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Plasma Cell MyelomaPhase 1/2NCT03194867

Isatuximab in Combination With Cemiplimab in Relapsed/Refractory Multiple Myeloma (RRMM) Patients

A Phase 1/2 study testing Isatuximab SAR650984 and Cemiplimab REGN2810 in people with Plasma Cell Myeloma, run by Sanofi at 30 sites in 10 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Primary Objectives: To evaluate the safety and tolerability of the combination of isatuximab (also known as SAR650984) and cemiplimab (also known as REGN2810) in patients with relapse/refractory multiple myeloma. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Plasma Cell Myeloma
What is being tested?
Isatuximab SAR650984 and Cemiplimab REGN2810
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
109 participants
Where
30 sitesin 10 countries
Study dates
21 Feb 2018to 5 Apr 2023
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients must have a known diagnosis of multiple myeloma with evidence of measurable disease, as defined below:
  • Serum M-protein ≥1 g/dL (≥0.5 g/dL in case of immunoglobulin A [IgA] disease), AND/OR
  • Urine M-protein ≥200 mg/24 hours, OR
  • In the absence of measurable M-protein, serum immunoglobulin free light chain ≥10 mg/dL, and abnormal serum immunoglobulin kappa lambda free light chain ratio (<0.26 or >1.65).
  • Patients must have received prior treatment with an immunomodulatory drug (IMiD) (for ≥2 cycles or ≥2 months of treatment) and a proteasome inhibitor (PI) (for ≥2 cycles or ≥2 months of treatment).
  • Patients must have received at least 3 prior lines of therapy (Note: Induction therapy and stem cell transplant ± maintenance will be considered as one line).
  • Patient must have achieved MR or better with any anti-myeloma therapy (ie, primary refractory disease is not eligible).

Who cannot join

  • Prior exposure to isatuximab or participated clinical studies with isatuximab.
  • Prior exposure to any agent (approved or investigational) that blocks the programmed cell death-1 (PD-1)/PD-L1 pathway.
  • Evidence of other immune related disease/conditions.
  • History of non-infectious pneumonitis requiring steroids or current pneumonitis; history of the thoracic radiation.
  • Has received a live-virus vaccination within 30 days of planned treatment start. Seasonal flu vaccines that do not contain live virus are permitted.
  • Has allogenic haemopoietic stem cell (HSC) transplant.
Show all 11Show fewer
  • Prior treatment with idelalisib (a PI3K inhibitor).
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) >2.
  • Poor bone marrow reserve.
  • Poor organ function.
  • The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Trial locations and contacts

30 sites in 10 countries.

