Multiple MyelomaPhase 1/2NCT05573802
A Study to Investigate Safety and Clinical Activity of Belantamab Mafodotin in Combination With Lenalidomide, Dexamethasone and Nirogacestat in Patients With Transplant Ineligible Newly Diagnosed Multiple Myeloma
A Phase 1/2 study testing Belantamab Mafodotin-Blmf, Lenalidomide and Dexamethasone in people with Multiple Myeloma and Neoplasms, run by Hellenic Society of Hematology at 2 sites in Greece.
Trial summary
This is a phase 1/2, open-label study designed to assess the safety and clinical activity of different belantamab mafodotin doses in combination with lenalidomide, dexamethasone and nirogacestat in patients with transplant ineligible newly diagnosed multiple myeloma. This will be a 2-part study. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Multiple Myeloma, Neoplasms, Neoplasm, Plasma Cell
- What is being tested?
- Belantamab Mafodotin-Blmf, Lenalidomide and Dexamethasone
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 2 sitesGreece
- Study dates
- 14 Jul 2023to 31 Oct 2026
- Phase
- Phase 1/2
- 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
- Participant must be >18 years of age
- Monoclonal plasma cells in the bone marrow (BM) ≥10% or presence of a biopsy proven plasmacytoma and documented Multiple Myeloma (MM) satisfying at least one of the calcium, renal, anemia, bone (CRAB) criteria or biomarkers of malignancy criteria:
- CRAB criteria:
- Hypercalcemia: serum calcium >0.25 mmol/L (>1 mg/dL) higher than upper limit of normal (ULN) or >2.75 mmol/L (>11 mg/dL).
- Renal insufficiency: creatinine clearance (CrCI) <40mL/min or serum creatinine >177 μmol/L (>2 mg/dL).
- Anemia: hemoglobin >2 g/dL below the lower limit of normal or hemoglobin <10 g/dL.
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- Bone lesions: one or more osteolytic lesions on skeletal radiography, Computed tomography (CT), or Positron emission tomography (PET-CT).
- Biomarkers of Malignancy:
- Clonal BM plasma cell percentage ≥60%.
- Involved: uninvolved serum free light chain (sFLC) ratio ≥100.
- More than 1 focal lesion on magnetic resonance imaging (MRI) studies.
- Must have at least ONE aspect of measurable disease, defined as one of the following:
- Urine M-protein excretion ≥200 mg/24 hrs (≥0.2 g/24 hrs), or
- Serum M-protein concentration ≥0.5 g/dL (≥5.0 g/L), or
- Serum FLC assay: involved FLC level ≥10 mg/dL (≥100 mg/L) and an abnormal serum FLC ratio (<0.26 or >1.65).
- Not a candidate for high-dose chemotherapy with autologous stem cell transplantation due to presence of significant comorbid condition(s), such as cardiac, pulmonary or other major organ dysfunction that are likely to have a negative impact on tolerability of high dose chemotherapy with stem cell transplantation. The patients will be assessed with the IMWG frailty index, a scoring system based on age, comorbidities, and cognitive and physical conditions, which is recommended by the European Society for Medical Oncology (ESMO) guidelines. Patients with International Myeloma Working Group (IMWG) frailty index score 1 or 2 will be considered transplant ineligible. The reason(s) for transplant ineligibility will be collected in the case report forms (CRFs).
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-2.
- Adequate organ system function as defined by the below laboratory assessments. Hematologic
- Absolute neutrophil count (ANC) ≥1.25 X 10^9/L; granulocyte colony-stimulating factor (G-CSF) use for the past 14 days is NOT allowed.
- Hemoglobin ≥8.0 g/dL; transfusions are not permitted in the past 14 days prior to the assessment. Erythropoietin use is allowed.
- Platelet count ≥50 x 10^9/L if the BM is >50% involved in myeloma. Otherwise, ≥75 x 10^9/L; transfusions or platelet stimulating agents are NOT allowed in the past 14 days prior to the assessment.
