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Multiple MyelomaPhase 2ROTATENCT06993675

Engaging T-cells to Eliminate MRD in Newly Diagnosed Myeloma Optimizing Response With Talquetmab and Teclistamab (ROTATE)

A Phase 2 study testing Talquetamab and Teclistamab in people with Multiple Myeloma, run by Noffar Bar at 3 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Multiple myeloma is characterized by a pattern of recurrent relapse and remains an incurable malignancy. Participants with minimal residual disease (MRD) after front line therapy with induction and transplant have worse prognosis than those with MRD negative disease. 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?
Talquetamab and Teclistamab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
3 sitesUnited States
Study dates
21 Aug 2025to Aug 2029
Phase
Phase 2
Are there results?
Not yet: the study is under way

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

  • To qualify for participation in this study, an individual must satisfy each of the following criteria:
  • Provision of signed and dated ICF.
  • Stated willingness to comply with all study procedures and availability for the duration of the study.
  • Male or female aged 18 years or older.
  • Newly diagnosed multiple myeloma participants who are transplant eligible and have completed at least four cycles of quadruplet, anti-CD38 antibody-based induction and have received HDM ASCT within 60-120 days. If consolidation with the same induction regimen is used post ASCT, enrolment up to 60 days post consolidation.
  • Must have MRD positive disease at 10-5 based on NGS with a PR or better response.
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  • Must not be progressing as per IMWG criteria
  • Eastern Cooperative Oncology Group (ECOG) Performance Status Scale of 0 or 1. ECOG 2 or 3 are eligible for the study if the ECOG PS score is related to stable physical limitations (e.g., wheelchair-bound due to prior spinal cord injury) and not related to multiple myeloma or associated therapy. Adequate bone marrow function:
  • Hemoglobin 8 g/dl (³5mmol/L; without prior RBC transfusion within 7 days before the laboratory test; recombinant human erythropoietin use is permitted).
  • Absolute neutrophil count ≥1.0×109/L (prior growth factor support is permitted but must be without support for 7 days for G-CSF or GM-CSF and for 14 days for pegylated-G-CSF).
  • Platelets ³75×109/L (without transfusion support or thrombopoietin receptor agonist within 7 days before the laboratory test).
  • Estimated creatinine clearance ≥30 mL/min based on the Cockcroft-Gault Equation (see https://www.mdcalc.com/calc/43/creatinine-clearance-cockcroft-gault-equation)
  • Must have adequate liver function:
  • Aspartate aminotransferase ≤2.5 folds of the upper limit of normal (ULN).
  • Alanine aminotransferase ≤2.5 folds of the ULN.
  • Serum bilirubin ≤ 1.5 x ULN (except in participants with congenital bilirubinemia, such as Gilbert syndrome where must be <5xULN).
  • Participants must adhere to the following reproductive and contraceptive requirements while on study treatment and for the specified duration after the last dose of talquetamab or teclistamab:
  • For participants receiving talquetamab, these criteria apply for three months after the last dose.
  • For participants receiving teclistamab, these criteria apply for five months for those assigned female at birth and three months for those assigned male at birth.
  • General Requirements:
  • Participants must not be pregnant or breastfeeding. ii. Participants must not donate gametes (i.e., eggs or sperm) or freeze gametes for future use related to assisted reproduction.
  • For participants of childbearing potential: Participant of childbearing potential is defined as an individual who is premenopausal and capable of becoming pregnant, including those using contraception, those who are single, or those with partners who have had a vasectomy.
  • A negative highly sensitive pregnancy test must be obtained at screening within 24 hours before the first dose of talquetamab (first study treatment), and participants must agree to further pregnancy tests throughout the study.
  • Participants must practice at least one highly effective method of contraception.
  • For Partners of Participants: i. If the participant's partner is of childbearing potential, the partner must also practice a highly effective method of contraception while the participant is on study treatment and for three months after the last dose of talquetamab or the last dose of teclistamab, unless the participant is vasectomized.
  • Highly effective methods of contraception include, but are not limited to: i. Combined hormonal contraception (estrogen and progestogen) that inhibits ovulation (oral, intravaginal, or transdermal).
  • Progestogen-only hormonal contraception that inhibits ovulation (oral, injectable, or implantable).
  • Intrauterine device (IUD). iv. Intrauterine hormone-releasing system. v. Bilateral tubal occlusion. vi. Sexual abstinence (the reliability of abstinence must be evaluated concerning the duration of the clinical study and the participant's lifestyle).
  • A vasectomized partner (provided the partner is the sole sexual partner of the WOCBP study participant and that the vasectomized partner has received medical confirmation of the surgical success).