30 sites in 10 countries

Spain5 sites
  • Investigational Site Number :7240004

    Badalona, Catalunya [Cataluña], 08916

  • Investigational Site Number :7240003

    Barcelona, Barcelona [Barcelona], 08035

  • Investigational Site Number :7240002

    Barcelona, Catalunya [Cataluña], 08036

  • Investigational Site Number :7240006

    Madrid, 28041

  • Investigational Site Number :7240005

    Valencia, Valenciana, Comunidad, 46017

Other trials in Spain

United States4 sites
  • University of Colorado-Site Number:8400001

    Denver, Colorado, 80262

  • University of Kansas Medical Center-Site Number:8400003

    Kansas City, Kansas, 66160-7321

  • Memorial Sloan-Kettering Cancer Center-Site Number:8400002

    New York, New York, 10021

  • Fox Chase Cancer Center-Site Number:8400004

    Philadelphia, Pennsylvania, 19111

Other trials in United States

France4 sites
  • Investigational Site Number :2500004

    Lille, 59037

  • Investigational Site Number :2500002

    Nantes, 44093

  • Investigational Site Number :2500003

    Pierre-Bénite, 69495

  • Investigational Site Number :2500001

    Villejuif, 94800

Other trials in France

Australia3 sites
  • Investigational Site Number :0360002

    Richmond, Victoria, 3121

  • Investigational Site Number :0360001

    West Perth, Western Australia, 6005

  • Investigational Site Number :0360003

    Wollongong, New South Wales, 2500

Other trials in Australia

Brazil3 sites
  • Investigational Site Number :0760003

    Goiânia, Goiás, 74605-020

  • Investigational Site Number :0760001

    Porto Alegre, Rio Grande do Sul, 90110-270

  • Investigational Site Number :0760004

    São Paulo, São Paulo, 01236030

Other trials in Brazil

Canada3 sites
  • Investigational Site Number :1240001

    Montreal, Quebec, H1T 2M4

  • Investigational Site Number :1240005

    Montreal, Quebec, H4J 1C5

  • Investigational Site Number :1240003

    Sherbrooke, Quebec, J1H 5N4

Other trials in Canada

Czechia3 sites
  • Investigational Site Number :2030002

    Brno, 62500

  • Investigational Site Number :2030003

    Ostrava - Poruba, 70852

  • Investigational Site Number :2030001

    Prague, 12808

Other trials in Czechia

Italy3 sites
  • Investigational Site Number :3800003

    Brescia, 25123

  • Investigational Site Number :3800005

    Rozzano, Milano, 20089

  • Investigational Site Number :3800001

    Torino, 10126

Other trials in Italy

Greece1 site
  • Investigational Site Number :3000001

    Athens, 11528

Other trials in Greece

Hungary1 site
  • Investigational Site Number :3480002

    Budapest, 1083

Other trials in Hungary

About this study

Official title: A Phase 1/2 Study to Evaluate Safety, Pharmacokinetics and Efficacy of Isatuximab in Combination With Cemiplimab in Patients With Relapsed/Refractory Multiple Myeloma

Primary Objectives:

  • To evaluate the safety and tolerability of the combination of isatuximab (also known as SAR650984) and cemiplimab (also known as REGN2810) in patients with relapse/refractory multiple myeloma.
  • To compare the overall response of the combination of isatuximab and cemiplimab versus isatuximab alone in patients with RRMM based on International Myeloma Working Group (IMWG) criteria.
Read more

Secondary Objectives:

  • To evaluate the efficacy as assessed by clinical benefit rate (CBR), duration of response (DOR), time to response (TTR), progression free survival (PFS), and overall survival (OS).
  • To assess the pharmacokinetics (PK) of isatuximab and cemiplimab when given in combination.
  • To assess the immunogenicity of isatuximab and cemiplimab when given in combination.
Read the detailed description

The duration of the study for a patient will include a period for screening of up to 21 days and 3-month post treatment follow up. The cycle duration is 28 days. Patients will continue treatment until disease progression, unacceptable adverse events, consent withdrawal, or any other reason.

Being tested
Isatuximab SAR650984, Cemiplimab REGN2810
Keywords
Anti-CD38 monoclonal antibody
Medical subject headings
Multiple Myeloma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Isatuximab SAR650984Drug

    Also called Sarclisa

    Pharmaceutical form: solution for infusion

    Route of administration: intravenous

  • Cemiplimab REGN2810Drug

    Pharmaceutical form: solution for infusion

    Route of administration: intravenous

Study groups in NCT03194867
Study groupRoleWhat they receive
Isatuximab/cemiplimab (Regimen 1)ExperimentalIsatuximab on Days 1, 8, 15, and 22, then Days 1 and 15 in 28-day cycles up to disease progression. Cemiplimab on Days 1 and 15 in 28-day cycle up to disease progression.
Receives: Drug: Isatuximab SAR650984; Drug: Cemiplimab REGN2810
Isatuximab/cemiplimab (Regimen 2)ExperimentalIsatuximab on Days 1, 8, 15, and 22, then Days 1 and 15 in 28-day cycles up to disease progression. Cemiplimab on Day 1 in 28-day cycle up to disease progression.
Receives: Drug: Isatuximab SAR650984; Drug: Cemiplimab REGN2810
IsatuximabActive comparatorIsatuximab on Days 1, 8, 15 and 22, then Day 1 and 15 in 28-day cycles up to disease progression.
Receives: Drug: Isatuximab SAR650984

