completion Date
December 6, 2026 (Anticipated)

3. Sponsor/Collaborators

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

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 is a global, open-label, multi-arm, multi-cohort, multi-center, phase 1/2 study to determine the safety, tolerability, efficacy, PK of bb2121 in combination with other therapies in adult subjects with R/RMM. The following combinations will be Arm A will test bb2121 in combination with CC-220 (± low-dose dexamethasone) Arm B will test bb2121 in combination with BMS-986405 (JSMD194) Combination agents being tested may be administered before, concurrently with and/or following (ie, maintenance) bb2121 infusion. The study will consist of 2 parts: dose finding (Phase 1) and dose expansion (Phase 2). Dose expansion may occur in one or more arms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Relapsed/Refractory Multiple Myeloma, BB2121, ide-cel, CC-220, JSMD194, BMS-986405, DPd, PVd, CAR T, KarMMa-7, Phase I, Phase II, DARA, POM, BTZ

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
312 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm A- bb2121 in combination with CC-220 (± low-dose dexamethasone)
Arm Type
Experimental
Arm Description
bb2121 will be administered at a target dose of 450 x 10^6 CAR+T cells. The combination agent will be administered at different doses and/ or schedules, depending on dose limiting toxicity (DLT) evaluation.
Arm Title
Arm B- bb2121 in combination with BMS-986405 (JSMD194)
Arm Type
Experimental
Arm Description
bb2121 will be administered at a target dose of 450 x 10^6 CAR+T cells. The combination agent will be administered during Month 1 starting from the day of bb2121 infusion Enrollment is closed for this Arm
Intervention Type
Biological
Intervention Name(s)
BB2121
Other Intervention Name(s)
ide-cel
Intervention Description
CAR T Cell Therapy
Intervention Type
Drug
Intervention Name(s)
CC-220
Intervention Description
Cereblon (CRBN) E3 ligase modulatory compound (CELMoD)
Intervention Type
Drug
Intervention Name(s)
BMS-986405
Other Intervention Name(s)
JSMD194
Intervention Description
gamma secretase inhibitor (GSI)
Primary Outcome Measure Information:
Title
Does Limiting Toxicity (DLT) rates _Phase 1
Description
Percentage of participants experiencing DLTs
Time Frame
Up to 28 days from start of the combination therapy
Title
Complete Response Rate (CRR)_ Phase 2
Description
Proportion of participants who achieved CR or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed by investigator's review
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Incidence of Adverse Event (AEs)
Description
An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a participant during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values, regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) should be considered an AE.
Time Frame
Up to 24 months after the last participant received any study treatment
Title
Overall Response Rate (ORR)
Description
Proportion of participants who achieved PR or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed investigator's review
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Progression-free Survival (PFS)
Description
Time from first study treatment (whichever is given earlier) start date to the date of either first observation of progressive disease or death due to any cause
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Overall Survival (OS)
Description
Time from first study treatment (whichever is given earlier) start date to death due to any cause
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Time to response (TTR)
Description
Time from first study treatment start date to the first date of documented response (PR or better)
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Duration of Response (DoR)
Description
Time from first documentation of response (PR or better) to first documentation of PD or death due to any cause
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Time to next antimyeloma treatment (TTNT)
Description
Time from first study treatment (whichever is given earlier) start date to first day when participant receives another antimyeloma treatment
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Progression-free survival after next antimyeloma therapy (PFS2)
Description
Time from first study treatment (whichever is given earlier) start date to documentation of PD on the next-line treatment or death from any cause, whichever is first.
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Feasibility of maintenance therapy in combination with bb2121
Description
Cumulative incidence of the maintenance therapy starting from bb2121 infusion with death as the competing risk
Time Frame
Up to 4 months after bb2121 infusion in the respective cohort
Title
Pharmacokinetics - Cmax_Phase 1 and 2
Description
Maximum transgene level
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Pharmacokinetics - Tmax_Phase 1 and 2
Description
Time to maximum observed transgene level
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Pharmacokinetics - AUC_Phase 1 and 2
Description
Area under the curve of transgene level
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Pharmacokinetics - AUC0-28days _Phase 1 and 2
Description
Area under the curve of transgene level from time 0 to 28 days
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort
Title
Pharmacokinetics - Tlast _Phase 1 and 2
Description
Time of last measurable transgene level
Time Frame
Up to 24 months after the last participant received any study treatment in the respective cohort