- Hepatic
- Total bilirubin ≤1.5xULN (isolated bilirubin ≥1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%).
- ALT ≤ 2.5xULN. Renal
- Estimate glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2; calculated using the Modified Diet in Renal Disease (MDRD) formula.
- Spot urine (albumin/creatinine ratio) <500 mg/g (56 mg/mmol) OR
- Urine Dipstick: Negative trace; if ≥1+ only eligible if confirmed <500 mg/g [56 mg/mmol] by albumin/creatinine ratio (spot urine from first void).
- Female participants: contraceptive use should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies:
- A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
- Is not a woman of childbearing potential (WOCBP) defined as follows:
- ≥ 45 years of age and has not had menses for > 1 year
- Patients who have been amenorrhoeic for < 2 years without history of a hysterectomy and oophorectomy must have a follicle stimulating hormone value in the postmenopausal range upon screening evaluation
- Post-hysterectomy, post-bilateral oophorectomy, or post-tubal ligation. Documented hysterectomy or oophorectomy must be confirmed with medical records of the actual procedure or confirmed by an ultrasound. Tubal ligation must be confirmed with medical records of the actual procedure.
- OR
- Is a WOCBP and using two methods of reliable birth control (one method that is highly effective and one additional effective [barrier] method), beginning 4 weeks before initiating treatment with lenalidomide, during therapy, during dose interruptions and continuing for 4 weeks following discontinuation of lenalidomide treatment. WOCBP participants must use one method of reliable birth control that is highly effective for 4 months following discontinuation of belantamab mafodotin. WOCBP must also agree not to donate eggs (ova, oocytes) for the purpose of reproduction during treatment, during dose interruptions and for 28-days following the last dose of lenalidomide or 4 months following discontinuation of belantamab mafodotin treatment, whichever is longer.
- A WOCBP must have two negative pregnancy tests before therapy initiation. The first test should be performed within 10-14 days, and the second test within 24 hours before the start of lenalidomide therapy.
- The participant should not receive lenalidomide until the investigator has verified that the results of these pregnancy tests are negative. The investigator should evaluate the effectiveness of the contraceptive method in relation to the first dose of the study treatment. The investigator is responsible for a review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with a nearly undetected pregnancy.
- WOCBP is a female who:
- has achieved menarche at some time point
- has not undergone a hysterectomy or bilateral oophorectomy or
- has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months).
- Male participants: contraceptive use should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies:
- Male participants are eligible to participate if they agree to the following during the intervention period and until 28 days after the last dose of lenalidomide or 6 months after the last dose of belantamab mafodotin, whichever is longer, to allow for clearance of any altered sperm.
- Refrain from donating sperm
- PLUS either:
- Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent, OR
- Must agree to use contraception/barrier as detailed below:
- Agree to use a male condom, even if they have undergone a successful vasectomy, and female partner to use an additional highly effective contraceptive method with a failure rate of <1% per year as when having sexual intercourse with a woman of childbearing potential (including pregnant females).
- Participants must be able to understand the study procedures and agree to participate in the study by providing written informed consent.
Who cannot join
- Prior systemic therapy for MM or Smoldering MM.
- NOTE 1: An emergency course of steroids (defined as not greater than 40 mg of dexamethasone [or equivalent] per day for a maximum of 4 days [i.e., a total of 160 mg]) is permitted.
- NOTE 2: Focal palliative radiation is permitted before enrollment, provided that: it occurred at least 2 weeks before the first dose of the study drug; the participant has recovered from radiation-related toxicities; and the participant did not require corticosteroid administration (for a longer period than that specified in NOTE 1 above) for radiation-induced AEs.
- Peripheral neuropathy or neuropathic pain Grade 2 or higher, as defined by the National Cancer Institute Common Toxicity Criteria for AEs version 5.