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase 1: Number of Participants With Dose-Limiting Toxicities (DLTs)

    Potential DLTs were defined as the occurrence of any of the following adverse reactions at first treatment cycle, unless due to disease progression or obviously unrelated cause: Hematological DLTs: Grade(G) 4 neutropenia (N) for more than 7 consecutive days, G3 to G4 N complicated by fever (temperature greater than or equal to [>=] 38.5 degree Celsius on more than 1 occasion) or microbiologically/radiographically documented infection, G3 to G4 thrombocytopenia associated with clinically significant bleeding requiring clinical intervention or Non-hematological DLTs: G4 non-hematologic AE, G>=2 uveitis, G3 non-hematological AE lasting greater than (>)3 days despite optimal care support, delay in initiation of Cycle 2 >14 days due to treatment related laboratory abnormalities/AE. Any other AE that the investigator/study committee deemed to be dose-limiting, regardless of grade, was also considered as DLT.

    Measured: Cycle 1 Day 1 to Day 28

  2. Phase 1 and Phase 2: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Treatment-Emergent Serious Adverse Events (TESAEs)

    An AE was defined as any untoward medical occurrence in a participant or clinical investigation participant administered with a pharmaceutical product and which did not necessarily have a causal relationship with study treatment. SAEs were any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as an AE which occurred after the first dose of study treatment administration up to 30 days after the last dose of study treatment administration. The DLT observation period was 1 cycle (28 days). However, all AEs during treatment, unless due to disease progression or an obviously unrelated cause, were taken into consideration by the Study Committee for the determination of the maximum tolerated dose and recommended Phase 2 dose.

    Measured: TEAEs were collected from the first dose up to 30 days after the last dose of study treatment, approximately 50 months

  3. Phase 2: Percentage of Participants With Overall Response Rate (ORR)

    ORR by Investigator using international myeloma working group (IMWG) response criteria:percentage of participants with complete response (CR) (including stringent CR [sCR]very good partial response [VGPR] and partial response [PR]).CR:negative immunofixation on serum and urine,disappearance of any soft tissue plasmacytomas,less than (<)5% plasma cells in bone marrow (BM) aspirates and normal free light chain(FLC)ratio (0.26-1.65).sCR:CR plus no clonal cells in BM biopsy.VGPR:serum and urine M-protein detectable by immunofixation,not electrophoresis;>=90% reduction in serum M-protein plus urine M-protein level<100mg/24hour(h);FLC only:>=90% decrease in difference between involved and uninvolved FLC levels.PR:>=50% reduction of serum M-protein and reduction in 24h urine M-protein by >=90% or <200mg/24h.In addition to above, if present at baseline,>=50% reduction in size (sum of products of maximal perpendicular diameters of measured lesions [SPD]) of soft tissue plasmacytomas required.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

Secondary outcomes (15)
  1. Phase 2: Percentage of Participants With Clinical Benefit Rate (CBR)

    CBR by Investigator using IMWG response criteria: percentage of participants with CR (including sCR), VGPR, PR (all defined in previous OM) or MR. MR was defined as >= 25% but <= 49% reduction in serum M-protein and reduction in 24h urine M-protein by 50-89%, which still exceeded 200 mg/24h; if present at baseline, >=50% reduction in size (SPD) of soft tissue plasmacytomas was also required.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

  2. Phase 2: Duration of Follow-up

    Duration of follow-up was defined as the date of randomization to the date of last contact or death, whichever came first. Median duration of follow-up is reported.

