Multiple MyelomaPhase 3KarMMa-3NCT03651128
Efficacy and Safety Study of bb2121 Versus Standard Regimens in Subjects With Relapsed and Refractory Multiple Myeloma (RRMM)
A Phase 3 study testing bb2121, Daratumumab and Pomalidomide in people with Multiple Myeloma, run by Celgene at 62 sites in 13 countries.
Trial summary
This is a multicenter, randomized, open-label, Phase 3 study comparing the efficacy and safety of bb2121 versus standard regimens in subjects with relapsed and refractory multiple myeloma (RRMM). The study is anticipated to randomize approximately 381 subjects with RRMM. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Multiple Myeloma
- What is being tested?
- bb2121, Daratumumab and Pomalidomide
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 386 participants
- Where
- 62 sitesin 13 countries
- Study dates
- 16 Apr 2019to 13 Apr 2026
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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
- Subjects must satisfy the following criteria to be enrolled in the study:
- Subject is ≥ 18 years of age at the time of signing the informed consent form (ICF).
- Subject must understand and voluntarily sign an ICF prior to any study-related assessments/procedures being conducted.
- Subject is willing and able to adhere to the study visit schedule and other protocol requirements within this protocol and for a subject randomized to Treatment Arm A, subject agrees to continued follow-up for up to 15 years as mandated by the regulatory guidelines for gene therapy trials.
- Subject has documented diagnosis of MM and measurable disease, defined as:
- M-protein (serum protein electrophoresis [sPEP] or urine protein electrophoresis [uPEP]): sPEP ≥ 0.5 g/dL or uPEP ≥ 200 mg/24 hours and/or
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- 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
- Subject has received at least 2 but no greater than 4 prior MM regimens.
- Subject has received prior treatment with DARA, a proteasome inhibitor- and an immunomodulatory compound-containing regimen for at least 2 consecutive cycles.
- Subject must be refractory to the last treatment regimen. Refractory is defined as documented progressive disease during or within 60 days (measured from the last dose of any drug within the regimen) of completing treatment with the last anti-myeloma regimen before study entry.
- Subject achieved a response (minimal response [MR] or better) to at least 1 prior treatment regimen.
- Subject has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Recovery to Grade 1 or baseline of any non-hematologic toxicities due to prior treatments, excluding alopecia and Grade 2 peripheral neuropathy.
- Adequate vascular access for leukapheresis
- Females of childbearing potential (FCBP) must:
- Have negative pregnancy test(s) as verified by the Investigator. This applies even if the subject practices true abstinence from heterosexual contact.
- Either practice true abstinence from heterosexual contact or agree to use, and be able to comply with, effective measures of contraception without interruption.
- Agree to abstain from breastfeeding during study participation. d. Refrain from tissue donation including egg cell donation or any other tissue/blood/organ donations.
- Male subjects must:
- Practice true abstinence or agree to use a condom during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, during dose interruptions, even if he has undergone a successful vasectomy.
- Refrain from tissue donation including sperm or any other tissue/blood/organ donations.
- Only subjects that would be considered for any of the 5 proposed standard regimens (DPd, DVd, IRd, Kd, or EPd), as judged by the investigator, should be included in the study.
Who cannot join
- The presence of any of the following will exclude a subject from enrollment:
- Subject has any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
- Subject has any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study.
- Subject has any condition that confounds the ability to interpret data from the study.
- Subject has nonsecretory multiple myeloma (MM).