- Major surgery within 2 weeks before the first dose of the study drug.
- NOTE 1: patients who underwent major surgery must be clinically stable to be enrolled in the study.
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- NOTE 2: major surgery shall be defined based on the Investigator's judgment according to the extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes.
- Presence of active renal condition (infection, requirement for dialysis or any other significant condition that could affect the participant's safety). Participants with isolated proteinuria resulting from MM are eligible, provided that they fulfil the other inclusion criteria.
- Any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions (including laboratory abnormalities) that could interfere with the participant's safety, obtaining informed consent, or compliance with the study procedures.
- Evidence of active mucosal or internal bleeding uncontrolled by local therapy and not explained by reversible coagulopathy.
- Current active liver or biliary disease (except for Gilbert's syndrome or asymptomatic gallstones, or otherwise stable chronic liver disease as per the investigator's assessment).
- Participants with previous or concurrent malignancies other than MM are excluded. Exceptions are surgically treated cervical carcinoma in situ or any other malignancy that has been considered medically stable for at least 2 years. The participant must not be receiving active therapy other than hormonal therapy for this disease.
- NOTE: Participants with curatively treated non-melanoma skin cancer are allowed without a 2-year restriction.
- Evidence of cardiovascular risk including any of the following:
- Evidence of current clinically significant untreated arrhythmias, including clinically significant electrocardiogram (ECG) abnormalities, second degree (Mobitz Type II), or third degree atrioventricular (AV) block.
- History of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty, or stenting or bypass grafting within 3 months of screening.
- Class III or IV heart failure as defined by the New York Heart Association functional classification system.
- Uncontrolled hypertension.
- Active infection requiring treatment.
- Known HIV infection, unless the participant can meet all of the following criteria:
- Established anti-retroviral therapy (ART) for at least 4 weeks and HIV viral load <400 copies/mL.
- CD4+ T-cell (CD4+) count ≥350 cells/uL.
- No history of AIDS-defining opportunistic infections within the last 12 months.
- NOTE: consideration must be given to ART and prophylactic antimicrobials that may have a drug:drug interaction and/or overlapping toxicities with belantamab mafodotin or other combination products as relevant
- Seropositivity for hepatitis B (defined by a positive test for hepatitis B surface antigen [HBsAg]).
- NOTE 1: Participants with resolved infection (i.e., participants who are positive for antibodies to hepatitis B core antigen [antiHBc] or antibodies to hepatitis B surface antigen [antiHBs]) must be screened using real-time polymerase chain reaction (PCR). Those who are PCR positive will be excluded.
- NOTE 2: presence of antiHBs indicating previous vaccination will not constitute an exclusion criterion.
- Positive hepatitis C antibody test result or positive hepatitis C RNA test result at screening or within 3 months before the first dose of the study treatment unless the participant can meet the following criteria:
- RNA test negative
- Successful anti-viral treatment (usually 8 weeks duration) is required, followed by a negative hepatitis C virus RNA test after a washout period of at least 4 weeks.
- Current corneal epithelial disease except for mild punctate keratopathy.
- NOTE: Participants with mild punctate keratopathy are allowed. Mild (Grade 1) punctuate keratopathy is characterized by the appearance of only a few, if any, microcyst-like epithelial changes (MECs), as identified in the slit-lamp examination, with a low density (non-confluent), and predominantly (≥80%) located in the periphery of the cornea
- Intolerance or contraindications to anti-viral prophylaxis.
- Unable to tolerate antithrombotic prophylaxis.
- AL amyloidosis (light chain amyloidosis), active POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma proliferative disorder, skin changes) or active plasma cell leukemia at the time of screening.
- Exhibiting clinical signs of or with known history of meningeal or central nervous system involvement by MM.
- Known immediate or delayed hypersensitivity reaction or idiosyncratic reaction to drugs chemically related to belantamab mafodotin or any of the components of the study treatment.
