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Safety and Efficacy Study of An Anti-CD38 Antibody Drug Conjugate in Relapsed or Refractory Multiple Myeloma

Primary Purpose

Relapsed or Refractory Multiple Myeloma

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
STI-6129
Sponsored by
Zhejiang ACEA Pharmaceutical Co. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed or Refractory Multiple Myeloma

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years old, regardless of gender.
  2. Previously treated with at least three drugs (including PI, IMiD, and anti-CD38 antibody), and relapsed/refractory after the most recent anti-MM therapy.
  3. Diagnosis of MM according to IMWG criteria with measurable lesions, meeting at least 1 of the following criteria:

    • Serum M protein ≥ 0.5g/dL (≥ 5 g/L); or
    • Urine M protein ≥ 200mg/24 hours; or
    • When the serum free light chain (FLC) ratio is abnormal, the affected FLC level is ≥10mg/dL (≥100 mg/L) (the normal FLC ratio is 0.26 to 1.65).
  4. ECOG performance status score is 0, 1, or 2.
  5. Willing and able to comply with the study schedule and all other study protocol requirements.
  6. Women of childbearing potential (WOCBP) (infertile women are defined as sexually mature females who had undergone a hysterectomy or bilateral oophorectomy or bilateral salpingectomy or bilateral tubal ligation/closure, or who are infertile due to a congenital or acquired condition or spontaneously menopausal for ≥ 12 months) must have a negative blood pregnancy test during the screening. Female subjects of childbearing potential and male subjects with fertility must use a highly effective method of contraception from screening to 6 months after the last treatment.

Exclusion Criteria:

  1. Known hypersensitivity to any of the ingredients of this product.
  2. Diagnosis of active plasma cell leukemia.
  3. Diagnosis of systemic light chain amyloidosis.
  4. MM involving the central nervous system.
  5. Has POEMS syndrome.
  6. There is spinal cord compression associated with MM.
  7. Needs to take concomitant drugs with a strong inhibitory effect or a strong induction effect on CYP3A4.
  8. Had received plasma exchange therapy within 28 days before the first administration of the study drug.
  9. Had received the following anti-tumor treatments before the first administration of the study drug: monoclonal antibody or cytotoxic drug or radiotherapy within 28 days; immunoregulator, targeted therapy or epigenetic therapy or investigational medical product or invasive investigational medical device or other anti-myeloma therapy within 28 days or 5 half-lives (whichever is shorter); proteasome inhibitor or anti-tumor traditional Chinese medicine treatment or corticosteroids with a cumulative dose of more than 140 mg prednisone (or equivalent) or a single dose of more than 40 mg/day dexamethasone (or equivalent) within 14 days.
  10. Had received CAR-T therapy or allogeneic hematopoietic stem cell transplantation therapy within 6 months before the first administration of the study drug, or have a concomitant disease of active graft-versus-host disease (GvHD) at screening.
  11. Had received autologous hematopoietic stem cell transplantation within 12 weeks before the first administration of the study drug.
  12. Had undergone major surgery or eye surgery within 28 days before the first administration of the study drug.
  13. Other malignant diseases within 3 years before the first administration of the study drug.
  14. History of grade ≥3 (muscle paralysis, eyelid disease, glaucoma requiring drug control, tearing eyes), or grade ≥2 any other ocular disease (as judged by NCI-CTCAE version 5.0) at screening.
  15. Has ≥ Grade 3 neuropathy or Grade 2 neuropathy with associated pain.
  16. The toxicity caused by the previous anti-tumor treatment did not subside to ≤ grade 1.
  17. Has the following hematological test results within 7 days before the first administration of the study drug:

    1. Hemoglobin <80g/L
    2. Platelet count <50×10^9/L
    3. Absolute neutrophil count <1.0×10^9/L
  18. Has the following blood chemistry test results within 7 days before the first administration of the study drug:

    1. Estimated creatinine clearance <30mL/min.
    2. AST or ALT>3×upper limit of normal (ULN) or serum total bilirubin> 1.5×ULN.
  19. Severe or uncontrolled cardiovascular and cerebrovascular diseases requiring treatment, including:

    1. New York Heart Association class>2;
    2. Unstable angina pectoris that cannot be controlled by drugs;
    3. Myocardial infarction occurred within 6 months before the first administration of the study drug;
    4. Poorly controlled arrhythmias;
    5. 12-lead ECG QTcF>470msec;
    6. Left ventricular ejection fraction <40%;
    7. Poorly controlled hypertension ;
    8. Stroke, cerebrovascular accident, or transient ischemic attack occurred within 6 months before the first administration of the study drug.
  20. Meets any of the following criteria:

    1. Known chronic obstructive pulmonary disease (COPD) and forced expiratory volume in 1 second (FEV1) <50% of predicted normal;
    2. Known moderate or severe persistent asthma, or a history of asthma within the past 2 years, or current uncontrolled asthma of any classification;
    3. with interstitial lung disease requiring corticosteroid therapy, drug-induced interstitial lung disease, a history of radiation pneumonitis, orclinically active interstitial lung disease suggested by any current evidence before the first administration of the study drug.
  21. Has an active bacterial, viral, or fungal infection or needs for intravenous antibiotic administration (IV) within 72 hours before the first administration of the study drug.
  22. Active or uncontrolled HBV , HCV , HIV positive.
  23. Is currently pregnant or breast feeding.
  24. Has any active severe mental illness, medical illness, or other symptoms/conditions that may affect treatment, compliance, or the ability to provide informed consent, as determined by the investigator.

Sites / Locations

  • Beijing Chao-Yang Hospital,Capital Medicine UniversityRecruiting
  • Peking university Third hospitalRecruiting
  • The first affiliated hospital ,Sun Yat-sen UniversityRecruiting
  • The First Affiliated Hospital Zhejiang University School of MedicineRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

STI-6129

Arm Description

Nine dosing cohorts will be evaluated: 0.25 mg/kg,0.50 mg/kg,0.67 mg/kg, 0.88 mg/kg, 1.18 mg/kg, 1.56 mg/kg, 2.08 mg/kg, 2.77 mg/kg, 3.68 mg/kg where STI-6129 will be intravenously administered once as part of a 4-week treatment cycle.

Outcomes

Primary Outcome Measures

Incidence of adverse events(AEs)
Assessing the incidence of adverse events (AEs) using the Common Terminology Criteria for Adverse Events (CTCAE Version 5).
Overall response rate(ORR)
ORR assessed by the modified IMWG response criteria.

Secondary Outcome Measures

Plasma concentration of the total anti-CD38 antibody
Determine plasma levels of the total antibody.
Plasma concentration of conjugated toxin
Determine plasma levels of conjugated toxin (STI 6129).
Plasma concentration of the free toxin
Determine plasma levels of the free toxin (duostatin 5.2).
Recommended Phase 2 dose (RP2D)
Determined according to the phase 1b.
Progression-Free Survival
PFS is the period from patient enrollment until PD or death.
Overall Survival (OS)
OS is the period from enrollment until death from any cause.
Time To First Response(TTR)
TTR is the period from the date of patient registration to the date of first response.
Duration of Response (DOR)
DOR is the period from the first documentation of response (CR or PR) to the first documentation of PD.
Clinical Benefit Rate (CBR)
CBR is the percentage of participants achieving a CR or PR at any time during the study or maintaining stable disease for at least 4 weeks from the first dose of study intervention.