- Subject has any of the following laboratory abnormalities:
Show all 40Show fewer
- Absolute neutrophil count (ANC) < 1,000/μL b. Platelet count: < 75,000/μL in subjects in whom < 50% of bone marrow nucleated cells are plasma cells and platelet count < 50,000/μL in subjects in whom ≥ 50% of bone marrow nucleated cells are plasma cells (it is not permissible to transfuse a subject to reach this level) c. Hemoglobin < 8 g/dL (< 4.9 mmol/L) (it is not permissible to transfuse a subject to reach this level) d. Serum creatinine clearance (CrCl) < 45 mL/min e. Corrected serum calcium > 13.5 mg/dL (> 3.4 mmol/L) f. Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 × upper limit of normal (ULN) g. Serum total bilirubin > 1.5 × ULN or > 3.0 mg/dL for subjects with documented Gilbert's syndrome h. International normalized ratio (INR) or activated partial thromboplastin time (aPTT) > 1.5 × ULN, or history of Grade ≥ 2 hemorrhage within 30 days, or subject requires ongoing treatment with chronic, therapeutic dosing of anticoagulants (eg, warfarin, low molecular weight heparin, Factor Xa inhibitors)
- Subject has inadequate pulmonary function defined as oxygen saturation (SaO2) < 92% on room air.
- Subject has prior history of malignancies, other than MM, unless the subject has been free of the disease for ≥ 5 years • Basal cell carcinoma of the skin
- Squamous cell carcinoma of the skin
- Carcinoma in situ of the cervix
- Carcinoma in situ of the breast
- Incidental histologic finding of prostate cancer (T1a or T1b using the tumor, nodes, metastasis [TNM] clinical staging system) or prostate cancer that can be treated with curative intent
- Subject has active or history of plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome or amyloidosis.
- Subject with known central nervous system (CNS) involvement with myeloma.
- Subject has clinical evidence of pulmonary leukostasis and disseminated intravascular coagulation.
- Subject has known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1 second (FEV1) 50% of predicted normal.
- Subject has a history or presence of clinically relevant CNS pathology such as epilepsy, seizure, paresis, aphasia, stroke, subarachnoid hemorrhage or other CNS bleed, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis.
- Subject was treated with DARA in combination with POM with or without dex (DP±d) as part of their most recent anti-myeloma treatment regimen, cannot receive DPd as bridging therapy but may receive DVd, IRd, Kd or EPdas bridging as per Investigator's discretion if randomized to Treatment Arm A.
- Subject was treated with DP±d as part of their most recent anti-myeloma treatment regimen, cannot receive DPd if randomized to Treatment Arm B but may receive DVd, IRd, Kd, or EPd as per Investigator's discretion.
- Subject was treated with DARA in combination with BTZ with or without dexamethasone (DV±d) as part of their most recent anti-myeloma treatment regimen, cannot receive DVd as bridging therapy but may receive DPd, IRd, Kd, or EPd as bridging as per Investigator's discretion if randomized to Treatment Arm A.
- Subject was treated with DV±d as part of their most recent anti-myeloma treatment regimen, cannot receive DVd if randomized to Treatment Arm B but may receive DPd, IRd, Kd, or EPd as per Investigator's discretion.
- Subject was treated with IXA in combination with LEN with or without dexamethasone (IR±d) as part of their most recent anti-myeloma treatment regimen, cannot receive IRd as bridging therapy but may receive DPd, DVd, Kd, or EPd as bridging as per Investigator's discretion if randomized to Treatment Arm A.
- Subject was treated with IR±d as part of their most recent anti-myeloma treatment regimen, cannot receive IRd if randomized to Treatment Arm B but may receive DPd, DVd, Kd, or EPd as per Investigator's discretion.
- 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.
- Subject has received autologous stem cell transplantation (ASCT) within 12 weeks prior to randomization.
- Subject has received any of the following within the last 14 days prior to randomization:
- Plasmapheresis b. Major surgery (as defined by the Investigator) c. Radiation therapy other than local therapy for myeloma-associated bone lesions d. Use of any investigational agents and systemic anti-myeloma drug therapy
- Echocardiogram (ECHO) or multigated acquisition (MUGA) with left ventricular ejection fraction (LVEF) < 45%.
- Ongoing treatment with chronic immunosuppressants (eg, cyclosporine or systemic steroids at any dose). Intermittent topical, inhaled or intranasal corticosteroids are allowed.