- Use of an investigational drug within 14 days or 5 half-lives (whichever is shorter) preceding the first dose of study drug.
- Plasmapheresis within 7 days before the first dose of the study drug.
- Participants with active small and/or large intestinal disease which is not adequately controlled with the appropriate treatment (e.g., uncontrolled diarrheal disease).
- Participants with uncontrolled skin disease.
- Participants with any condition causing hypophosphatemia, hypokalemia or hypomagnesemia which is refractory to electrolyte replacement.
- Participants with previous administration of a gamma secretase inhibitor.
- Participants with concomitant administration of a strong or moderate CYP3A4 inhibitor or inducer.
- Any serious and/or unstable pre-existing medical, psychiatric disorder or other conditions (including lab abnormalities) that could interfere with participant's safety, obtaining informed consent or compliance to the study procedures.
- Participant must not have received a live or live-attenuated vaccine within 30 days prior to first dose of belantamab mafodotin.
- Participant should not use contact lenses while receiving belantamab mafodotin.
- Because of the embryo-fetal risk of lenalidomide, all participants must adhere to the lenalidomide pregnancy prevention program applied in their region.
Trial locations and contacts
2 sites in 1 country.
Greece2 sites, 2 recruiting
- Recruiting
General Hospital of Athens "Alexandra", NKUA, Therapeutic Clinic
Athens, 11528
Meletios A. Dimopoulos, Professor
- Not yet recruiting
Anticancer Hospital of Thessaloniki "Theageneio"
Thessaloniki, 54639
Eirini Katodritou, Dr.
About this study
Official title: A Phase 1/2, Dose and Schedule Evaluation Study to Investigate the Safety and Clinical Activity of Belantamab Mafodotin Administrated in Combination With Lenalidomide, Dexamethasone and Nirogacestat in Patients With Transplant Ineligible Newly Diagnosed Multiple Myeloma
This is a phase 1/2, open-label study designed to assess the safety and clinical activity of different belantamab mafodotin doses in combination with lenalidomide, dexamethasone and nirogacestat in patients with transplant ineligible newly diagnosed multiple myeloma.
This will be a 2-part study. In part 1 participants will be enrolled in one cohort to receive belantamab mafodotin in combination with lenalidomide, dexamethasone and nirogacestat and will determine the recommended phase 2 dose (RP2D) to be further evaluated for safety and clinical activity in the dose expansion cohort. The RP2D dose will be used in future studies in the transplant-ineligible newly diagnosed multiple myeloma (NDMM) setting. In the dose expansion phase (Part 2) an expansion cohort will be treated with the RP2D. The expansion cohort will randomize participants (1:1) in two groups to evaluate two alternate dose modification guidelines for corneal AEs. Part 2 of the study will also evaluate an alternative dose modification guideline for corneal adverse events (AEs).
Overall, approximately 36 participants will be enrolled in the study. Participant follow-up will continue up to 3 years after the last participant is enrolled (follow-up period range: 3-4 years). The estimated accrual period will be 12 months, corresponding to an approximate total study duration of 4 years.
- Conditions
- Multiple Myeloma, Neoplasms, Neoplasm, Plasma Cell, Gammopathy, Monoclonal, Paraproteinemias, Blood Protein Disorders
- Being tested
- Belantamab Mafodotin-Blmf, Lenalidomide, Dexamethasone, Nirogacestat
- Medical subject headings
- Multiple Myeloma, Neoplasms, Neoplasms, Plasma Cell, Paraproteinemias, Blood Protein Disorders, Hematologic Diseases, Corneal Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Belantamab Mafodotin-BlmfDrug
Blmf will be available as 100 mg/vial in single-use vial for reconstitution, supplied as lyophilized powder. Blmf will be delivered as IV solution over at least 30 minutes.
LenalidomideDrug
Lenalidomide will be administered per os.
DexamethasoneDrug
Dexamethasone will be administered intravenously or per os.