    Measured: From the date of randomization up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

  3. Phase 2: Duration of Response (DOR)

    DOR: Time from date of first response (>=PR) that was subsequently confirmed to date of first documented progressive disease (PD) or death.DOR was determined only for participants who achieved a response of PR or better.If progression or death not observed, participant was censored at date of last valid disease assessment not showing disease progression performed prior to initiating further anticancer treatment and analysis cut-off date.PD(IMWG criteria):increase of >=25% from lowest confirmed value in any 1 of following:serum M-protein (absolute increase>=0.5 gram/deciliter[g/dL]), serum M-protein increase>=1g/dL if lowest M component >=5g/dL; urine M-component (absolute increase >=200mg/24h),appearance of new lesion(s),>=50% increase from nadir in SPD of >1 lesion or >=50% increase in longest diameter of a previous lesion >1cm in short axis,>=50% increase in circulating plasma cells (minimum 200 cells/microliter[c/mcL]) if that was the only measure of disease. PR: as defined in OM3.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

  4. Phase 2: Time to Response (TTR)

    TTR was defined as the time from randomization to first response (PR or better) that was subsequently confirmed. PR as per IMWG criteria was defined as >=50% reduction of serum M-protein and reduction in 24 hours urinary M-protein by >=90% or to <200 mg/24 hours. In addition to the above listed criteria, if present at baseline, a >=50% reduction in the size SPD of soft tissue plasmacytomas was also required.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

  5. Phase 2: Progression Free Survival (PFS)

    PFS: Time interval from the randomization date to the date of the first documented disease progression that is subsequently confirmed or the date of death due to any cause, whichever came first. If progression or death was not observed, participant was censored at date of last valid disease assessment not showing disease progression performed prior to initiation of a further anticancer treatment or the analysis cut-off date. Analysis was performed by Kaplan-Meier method. PD (IMWG) criteria: increase of >=25% from lowest confirmed value in any 1 of following: serum M-protein (absolute increase >=0.5g/dL), serum M-protein increase >=1g/dL if lowest M component was >=5g/dL; urine M-component (absolute increase >=200mg/24h), appearance of new lesion(s),>=50% increase from nadir in SPD of >1 lesion or >=50% increase in the longest diameter of a previous lesion >1 cm in short axis or >=50% increase in circulating plasma cells (minimum of 200 c/mcL) if that was the only measure of disease.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

  6. Phase 2: Overall Survival (OS)

    OS was defined as the time interval from the date of randomization to death from any cause. Participants without death prior to the analysis cut-off date were censored at the last date the participant was known to be alive or the cut-off date, whichever came first. The results provided below corresponds to descriptive OS information at the time of primary analysis completion date of 09 October 2019.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 17 months

  7. Phase 1 and 2: Plasma Concentration Observed at the End of IV Infusion (Ceoi) of Isatuximab Alone and in Combination With Cemiplimab

    Plasma samples were collected at specified timepoints and those non-impacted by the bioanalytical issue were used for evaluation of Ceoi. It was calculated using non-compartmental analysis (NCA) after the first administration in Cycle 1. The PK population was defined independently for isatuximab and cemiplimab and consisted of all participants from the all-treated (AT) population with at least 1 available concentration post-baseline (whatever the cycle and even if dosing was incomplete) with adequate documentation of dosing and sampling dates and times.

    Measured: At end of infusion (EOI) on Cycle 1 Day 1

  8. Phase 1 and 2: Maximum Observed Concentration (Cmax) of Isatuximab Alone and in Combination With Cemiplimab

    Plasma samples were collected at specified timepoints and those non-impacted by the bioanalytical issue were used for evaluation of Cmax. It was calculated using NCA after the first administration in Cycle 1.

    Measured: At start of infusion (SOI), EOI, EOI+4 hours, 72 hours and 168 hours on Day 1 of Cycle 1

  9. Phase 1 and 2: Time to Reach Cmax (Tmax) of Isatuximab Alone and in Combination With Cemiplimab

    Plasma samples were collected at specified timepoints and those non-impacted by the bioanalytical issue were used for evaluation of tmax. It was calculated using NCA after the first administration in Cycle 1.