- Subject is positive for human immunodeficiency virus (HIV-1 and HIV-2), chronic or active hepatitis B or active hepatitis A or C.
- Subject has uncontrolled systemic fungal, bacterial, viral or other infection (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antimicrobial treatment) or requiring IV antimicrobials for management.
- Subject has a history of class III or IV congestive heart failure (CHF) or severe nonischemic cardiomyopathy, unstable or poorly controlled angina, myocardial infarction, or ventricular arrhythmia within the previous 6 months prior to randomization.
- Hypersensitivity to DARA, thalidomide, lenalidomide, POM, BTZ, IXA, CFZ, ELO or dexamathasone. This includes rash ≥ Grade 3 during prior thalidomide, POM or lenalidomide therapy.
- Subject with known hypersensitivity to any component of bb2121 product, cyclophosphamide, fludarabine, and/or tocilizumab or hypersensitivity to the excipients contained in the formulation of DARA, POM, LEN, IXA, BTZ, CFZ, ELO or dexamethasone.
- Subject is a female who is pregnant, nursing, or breastfeeding
- For a subject randomized to Treatment Arm B and will be on a POM- or LEN-containing regimen; unable or unwilling to undergo protocol required thromboembolism prophylaxis.
- 28 Subject is intolerant to bortezomib, or has acute diffuse infiltrative pulmonary and pericardial disease, subject cannot receive DVd as bridging therapy if randomized to Treatment Arm A or cannot receive DVd if randomized to Treatment Arm B.
- 31. Subject was treated with K±d as part of their most recent anti-myeloma treatment regimen, cannot receive Kd if randomized to Treatment Arm B but may receive DPd, DVd, IRd or EPd as per Investigator's discretion.
- 32. Subject was treated with EP±d as part of their most recent anti-myeloma treatment regimen, cannot receive EPd if randomized to Treatment Arm B but may receive DPd, DVd, Kd or IRd as per Investigator's discretion.
Trial locations and contacts
62 sites in 13 countries.
62 sites in 13 countries
United States36 sites
Local Institution - 120
Ann Arbor, Michigan, 48109-5936
Local Institution - 131
Atlanta, Georgia, 30322
Local Institution - 140
Atlanta, Georgia, 30342
Local Institution - 142
Aurora, Colorado, 80045
Local Institution - 104
Baltimore, Maryland, 21201-1595
Local Institution - 109
Birmingham, Alabama, 10016
Local Institution - 134
Boston, Massachusetts, 02114
Local Institution - 123
Boston, Massachusetts, 02215
Local Institution - 139
Chicago, Illinois, 60611
Local Institution - 118
Dallas, Texas, 75246
Local Institution - 103
Dallas, Texas, 75390
Local Institution - 113
Durham, North Carolina, 27705
Local Institution - 138
Hackensack, New Jersey, 07601
Local Institution - 132
Houston, Texas, 77030
Local Institution - 100
Indianapolis, Indiana, 46202-528
Local Institution - 108
Jacksonville, Florida, 32224
Local Institution - 145
Los Angeles, California, 90048
Local Institution - 122
Los Angeles, California, 90095
Local Institution - 107
Madison, Wisconsin, 53792
Froedtert Hospital BMT Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Local Institution - 106
Nashville, Tennessee, 37203
Local Institution - 119
New York, New York, 10029
Local Institution - 115
New York, New York, 10065
Local Institution - 135
New York, New York, 10065
University Of Nebraska
Omaha, Nebraska, 68198-7680
Local Institution - 124
Palo Alto, California, 94304
Local Institution - 111
Philadelphia, Pennsylvania, 19107
Local Institution - 110
Philadelphia, Pennsylvania, 19111
Local Institution - 101
Pittsburgh, Pennsylvania, 15232
Local Institution - 125
Rochester, Minnesota, 55905-0001
Local Institution - 136
Salt Lake City, Utah, 84112
Local Institution - 141
Scottsdale, Arizona, 85259
Local Institution - 105