NirogacestatDrug
Nirogacestat will be administrated each day for all subsequent cycles were Blmf is also administrated.
| Study group | Role | What they receive |
|---|---|---|
| Part 1 : Dose finding | Experimental | Belantamab mafodotin will be administered as a combination therapy as a calculated dose on Day 1 of every other 28-day cycle.
Belantamab mafodotin starting dose:
• 1.4 mg/kg Q8W (i.e., on Day 1 of every other 28-day cycle)
* Dose Level +1: 1.9 mg/kg Q8W
* Dose Level -1: 1.0 mg/kg Q8W
* Dose Level -2: 1.0 mg/kg Q12W
Lenalidomide: 25 mg/d on day 1-21 of every 28-day cycle.
Dexamethasone: 40 mg/d on days 1, 8, 15, 22 of every 28-day cycle in participants < 75 years; 20 mg/d on days 1, 8, 15, 22 of every 28-day cycle in participants ≥ 75 years
Nirogacestat: 100 mg twice a day (BID) starting on day -3 and then each day of every other 28-day cycle (i.e., to be given only on cycles where belantamab mafodotin is administered). Receives: Drug: Belantamab Mafodotin-Blmf; Drug: Lenalidomide; Drug: Dexamethasone; Drug: Nirogacestat |
What is being measured
The primary outcome is the main question the study is designed to answer.
Part 1: Dose-Limiting Toxicity (DLT)
The number (%) of participants with DLTs using the DLT evaluable population.
Measured: Up to 28 days
Part 1 and 2: Adverse Events (AEs) and Serious adverse events (SAEs)
The number (%) of participants with AEs and SAEs using the DLT evaluable and Safety populations
Measured: Up to 4 years
Part 1 and 2: Ocular Toxicity
The number (%) of participants with grade 2 or above KVA events
Measured: Up to 4 years
Part 2: Overall Response Rate (ORR)
ORR as per International Myeloma Working Group (IMWG) by Investigator Assessment; defined as the percentage of participants with a confirmed Partial Response (PR), Very Good Partial Response (VGPR), Complete Response (CR) or stringent Complete Response sCR in the intent-to-treat (ITT) set.
Measured: Up to 4 years
Secondary outcomes (14)
Part 1 and 2: Lenalidomide Relative Dose Intensity (RDI)
The RDI is defined as the percentage of the total administered over the total planned lenalidomide dose.
Measured: Up to 4 years
Part 1 and 2: Nirogacestat Relative Dose Intensity (RDI)
The RDI is defined as the percentage of the total administered over the total planned nirogacestat dose.
Measured: Up to 4 years
Part 1 and 2: Cumulative dose of bentalamab mafodotin
Cumulative administered dose of belantamab mafodotin in combination with lenalidomide, dexamethasone and nirogacestat i.e., the total dose of belantamab mafodotin that was administered.
Measured: Up to 4 years
Part 1: Overall Response Rate (ORR)
Overall Response Rate as per IMWG by Investigator Assessment
Measured: Up to 4 years
Part 1 and 2: Time To Response (TTR)
TTR as per IMWG by Investigator Assessment (ITT population). TTR is defined as the time (in months) between the date of randomization and the first evidence of confirmed response (PR or better) for participants who achieve a response (i.e., confirmed PR or better).
Measured: Up to 4 years
Part 1 and 2: Duration of Response (DoR)
DoR is defined as the time (months) from first evidence of confirmed PR or better until the earliest date of: documented disease progression (PD) per IMWG response criteria; or death due to PD among participants who achieved a response of PR or better. For alive and progression-free participants, data will be censored at the date of initiation of the subsequent line of treatment or at the last date of FU that the participant was known to be alive and progression-free.
Measured: Up to 4 years
Part 1 and 2: Complete Response Rate (CRR)
CRR is defined as the percentage of participants with a confirmed CR or sCR. The denominator will be the total number of participants in each population and group respectively.