Full Information

First Posted
September 27, 2022
Last Updated
August 10, 2023
Sponsor
Zhejiang ACEA Pharmaceutical Co. Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05565807
Brief Title
Safety and Efficacy Study of An Anti-CD38 Antibody Drug Conjugate in Relapsed or Refractory Multiple Myeloma
Official Title
A Phase Ib/IIa, Open-Label, Dose-Escalation and Extension Study to Evaluate the Safety and Efficacy of An Anti-CD38 Antibody Drug Conjugate (STI-6129) in Patients With Relapsed or Refractory Multiple Myeloma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 9, 2023 (Actual)
Primary Completion Date
March 7, 2025 (Anticipated)
Study Completion Date
February 19, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zhejiang ACEA Pharmaceutical Co. Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a phase Ib/IIa, open-label, dose-escalation, and extension study to evaluate the safety and efficacy of an anti-CD38 antibody drug conjugate (STI-6129) in patients with relapsed or refractory multiple myeloma.
Detailed Description
This is a phase Ib/IIa, open-label, dose-escalation, and extension study to evaluate the safety and efficacy of an anti-CD38 antibody drug conjugate (STI-6129) in patients with relapsed or refractory multiple myeloma. The study is designed to identify the recommended phase 2 dose (RP2D) of STI-6129 by assessing the safety, preliminary efficacy and pharmacokinetics using a accelerated titration design and a conventional 3+3 study design for dose escalation in stage one and then the second stage will be an expansion study to assess preliminary efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed or Refractory Multiple Myeloma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
To determine DLT and RP2D, the design uses a accelerated titration design and a 3+3 design for the dose-escalation stage.
Masking
None (Open Label)
Allocation
N/A
Enrollment
84 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
STI-6129
Arm Type
Experimental
Arm Description
Nine dosing cohorts will be evaluated: 0.25 mg/kg,0.50 mg/kg,0.67 mg/kg, 0.88 mg/kg, 1.18 mg/kg, 1.56 mg/kg, 2.08 mg/kg, 2.77 mg/kg, 3.68 mg/kg where STI-6129 will be intravenously administered once as part of a 4-week treatment cycle.
Intervention Type
Biological
Intervention Name(s)
STI-6129
Intervention Description
Anti-CD38 A2 human antibody drug conjugate (ADC) containing an antibody covalently bound to a duostatin tubulin inhibitor.
Primary Outcome Measure Information:
Title
Incidence of adverse events(AEs)
Description
Assessing the incidence of adverse events (AEs) using the Common Terminology Criteria for Adverse Events (CTCAE Version 5).
Time Frame
Up to 2 years
Title
Overall response rate(ORR)
Description
ORR assessed by the modified IMWG response criteria.
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Plasma concentration of the total anti-CD38 antibody
Description
Determine plasma levels of the total antibody.
Time Frame
Up to 2 years
Title
Plasma concentration of conjugated toxin
Description
Determine plasma levels of conjugated toxin (STI 6129).
Time Frame
Up to 2 years
Title
Plasma concentration of the free toxin
Description
Determine plasma levels of the free toxin (duostatin 5.2).
Time Frame
Up to 2 years
Title
Recommended Phase 2 dose (RP2D)
Description
Determined according to the phase 1b.
Time Frame
Up to 2 years
Title
Progression-Free Survival
Description
PFS is the period from patient enrollment until PD or death.
Time Frame
Up to 2 years
Title
Overall Survival (OS)
Description
OS is the period from enrollment until death from any cause.
Time Frame
Up to 2 years
Title
Time To First Response(TTR)
Description
TTR is the period from the date of patient registration to the date of first response.
Time Frame
Up to 2 years
Title
Duration of Response (DOR)
Description
DOR is the period from the first documentation of response (CR or PR) to the first documentation of PD.
Time Frame
Up to 2 years
Title
Clinical Benefit Rate (CBR)
Description
CBR is the percentage of participants achieving a CR or PR at any time during the study or maintaining stable disease for at least 4 weeks from the first dose of study intervention.
Time Frame
Up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years old, regardless of gender. Previously treated with at least three drugs (including PI, IMiD, and anti-CD38 antibody), and relapsed/refractory after the most recent anti-MM therapy. Diagnosis of MM according to IMWG criteria with measurable lesions, meeting at least 1 of the following criteria: Serum M protein ≥ 0.5g/dL (≥ 5 g/L); or Urine M protein ≥ 200mg/24 hours; or When the serum free light chain (FLC) ratio is abnormal, the affected FLC level is ≥10mg/dL (≥100 mg/L) (the normal FLC ratio is 0.26 to 1.65). ECOG performance status score is 0, 1, or 2. Willing and able to comply with the study schedule and all other study protocol requirements. Women of childbearing potential (WOCBP) (infertile women are defined as sexually mature females who had undergone a hysterectomy or bilateral oophorectomy or bilateral salpingectomy or bilateral tubal ligation/closure, or who are infertile due to a congenital or acquired condition or spontaneously menopausal for ≥ 12 months) must have a negative blood pregnancy test during the screening. Female subjects of childbearing potential and male subjects with fertility must use a highly effective method of contraception from screening to 6 months after the last treatment. Exclusion Criteria: Known hypersensitivity to any of the ingredients of this product. Diagnosis of active plasma cell