Seattle, Washington, 98104
Local Institution - 114
St Louis, Missouri, 63110
Local Institution - 102
Tampa, Florida, 33612
Local Institution - 112
Westwood, Kansas, 66205-2003
Germany5 sites
Local Institution - 515
Cologne, 50937
Local Institution - 513
Düsseldorf, 40225
Local Institution - 514
Hamburg, 20246
Local Institution - 512
Heidelberg, 69120
Local Institution - 511
Würzburg, 97080
France4 sites
Local Institution - 402
Lille, 59037
Local Institution - 403
Nantes, 44093
Local Institution - 400
Paris, 75010
Local Institution - 401
Toulouse, 31059
Japan4 sites
Local Institution - 806
Bunkyō City, 113-8677
Local Institution - 804
Isehara City, Kanagawa, 259-1193
Local Institution - 807
Nagoya, 467-8602
Local Institution - 805
Shibuya-ku, 150-8935
Canada2 sites
Local Institution - 302
Calgary, Alberta, T2N 4N2
Local Institution - 303
Toronto, Ontario, M5G 2M9
Netherlands2 sites
Local Institution - 650
Amsterdam, 1081 HV
Local Institution - 651
Rotterdam, 3015 CN
Spain2 sites
Local Institution - 750
Pamplona, 31008
Local Institution - 751
Salamanca, 37007
United Kingdom2 sites
Local Institution - 850
Leeds, LS9 7TF
Local Institution - 851
London, SE5 9RS
About this study
Official title: A Phase 3, Multicenter, Randomized, Open-label Study to Compare the Efficacy and Safety of bb2121 Versus Standard Regimens in Subjects With Relapsed and Refractory Multiple Myeloma (RRMM) (KarMMa-3)
This is a multicenter, randomized, open-label, Phase 3 study comparing the efficacy and safety of bb2121 versus standard regimens in subjects with relapsed and refractory multiple myeloma (RRMM).
The study is anticipated to randomize approximately 381 subjects with RRMM. Approximately 254 subjects will be randomized to Treatment Arm A and approximately 127 subjects will be randomized to Treatment Arm B.
- Conditions
- Multiple Myeloma
- Being tested
- bb2121, Daratumumab, Pomalidomide, Dexamethasone, Bortezomib
- Keywords
- Multiple Myeloma, bb2121, Relapsed and Refractory Multiple Myeloma, High Risk Multiple Myeloma
- Medical subject headings
- Multiple Myeloma, Recurrence
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
bb2121Biological
bb2121
DaratumumabDrug
Daratumumab
PomalidomideDrug
Pomalidomide
DexamethasoneDrug
Dexamethasone
BortezomibDrug
Bortezomib
IxazomibDrug
Ixazomib
LenalidomideDrug
Lenalidomide
CarfilzomibDrug
Carfilzomib
ElotuzumabDrug
Elotuzumab
| Study group | Role | What they receive |
|---|---|---|
| Arm A - Administration of bb2121 | Experimental | bb2121 autologous CAR T cells will be infused at a dose ranging from 150 - 450 x 10^6 CAR+ T cells after receiving lymphodepleting chemotherapy Receives: Biological: bb2121 |
| Arm B- standard regimens as per Investigator's discretion | Experimental | The participants will receive one of following regimens dependent on the subject's most recent anti-myeloma treatment regimen:
* Daratumumab (DARA) in combination with pomalidomide (POM) and low-dose dexamethasone (dex) (DPd) OR
* DARA in combination with bortezomib (BTZ) and low-dose dex (DVd) OR
* Ixazomib (IXA) in combination with lenalidomide (LEN) and low-dose dex (IRd) OR
* Carfilzomib (CFZ) in combination with low-dose dexamethasone (Kd) OR
* Elotuzumab (ELO) in combination with POM and low-dose dexamethasone (EPd) Receives: Drug: Daratumumab; Drug: Pomalidomide; Drug: Dexamethasone; Drug: Bortezomib; Drug: Ixazomib; Drug: Lenalidomide; Drug: Carfilzomib; Drug: Elotuzumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-free Survival (PFS)
Time from randomization to the first documentation of progressive disease based on the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma assessed by an independent response committee (IRC) or death due to any cause, whichever occurs first.