Measured: Up to 4 years
Part 1 and 2: Very Good Partial Response (VGPR) or better
VGPR or better as per IMWG by Investigator Assessment (ITT population). VGPR or better rate is defined as the percentage of participants with a confirmed VGPR, CR or sCR. The denominator will be the total number of participants in each population and group respectively.
Measured: Up to 4 years
Part 1 and 2: Minimal Residual Disease (MRD) negative rate
MRD negativity rate (ITT population); defined as the number (%) of participants who achieve MRD negativity (at or below the threshold of 10^-5), assessed via NGF. The denominator will be the total number of participants in each population and group respectively.
Measured: Up to 4 years
Part 1 and 2: Progression Free Survival (PFS)
PFS as per IMWG by Investigator Assessment (ITT population, Safety population). PFS is defined as the time (in months) from randomization until the earliest date of documented PD per IMWG, or death due to any cause. For participants who neither progress nor die, the PFS will be censored at the date of their last adequate disease assessment. For participants who start a new anti-myeloma treatment, PFS will be censored at the date of the last adequate assessment before the start of the new treatment. For a randomized participant who does not have any post-baseline disease assessments and who has not died, PFS will be censored at the randomization date.
Measured: Up to 4 years
Part 1 and 2: Overall Survival (OS)
OS is defined as the time from first dose/randomization until death due to any cause. If a participant is not known to have died, survival time will be censored at the date of last contact ("last known date alive").
Measured: Up to 4 years
Part 1 and 2: Abnormal ocular findings
Number (%) of participants with abnormal ocular findings (on ophthalmic exam) (DLT evaluable population, Safety population).
Measured: Up to 4 years
Part 1 and 2:Pharmacokinetics (PK) Analysis
Concentration-time data: linear and semi-logistic unique profiles of concentration-time and the mean and median profiles (as applicable) will be graphically represented for belantamab mafodotin. Belantamab mafodotin concentrations will be presented for each participant and summarized (as applicable) at each PK timepoint.
Additionally, concentration-time and the mean and median profiles (as applicable) will be graphically represented for nirogacestat. Nirogacestat concentrations will be presented for each participant and summarized (as applicable) at each PK timepoint.
Measured: Up to 4 years
Part 1 and 2:Ocular symptoms and related impacts
Number of participants with changes from baseline and proportion of participants with within-participant meaningful change in self reported ocular symptoms and related impacts as measured by the OSDI questionnaire.
Measured: Up to 4 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Oct 2022
- Study start14 Jul 2023
- Primary completion31 Oct 2026 (estimated)
- Study completion31 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Multiple MyelomaStudies of the same condition, open and under way.
- 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 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hellenic Society of Hematology
- Sponsor type
- University, hospital or other
- Collaborators
- GlaxoSmithKline
- Responsible party
- Sponsor
- Investigators
- Evangelos Terpos, Prof, Principal investigator, Department of Clinical Therapeutics, School of Medicine, National Kapodistrian University of Athens (NKUA)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05573802
- Sponsor's protocol ID
- EAE128
- Status last verified
- Oct 2023
- First submitted
- 6 Oct 2022
- Last updated
- 24 Oct 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 24 Oct 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1/2, Dose and Schedule Evaluation Study to Investigate the Safety and Clinical Activity of Belantamab Mafodotin Administrated in Combination With Lenalidomide, Dexamethasone and Nirogacestat in Patients With Transplant Ineligible Newly Diagnosed Multiple Myeloma
- ClinicalTrials.gov ID
- NCT05573802
- Acronym / sponsor ID
- EAE128
- Conditions
- Multiple Myeloma, Neoplasms, Neoplasm, Plasma Cell, Gammopathy, Monoclonal, Paraproteinemias, Blood Protein Disorders
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Hellenic Society of HematologyUniversity, hospital or other
- Collaborators
- GlaxoSmithKline
- Study start
- 14 Jul 2023 (actual)
- Primary completion
- 31 Oct 2026 (estimated)
- Study completion
- 31 Oct 2026 (estimated)
- First posted
- 10 Oct 2022 (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 phase 1/2, open-label study designed to assess the safety and clinical activity of different belantamab mafodotin doses in combination with lenalidomide, dexamethasone and nirogacestat in patients with transplant ineligible newly diagnosed multiple myeloma.