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must satisfy the following criteria to be enrolled in the study: Participant has documented diagnosis of MM and measurable disease, defined as: M-protein (serum protein electrophoresis [sPEP ≥ 0.5 g/dL] or urine protein electrophoresis [uPEP]): uPEP ≥ 200 mg/24 hours and/or Light chain MM without measurable disease in the serum or urine: Serum immunoglobulin free light chain ≥ 10 mg/dL (100 mg/L) and abnormal serum immunoglobulin kappa lambda free light chain ratio Participant has received: at least 3 prior MM regimens for Arm A Cohort 1 and Arm B at least 1 but no greater than 3 prior MM regimens for Arm A Cohort 2 Arm A Cohort 1 and Arm B: Participant has received prior treatment with an immunomodulatory agent, a proteasome inhibitor and an anti-CD38 antibody-containing regimen for at least 2 consecutive cycles. Arm A Cohort 2: Participant has received prior treatment with an immunomodulatory agent for at least 2 consecutive cycles. Evidence of PD during or within 6 months (measured from the last dose of any drug within the regimen) of completing treatment with the last antimyeloma regimen before study entry. Participant achieved a response (minimal response [MR] or better) to at least 1 prior treatment regimen. Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Exclusion Criteria: The presence of any of the following will exclude a participant from enrollment: Participant has non-secretory MM or has history of or active plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) or amyloidosis. Participant has any of the following laboratory abnormalities: ANC and Platelets count as reported below Hemoglobin < 8 g/dL (< 4.9 mmol/L) (transfusion is not permitted within 21 days of screening) Creatinine clearance (CrCl) as reported below Corrected serum calcium > 13.5 mg/dL (> 3.4 mmol/L) Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 ×upper limit of normal (ULN) Serum total bilirubin > 1.5 × ULN or > 3.0 mg/dL for participants with documented Gilbert's syndrome International normalized ratio (INR) or activated partial thromboplastin time (aPTT) 1.5 × ULN, or history of Grade ≥ 2 hemorrhage within 30 days, or participant requires ongoing treatment with chronic, therapeutic dosing of anticoagulants (eg, warfarin, low molecular weight heparin, Factor Xa inhibitors) Participant has inadequate pulmonary function defined as oxygen saturation (SaO2) < 92% on room air. Participant has known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1 second (FEV1) 50% of predicted normal. Prior exposure to CC-220 (± low-dose dexamethasone) as part of their most recent antimyeloma treatment regimen (Arm A). Prior exposure to BMS-986405 (JSMD194) (Arm B). Previous history of an allogeneic hematopoietic stem cell transplantation, treatment with any gene therapy-based therapeutic for cancer, investigational cellular therapy for cancer or BCMA targeted therapy. Treatment Arm A Cohort 1 and Arm B: participant has received autologous stem cell transplantation (ASCT) within 12 weeks prior to leukapheresis. Treatment Arm A Cohort 2: participant has received autologous stem cell transplantation (ASCT) within 12 months prior to leukapheresis.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bristol-Myers Squibb
Organizational Affiliation
Bristol-Myers Squibb
Official's Role
Study Director
Facility Information:
Facility Name
Local Institution - 117
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
10016
Country
United States
Facility Name
Local Institution - 113
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Local Institution - 101
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224-1865
Country
United States
Facility Name
Local Institution - 104
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Local Institution - 120
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Local Institution - 114
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Local Institution - 108
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02117
Country
United States
Facility Name
Local Institution - 124
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Local Institution - 109
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
New York University Langone
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Local Institution - 110
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Local Institution - 111
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Local Institution - 118
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Local Institution - 103
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Local Institution - 107
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Local Institution - 201
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Facility Name
Local Institution - 202
City
Salamanca
ZIP/Postal Code
37007
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
BMS will provide access to individual anonymized participant data upon request from qualified researchers, and subject to certain criteria. Additional information regarding Bristol Myer Squibb's data sharing policy and process can be found at: https://www.bms.com/researchers-and-partners/clinical-trials-and-research/disclosurecommitment.html
IPD Sharing Time Frame
See Plan Description
IPD Sharing Access Criteria
See Plan Description
IPD Sharing URL
https://www.bms.com/researchers-and-partners/clinical-trials-and-research/disclosure-commitment.html
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

Safety and Efficacy of bb2121 (Ide-cel) Combinations in Multiple Myeloma

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