    Measured: At SOI, EOI, EOI+4 hours, 72 hours and 168 hours on Day 1 of Cycle 1

  10. Phase 1 and 2: Last Concentration Observed Above the Lower Limit of Quantitation (Clast) of Isatuximab Alone and in Combination With Cemiplimab

    Plasma samples were collected at specified timepoints and those non-impacted by the bioanalytical issue were used for evaluation of Clast. It was calculated using NCA after the first administration in Cycle 1.

    Measured: At SOI, EOI, EOI+4 hours, 72 hours and 168 hours on Day 1 of Cycle 1

  11. Phase 1 and 2: Time of Clast (Tlast) of Isatuximab Alone and in Combination With Cemiplimab

    Plasma samples were collected at specified timepoints and those non-impacted by the bioanalytical issue were used for evaluation of tlast. It was calculated using NCA after the first administration in Cycle 1.

    Measured: At SOI, EOI, EOI+4 hours, 72 hours and 168 hours on Day 1 of Cycle 1

  12. Phase 1 and 2: Area Under the Concentration Versus Time Curve (AUC) From Time Zero to Tlast (AUClast) of Isatuximab Alone and in Combination With Cemiplimab

    AUClast was defined as the area under the plasma concentration versus time curve from time 0 to real time tlast calculated using the trapezoidal method over the dosing interval after the first administration in Cycle 1.

    Measured: At SOI, EOI, EOI+4 hours, 72 hours and 168 hours on Day 1 of Cycle 1

  13. Phase 1 and 2: AUC From Time 0 to Week 1 (AUC1week) of Isatuximab Alone and in Combination With Cemiplimab

    AUC1week was defined as the area under the plasma concentration versus time curve from time 0 to 1 week post dose calculated using the trapezoidal method over the dosing interval after the first administration in Cycle 1.

    Measured: At SOI, EOI, EOI+4 hours, 72 hours and 168 hours on Day 1 of Cycle 1

  14. Phase 1 and 2: Number of Participants With Anti-Drug Antibodies (ADA) to Isatuximab

    ADA responses were categorized as treatment-induced ADA and treatment boosted ADA. Pre-existing ADA was defined as ADA that were present in samples drawn during the pre-treatment period. Treatment-induced ADA was defined as ADA that developed at any time during the ADA on-study observation period in participants without pre-existing ADA. Treatment boosted ADA was defined as pre-existing ADAs with a significant increase in the ADA titer during the study compared to the Baseline titer. The ADA evaluable population was defined independently for isatuximab and cemiplimab and consisted of all participants from AT population with at least 1 ADA result (negative, positive, or inconclusive) post-baseline.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 20 months

  15. Phase 1 and 2: Number of Participants With ADA to Cemiplimab

    ADA responses were categorized as treatment-induced ADA and treatment boosted ADA. Pre-existing ADA was defined as ADA that were present in samples drawn during the pre-treatment period. Treatment-induced ADA was defined as ADA that developed at any time during the ADA on-study observation period in participants without pre-existing ADA. Treatment boosted ADA was defined as pre-existing ADAs with a significant increase in the ADA titer during the study compared to the Baseline titer.

    Measured: From Cycle 1 Day 1 up to primary analysis completion date of 9 Oct 2019 i.e., up to approximately 20 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jun 2017
  2. Study start21 Feb 2018
  3. Primary completion5 Apr 2023
  4. Study completion5 Apr 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
109 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03194867
Sponsor's protocol ID
TCD14906
Other IDs
2017-001431-39, U1111-1189-4706, 2017
Status last verified
May 2024
First submitted
19 Jun 2017
Last updated
14 Jun 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Isatuximab SAR650984 and Cemiplimab REGN2810 in people with Plasma Cell Myeloma, run by Sanofi at 30 sites in 10 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 30 sites in Spain, United States, France, Australia, Brazil and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Jun 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1: Number of Participants With Dose-Limiting Toxicities (DLTs) (time frame: Cycle 1 Day 1 to Day 28). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jun 2024.

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