This will be a 2-part study. In part 1 participants will be enrolled in one cohort to receive belantamab mafodotin in combination with lenalidomide, dexamethasone and nirogacestat and will determine the recommended phase 2 dose (RP2D) to be further evaluated for safety and clinical activity in the dose expansion cohort. The RP2D dose will be used in future studies in the transplant-ineligible newly diagnosed multiple myeloma (NDMM) setting. In the dose expansion phase (Part 2) an expansion cohort will be treated with the RP2D. The expansion cohort will randomize participants (1:1) in two groups to evaluate two alternate dose modification guidelines for corneal AEs. Part 2 of the study will also evaluate an alternative dose modification guideline for corneal adverse events (AEs).
Overall, approximately 36 participants will be enrolled in the study. Participant follow-up will continue up to 3 years after the last participant is enrolled (follow-up period range: 3-4 years). The estimated accrual period will be 12 months, corresponding to an approximate total study duration of 4 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Part 1 : Dose finding | Experimental | Drug: Belantamab Mafodotin-Blmf, Drug: Lenalidomide, Drug: Dexamethasone, Drug: NirogacestatBelantamab mafodotin will be administered as a combination therapy as a calculated dose on Day 1 of every other 28-day cycle. Belantamab mafodotin starting dose: • 1.4 mg/kg Q8W (i.e., on Day 1 of every other 28-day cycle) * Dose Level +1: 1.9 mg/kg Q8W * Dose Level -1: 1.0 mg/kg Q8W * Dose Level -2: 1.0 mg/kg Q12W Lenalidomide: 25 mg/d on day 1-21 of every 28-day cycle. Dexamethasone: 40 mg/d on days 1, 8, 15, 22 of every 28-day cycle in participants < 75 years; 20 mg/d on days 1, 8, 15, 22 of every 28-day cycle in participants ≥ 75 years Nirogacestat: 100 mg twice a day (BID) starting on day -3 and then each day of every other 28-day cycle (i.e., to be given only on cycles where belantamab mafodotin is administered). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (49 listed)
- Participant must be >18 years of age
- Monoclonal plasma cells in the bone marrow (BM) ≥10% or presence of a biopsy proven plasmacytoma and documented Multiple Myeloma (MM) satisfying at least one of the calcium, renal, anemia, bone (CRAB) criteria or biomarkers of malignancy criteria:
- Must have at least ONE aspect of measurable disease, defined as one of the following:
- Not a candidate for high-dose chemotherapy with autologous stem cell transplantation due to presence of significant comorbid condition(s), such as cardiac, pulmonary or other major organ dysfunction that are likely to have a negative impact on tolerability of high dose chemotherapy with stem cell transplantation. The patients will be assessed with the IMWG frailty index, a scoring system based on age, comorbidities, and cognitive and physical conditions, which is recommended by the European Society for Medical Oncology (ESMO) guidelines. Patients with International Myeloma Working Group (IMWG) frailty index score 1 or 2 will be considered transplant ineligible. The reason(s) for transplant ineligibility will be collected in the case report forms (CRFs).
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-2.
Key exclusion criteria (48 listed)
- Prior systemic therapy for MM or Smoldering MM.
- Peripheral neuropathy or neuropathic pain Grade 2 or higher, as defined by the National Cancer Institute Common Toxicity Criteria for AEs version 5.
- Major surgery within 2 weeks before the first dose of the study drug.