leukemia. Diagnosis of systemic light chain amyloidosis. MM involving the central nervous system. Has POEMS syndrome. There is spinal cord compression associated with MM. Needs to take concomitant drugs with a strong inhibitory effect or a strong induction effect on CYP3A4. Had received plasma exchange therapy within 28 days before the first administration of the study drug. Had received the following anti-tumor treatments before the first administration of the study drug: monoclonal antibody or cytotoxic drug or radiotherapy within 28 days; immunoregulator, targeted therapy or epigenetic therapy or investigational medical product or invasive investigational medical device or other anti-myeloma therapy within 28 days or 5 half-lives (whichever is shorter); proteasome inhibitor or anti-tumor traditional Chinese medicine treatment or corticosteroids with a cumulative dose of more than 140 mg prednisone (or equivalent) or a single dose of more than 40 mg/day dexamethasone (or equivalent) within 14 days. Had received CAR-T therapy or allogeneic hematopoietic stem cell transplantation therapy within 6 months before the first administration of the study drug, or have a concomitant disease of active graft-versus-host disease (GvHD) at screening. Had received autologous hematopoietic stem cell transplantation within 12 weeks before the first administration of the study drug. Had undergone major surgery or eye surgery within 28 days before the first administration of the study drug. Other malignant diseases within 3 years before the first administration of the study drug. History of grade ≥3 (muscle paralysis, eyelid disease, glaucoma requiring drug control, tearing eyes), or grade ≥2 any other ocular disease (as judged by NCI-CTCAE version 5.0) at screening. Has ≥ Grade 3 neuropathy or Grade 2 neuropathy with associated pain. The toxicity caused by the previous anti-tumor treatment did not subside to ≤ grade 1. Has the following hematological test results within 7 days before the first administration of the study drug: Hemoglobin <80g/L Platelet count <50×10^9/L Absolute neutrophil count <1.0×10^9/L Has the following blood chemistry test results within 7 days before the first administration of the study drug: Estimated creatinine clearance <30mL/min. AST or ALT>3×upper limit of normal (ULN) or serum total bilirubin> 1.5×ULN. Severe or uncontrolled cardiovascular and cerebrovascular diseases requiring treatment, including: New York Heart Association class>2; Unstable angina pectoris that cannot be controlled by drugs; Myocardial infarction occurred within 6 months before the first administration of the study drug; Poorly controlled arrhythmias; 12-lead ECG QTcF>470msec; Left ventricular ejection fraction <40%; Poorly controlled hypertension ; Stroke, cerebrovascular accident, or transient ischemic attack occurred within 6 months before the first administration of the study drug. Meets any of the following criteria: Known chronic obstructive pulmonary disease (COPD) and forced expiratory volume in 1 second (FEV1) <50% of predicted normal; Known moderate or severe persistent asthma, or a history of asthma within the past 2 years, or current uncontrolled asthma of any classification; with interstitial lung disease requiring corticosteroid therapy, drug-induced interstitial lung disease, a history of radiation pneumonitis, orclinically active interstitial lung disease suggested by any current evidence before the first administration of the study drug. Has an active bacterial, viral, or fungal infection or needs for intravenous antibiotic administration (IV) within 72 hours before the first administration of the study drug. Active or uncontrolled HBV , HCV , HIV positive. Is currently pregnant or breast feeding. Has any active severe mental illness, medical illness, or other symptoms/conditions that may affect treatment, compliance, or the ability to provide informed consent, as determined by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
chao wang, master
Phone
15838131673
Email
chao.wang@aceapharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
meiping kong, bachelor
Phone
13735478976
Email
meiping.kong@aceapharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
jie jin, doctor
Organizational Affiliation
Zhejiang University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
juan li, doctor
Organizational Affiliation
First Affiliated Hospital, Sun Yat-Sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Chao-Yang Hospital,Capital Medicine University
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
wenming chen, doctor
Phone
010-85231000
Email
13910107759@163.com
Facility Name
Peking university Third hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100191
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
hongmei jing, doctor
Phone
010-82265531
Email
bysyjhm@sina.com
Facility Name
The first affiliated hospital ,Sun Yat-sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510080
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
juan LI, doctor
Phone
13719209240
Email
13719209240@163.com
Facility Name
The First Affiliated Hospital Zhejiang University School of Medicine
City
Hangzhou
State/Province
Zhejiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jie Jin
Phone
0571-87236898
Email
jiej0503@163.com
First Name & Middle Initial & Last Name & Degree
Jie Jin

12. IPD Sharing Statement

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Safety and Efficacy Study of An Anti-CD38 Antibody Drug Conjugate in Relapsed or Refractory Multiple Myeloma

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