Measured: Minimum of 5 years from randomization
Secondary outcomes (18)
Overall Survival (OS)
Time from randomization to time of death due to any cause
Measured: Minimum of 5 years from randomization
Event-free Survival (EFS)
Time from randomization to the first documentation of progressive disease, first day when subject receives another anti-myeloma treatment or death due to any cause, whichever occurs first
Measured: Minimum of 5 years from randomization
Overall Response Rate (ORR)
Percentage of subjects who achieved partial response (PR) or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed by an IRC
Measured: Minimum of 5 years from randomization
Minimal Residual Disease (MRD)
Percentage of MRD evaluable subjects that are MRD negative (defined at a minimum of 1 in 10^5 nucleated cells) using flow cytometry (EuroFlow) and next generation sequencing (NGS)
Measured: Minimum of 5 years from randomization
Complete Response (CR) Rate
Percentage of subjects who achieved CR or better according to IMWG Uniform Response Criteria for Multiple Myeloma as assessed by an IRC
Measured: Minimum of 5 years from randomization
Duration of Response (DOR)
Time from first documentation of response (PR or better) to first documentation of disease progression or death from any cause, whichever occurs first
Measured: Minimum of 5 years from randomization
Time to Response (TTR)
TTR is calculated as the time from randomization to the initial documented response (PR or better) based on IMWG guideline for responders
Measured: Minimum of 5 years from randomization
Adverse Events (AEs)
Number of participants with adverse events
Measured: Minimum of 5 years from randomization
Pharmacokinetics- Cmax
Maximum peak in bb2121 chimeric antigen receptor (CAR) T cells
Measured: Minimum 5 years after bb2121 infusion
Pharmacokinetics- tmax
Time to peak of bb2121 CAR T cells
Measured: Minimum 5 years after bb2121 infusion
Pharmacokinetics- AUC
Area under the curve of CAR T cells
Measured: Minimum 5 years after bb2121 infusion
Pharmacokinetics- t-last
Time to last measurable CAR T cells
Measured: Minimum 5 years after bb2121 infusion
Pharmacokinetics- AUC0-28days
Area under the curve of CAR T cells from time zero to Day 28
Measured: Minimum 5 years after bb2121 infusion
Subject-reported outcomes as measured by European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC-QLQ-C30)
Questionnaire will be used as a measure of health-related quality of life
Measured: Minimum of 5 years from randomization
Subject-reported outcomes as measured by EuroQoL Group European Quality of Life-5 Dimensions health state classifier to 5 Levels (EQ-5D-5L) Health Questionnaire
Is a standardized measure of health status developed by the EuroQol Group in order to provide a simple, generic measure of health for clinical and economic appraisal
Measured: Minimum of 5 years from randomization
Subject-reported outcomes as measured by European Quality of Life Multiple Myeloma Module (EORTC-QLQ-MY20)
Is a 20-item myeloma module intended for use among patients varying in disease stage and treatment modality
Measured: Minimum of 5 years from randomization
Time to next antimyeloma treatment
Time from randomization to first day when subject receives another anti-myeloma treatment
Measured: Minimum of 5 years from randomization
Progression-free survival after next line therapy (PFS2)
Time from randomization to second objective disease progression or death from any cause, whichever is first
Measured: Minimum of 5 years from randomization
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Aug 2018
- Study start16 Apr 2019
- Primary completion13 Apr 2026
- Study completion13 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Multiple MyelomaStudies of the same condition, open and under way.