- Presence of active renal condition (infection, requirement for dialysis or any other significant condition that could affect the participant's safety). Participants with isolated proteinuria resulting from MM are eligible, provided that they fulfil the other inclusion criteria.
- Any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions (including laboratory abnormalities) that could interfere with the participant's safety, obtaining informed consent, or compliance with the study procedures.
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 |
|---|---|---|
| Belantamab Mafodotin-BlmfBlmf will be available as 100 mg/vial in single-use vial for reconstitution, supplied as lyophilized powder. Blmf will be delivered as IV solution over at least 30 minutes. | Drug | Part 1 : Dose finding |
| LenalidomideLenalidomide will be administered per os. | Drug | Part 1 : Dose finding |
| DexamethasoneDexamethasone will be administered intravenously or per os. | Drug | Part 1 : Dose finding |
| NirogacestatNirogacestat will be administrated each day for all subsequent cycles were Blmf is also administrated. | Drug | Part 1 : Dose finding |
Primary outcome
Part 1: Dose-Limiting Toxicity (DLT)
Time frame: Up to 28 days
The number (%) of participants with DLTs using the DLT evaluable population.
Part 1 and 2: Adverse Events (AEs) and Serious adverse events (SAEs)
Time frame: Up to 4 years
The number (%) of participants with AEs and SAEs using the DLT evaluable and Safety populations
Part 1 and 2: Ocular Toxicity
Time frame: Up to 4 years
The number (%) of participants with grade 2 or above KVA events
Part 2: Overall Response Rate (ORR)
Time frame: Up to 4 years
ORR as per International Myeloma Working Group (IMWG) by Investigator Assessment; defined as the percentage of participants with a confirmed Partial Response (PR), Very Good Partial Response (VGPR), Complete Response (CR) or stringent Complete Response sCR in the intent-to-treat (ITT) set.
14 secondary outcomes
Part 1 and 2: Lenalidomide Relative Dose Intensity (RDI)
Time frame: Up to 4 years
Part 1 and 2: Nirogacestat Relative Dose Intensity (RDI)
Time frame: Up to 4 years
Part 1 and 2: Cumulative dose of bentalamab mafodotin
Time frame: Up to 4 years
Part 1: Overall Response Rate (ORR)
Time frame: Up to 4 years
Part 1 and 2: Time To Response (TTR)
Time frame: Up to 4 years
Part 1 and 2: Duration of Response (DoR)
Time frame: Up to 4 years
Part 1 and 2: Complete Response Rate (CRR)
Time frame: Up to 4 years
Part 1 and 2: Very Good Partial Response (VGPR) or better
Time frame: Up to 4 years
Part 1 and 2: Minimal Residual Disease (MRD) negative rate
Time frame: Up to 4 years
Part 1 and 2: Progression Free Survival (PFS)
Time frame: Up to 4 years
Part 1 and 2: Overall Survival (OS)
Time frame: Up to 4 years
Part 1 and 2: Abnormal ocular findings
Time frame: Up to 4 years
Part 1 and 2:Pharmacokinetics (PK) Analysis
Time frame: Up to 4 years
Part 1 and 2:Ocular symptoms and related impacts
Time frame: Up to 4 years
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Oct 2023.
- Individual participant dataSharing planned: No
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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.
Evangelos Terpos, Prof principal investigator
Department of Clinical Therapeutics, School of Medicine, National Kapodistrian University of Athens (NKUA)
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Belantamab Mafodotin-Blmf, Lenalidomide and Dexamethasone in people with Multiple Myeloma and Neoplasms, run by Hellenic Society of Hematology at 2 sites in Greece.
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 49 inclusion and 48 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: status not confirmed, as of the sponsor's last update on 24 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Greece. 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Maria Pagoni, Dr (+302107211806, info@eae.gr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Part 1: Dose-Limiting Toxicity (DLT) (time frame: Up to 28 days). The study lists 4 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 24 Oct 2023.