- More trials run by CelgeneThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 386 participants (actual)
Sponsor and investigators
- Lead sponsor
- Celgene
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Bristol-Myers Squibb, Study director, Bristol-Myers Squibb
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03651128
- Sponsor's protocol ID
- BB2121-MM-003
- Other IDs
- U1111-1217-9988, 2018-001023-38, 2018
- Acronym
- KarMMa-3
- Status last verified
- Jun 2026
- First submitted
- 16 Aug 2018
- Last updated
- 22 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: 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.html
Publications
Lopez-Munoz N, Bar N, Diels J, van Sanden S, Mendes J, Lee S, Hernando T, Lendvai N, Patel N, Ishida T, Er J, Harrison SJ. Ciltacabtagene Autoleucel Versus Idecabtagene Vicleucel in Triple-Class-Exposed Relapsed/Refractory Multiple Myeloma with 2-4 Prior Lines of Therapy: Updated Matching-Adjusted Indirect Comparison. Adv Ther. 2026 Mar;43(3):1327-1340. doi: 10.1007/s12325-025-03479-y. Epub 2026 Feb 2.
PubMed 41627370Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon S, Abrahamsen IW, Baz R, Broijl A, Chen C, Jagannath S, Raje N, Scheid C, Delforge M, Benjamin R, Pabst T, Iida S, Berdeja J, Giralt S, Truppel-Hartmann A, Chen Y, Zhong X, Wu F, Piasecki J, Eliason L, Dhanda D, Felten J, Caia A, Cook M, Popa McKiver M, Rodriguez-Otero P. Ide-cel vs standard regimens in triple-class-exposed relapsed and refractory multiple myeloma: updated KarMMa-3 analyses. Blood. 2024 Dec 5;144(23):2389-2401. doi: 10.1182/blood.2024024582.
PubMed 39197072Rodriguez-Otero P, Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon SR, Delforge M, Berdeja J, Truppel-Hartmann A, Yang Z, Favre-Kontula L, Wu F, Piasecki J, Cook M, Giralt S. Plain language summary of the KarMMa-3 study of ide-cel or standard of care regimens in people with relapsed or refractory multiple myeloma. Future Oncol. 2024;20(18):1221-1235. doi: 10.2217/fon-2023-0954. Epub 2024 Apr 23.
PubMed 38651976Rodriguez-Otero P, Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon SR, Delforge M, Berdeja J, Truppel-Hartmann A, Yang Z, Favre-Kontula L, Wu F, Piasecki J, Cook M, Giralt S. Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma. N Engl J Med. 2023 Mar 16;388(11):1002-1014. doi: 10.1056/NEJMoa2213614. Epub 2023 Feb 10.
PubMed 36762851
Study at a glance
From the registry record, last updated by the sponsor on 22 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Multicenter, Randomized, Open-label Study to Compare the Efficacy and Safety of bb2121 Versus Standard Regimens in Subjects With Relapsed and Refractory Multiple Myeloma (RRMM) (KarMMa-3)
- ClinicalTrials.gov ID
- NCT03651128
- Acronym / sponsor ID
- KarMMa-3 / BB2121-MM-003
- Conditions
- Multiple Myeloma
- Keywords
- Multiple Myeloma, bb2121, Relapsed and Refractory Multiple Myeloma, High Risk Multiple Myeloma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 386 participants (actual)
- Lead sponsor
- CelgeneIndustry (pharma, biotech, devices)
- Study start
- 16 Apr 2019 (actual)
- Primary completion
- 13 Apr 2026 (actual)
- Study completion
- 13 Apr 2026 (actual)
- First posted
- 29 Aug 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a multicenter, randomized, open-label, Phase 3 study comparing the efficacy and safety of bb2121 versus standard regimens in subjects with relapsed and refractory multiple myeloma (RRMM).
The study is anticipated to randomize approximately 381 subjects with RRMM. Approximately 254 subjects will be randomized to Treatment Arm A and approximately 127 subjects will be randomized to Treatment Arm B.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm A - Administration of bb2121 | Experimental | Biological: bb2121bb2121 autologous CAR T cells will be infused at a dose ranging from 150 - 450 x 10^6 CAR+ T cells after receiving lymphodepleting chemotherapy |
| Arm B- standard regimens as per Investigator's discretion | Experimental | Drug: Daratumumab, Drug: Pomalidomide, Drug: Dexamethasone, Drug: Bortezomib, Drug: Ixazomib, Drug: Lenalidomide, Drug: Carfilzomib, Drug: ElotuzumabThe participants will receive one of following regimens dependent on the subject's most recent anti-myeloma treatment regimen: * Daratumumab (DARA) in combination with pomalidomide (POM) and low-dose dexamethasone (dex) (DPd) OR * DARA in combination with bortezomib (BTZ) and low-dose dex (DVd) OR * Ixazomib (IXA) in combination with lenalidomide (LEN) and low-dose dex (IRd) OR * Carfilzomib (CFZ) in combination with low-dose dexamethasone (Kd) OR * Elotuzumab (ELO) in combination with POM and low-dose dexamethasone (EPd) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (22 listed)
- Subject is ≥ 18 years of age at the time of signing the informed consent form (ICF).
- Subject must understand and voluntarily sign an ICF prior to any study-related assessments/procedures being conducted.
- Subject is willing and able to adhere to the study visit schedule and other protocol requirements within this protocol and for a subject randomized to Treatment Arm A, subject agrees to continued follow-up for up to 15 years as mandated by the regulatory guidelines for gene therapy trials.
- Subject has documented diagnosis of MM and measurable disease, defined as:
- Subject has received at least 2 but no greater than 4 prior MM regimens.
Key exclusion criteria (40 listed)
- Subject has any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
- Subject has any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study.
- Subject has any condition that confounds the ability to interpret data from the study.
- Subject has nonsecretory multiple myeloma (MM).
- Subject has any of the following laboratory abnormalities:
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| bb2121bb2121 | Biological | Arm A - Administration of bb2121 |
| DaratumumabDaratumumab | Drug | Arm B- standard regimens as per Investigator's discretion |
| PomalidomidePomalidomide | Drug | Arm B- standard regimens as per Investigator's discretion |
| DexamethasoneDexamethasone | Drug | Arm B- standard regimens as per Investigator's discretion |
| BortezomibBortezomib | Drug | Arm B- standard regimens as per Investigator's discretion |
| IxazomibIxazomib | Drug | Arm B- standard regimens as per Investigator's discretion |
| LenalidomideLenalidomide | Drug | Arm B- standard regimens as per Investigator's discretion |
| CarfilzomibCarfilzomib | Drug | Arm B- standard regimens as per Investigator's discretion |
| ElotuzumabElotuzumab | Drug | Arm B- standard regimens as per Investigator's discretion |
Primary outcome
Progression-free Survival (PFS)
Time frame: Minimum of 5 years from randomization
Time from randomization to the first documentation of progressive disease based on the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma assessed by an independent response committee (IRC) or death due to any cause, whichever occurs first.
18 secondary outcomes
Overall Survival (OS)
Time frame: Minimum of 5 years from randomization
Event-free Survival (EFS)
Time frame: Minimum of 5 years from randomization
Overall Response Rate (ORR)
Time frame: Minimum of 5 years from randomization
Minimal Residual Disease (MRD)
Time frame: Minimum of 5 years from randomization
Complete Response (CR) Rate
Time frame: Minimum of 5 years from randomization
Duration of Response (DOR)
Time frame: Minimum of 5 years from randomization
Time to Response (TTR)
Time frame: Minimum of 5 years from randomization
Adverse Events (AEs)
Time frame: Minimum of 5 years from randomization
Pharmacokinetics- Cmax
Time frame: Minimum 5 years after bb2121 infusion
Pharmacokinetics- tmax
Time frame: Minimum 5 years after bb2121 infusion
Pharmacokinetics- AUC
Time frame: Minimum 5 years after bb2121 infusion
Pharmacokinetics- t-last
Time frame: Minimum 5 years after bb2121 infusion
Pharmacokinetics- AUC0-28days
Time frame: Minimum 5 years after bb2121 infusion
Subject-reported outcomes as measured by European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC-QLQ-C30)
Time frame: Minimum of 5 years from randomization
Subject-reported outcomes as measured by EuroQoL Group European Quality of Life-5 Dimensions health state classifier to 5 Levels (EQ-5D-5L) Health Questionnaire
Time frame: Minimum of 5 years from randomization
Subject-reported outcomes as measured by European Quality of Life Multiple Myeloma Module (EORTC-QLQ-MY20)
Time frame: Minimum of 5 years from randomization
Time to next antimyeloma treatment
Time frame: Minimum of 5 years from randomization
Progression-free survival after next line therapy (PFS2)
Time frame: Minimum of 5 years from randomization
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jun 2026.
- Derived from this study: PubMed 41627370Lopez-Munoz N, Bar N, Diels J, van Sanden S, Mendes J, Lee S, Hernando T, Lendvai N, Patel N, Ishida T, Er J, Harrison SJ. Ciltacabtagene Autoleucel Versus Idecabtagene Vicleucel in Triple-Class-Exposed Relapsed/Refractory Multiple Myeloma with 2-4 Prior Lines of Therapy: Updated Matching-Adjusted Indirect Comparison. Adv Ther. 2026 Mar;43(3):1327-1340. doi: 10.1007/s12325-025-03479-y. Epub 2026 Feb 2.
- Derived from this study: PubMed 39197072Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon S, Abrahamsen IW, Baz R, Broijl A, Chen C, Jagannath S, Raje N, Scheid C, Delforge M, Benjamin R, Pabst T, Iida S, Berdeja J, Giralt S, Truppel-Hartmann A, Chen Y, Zhong X, Wu F, Piasecki J, Eliason L, Dhanda D, Felten J, Caia A, Cook M, Popa McKiver M, Rodriguez-Otero P. Ide-cel vs standard regimens in triple-class-exposed relapsed and refractory multiple myeloma: updated KarMMa-3 analyses. Blood. 2024 Dec 5;144(23):2389-2401. doi: 10.1182/blood.2024024582.
- Derived from this study: PubMed 38651976Rodriguez-Otero P, Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon SR, Delforge M, Berdeja J, Truppel-Hartmann A, Yang Z, Favre-Kontula L, Wu F, Piasecki J, Cook M, Giralt S. Plain language summary of the KarMMa-3 study of ide-cel or standard of care regimens in people with relapsed or refractory multiple myeloma. Future Oncol. 2024;20(18):1221-1235. doi: 10.2217/fon-2023-0954. Epub 2024 Apr 23.
- Derived from this study: PubMed 36762851Rodriguez-Otero P, Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon SR, Delforge M, Berdeja J, Truppel-Hartmann A, Yang Z, Favre-Kontula L, Wu F, Piasecki J, Cook M, Giralt S. Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma. N Engl J Med. 2023 Mar 16;388(11):1002-1014. doi: 10.1056/NEJMoa2213614. Epub 2023 Feb 10.
- BMS Clinical Trial InformationLink provided by the sponsor.
- BMS Clinical Trial Patient RecruitingLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. 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.html
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Bristol-Myers Squibb study director
Bristol-Myers Squibb
62 sites in 13 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing bb2121, Daratumumab and Pomalidomide in people with Multiple Myeloma, run by Celgene at 62 sites in 13 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 22 inclusion and 40 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 22 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 62 sites in United States, Germany, France, Japan, Canada and 8 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 phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Progression-free Survival (PFS) (time frame: Minimum of 5 years from randomization). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03651128, which also lists 4 linked publications.
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 22 Jun 2026.