Who cannot join

  • An individual who meets any of the following criteria will be excluded from participation in this study:
  • Prior or concurrent exposure to any of the following within the specified timeframe before first dose of study drug:
  • Targeted therapy, epigenetic therapy, or treatment with an investigational drug or an invasive investigational medical device within 21 days or ≥5 half-lives, whichever is less.
  • Investigational vaccine within four weeks.
  • Monoclonal antibody therapy within 21 days.
  • Cytotoxic therapy within 14 days.
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  • PI therapy within 14 days.
  • IMiD agent therapy within 14 days.
  • Radiotherapy within 14 days or focal radiation within seven days.
  • Gene-modified adoptive cell therapy (e.g., NK cells) within three months.
  • Prior exposure to a bispecific T-cell engager or CAR T-cell therapy.
  • An active or suspected infection at time of screening. For rescreening refer to section 5.5.
  • Known history or serologic evidence of human immunodeficiency virus (HIV) infection.
  • Known history, virologic, or serological evidence of hepatitis B or C virus (HBV/HCV) infection; participants who had HCV but have received an antiviral treatment and show no detectable HCV viral RNA for six months are eligible. Participants with no active hepatitis B infection (e.g., HBsAg negative, anti-HBcAb positive) who are under adequate prophylaxis per local standard of care against HBV reactivation may be eligible.
  • Class III or IV congestive heart failure.
  • Presence of clinically relevant CNS pathology.
  • Another active malignancy that requires treatment.
  • Pregnancy or lactation.
  • Known allergic reactions to components of talquetamab or teclistamab.
  • Received a cumulative dose of corticosteroids equivalent to ≥140 mg of prednisone within 14 days before first dose of study drug.
  • Received a live, attenuated vaccine within four weeks before the first dose of study drug.
  • Plasma cell leukemia, smoldering multiple myeloma, Waldenström's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes), or primary light chain amyloidosis.
  • Any active malignancy (i.e., progressing or requiring treatment change in the last 24 months) other than multiple myeloma. The only allowed exceptions are malignancies treated within the last 24 months that are considered cured:
  • Non-muscle invasive bladder cancer (solitary Ta-PUN-LMP or low grade, <3 cm, no CIS).
  • Non-melanoma skin cancers treated with curative therapy or localized melanoma treated with curative surgical resection alone.
  • Non-invasive cervical cancer.
  • Breast cancer: adequately treated lobular carcinoma in situ or ductal carcinoma in situ or history of localized breast cancer (anti-antihormonal therapy is permitted).
  • Localized prostate cancer (M0, N0) with a Gleason Score ≤7a, treated locally only (RP/RT/focal treatment).
  • Other malignancy that is considered cured with minimal risk of recurrence in consultation with the sponsor-investigator.
  • NOTE: In the event of any questions, consult with the sponsor-investigator prior to enrolling a participant.
  • Stroke, transient ischemic attack or seizure within six months prior to enrolment.
  • Presence of the following cardiac conditions:
  • New York Heart Association stage III or IV congestive heart failure (Appendix 5: New York Heart Association Functional Classification).
  • Myocardial infarction, unstable angina, or coronary artery bypass graft ≤6 months prior to randomization.
  • History of clinically significant ventricular arrhythmia or unexplained syncope, not believed to be vasovagal in nature or due to dehydration.
  • Uncontrolled cardiac arrhythmia or clinically significant ECG abnormalities.
  • Major surgery within two weeks prior to the start of administration of study treatment, or will not have fully recovered from surgery, or has major surgery planned during the time the participant is expected to be treated in the study or within two weeks after administration of the last dose of study treatment.
  • NOTE: Participants with planned surgical procedures to be conducted under local anesthesia may participate. Kyphoplasty or vertebroplasty are not considered major surgery. If there is a question whether a procedure is considered a major surgery, the investigator must consult with the appropriate sponsor representative and resolve any issues before enrolling a participant in the study.
  • Concurrent medical or psychiatric condition or disease that is likely to interfere with study procedures or results, or that in the opinion of the investigator would constitute a hazard for participating in this study, such as:
  • Acute diffuse infiltrative pulmonary disease
  • Evidence of active systemic viral, fungal, or bacterial infection, requiring systemic antimicrobial therapy
  • Active autoimmune disease requiring systemic immunosuppressive therapy within six months before start of study treatment. Exception: Participants with vitiligo, controlled type I diabetes, and prior autoimmune thyroid disease that is currently euthyroid based on clinical symptoms and laboratory testing are eligible regardless of when these conditions were diagnosed.
  • Disabling psychiatric conditions (e.g., alcohol or drug abuse), severe dementia, or altered mental status
  • Any other issue that would impair the ability of the participant to receive or tolerate the planned treatment at the investigational site, to understand informed consent or any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (e.g., compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments
  • History of noncompliance with recommended medical treatments.

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United States3 sites, 3 recruiting
  • Yale University

    New Haven, Connecticut, 06519

    Myeloma Clinical Research Team, 203-500-0834, daniel.moncayo@yale.edu

    Noffar Bar

    Recruiting
  • University of Nebraska Medical Center

    Omaha, Nebraska, 68198

    Kellee Halliburton, 402-559-1193, khalliburton@unmc.edu

    Sarah Holstein, MD

    Recruiting
  • Wilmot Cancer Center, Clinical Trial Office of the University of Rochester Medical Center

    Rochester, New York, 14642

    Marina Crouch, 585-275-5863, WCICTOResearch@URMC.Rochester.edu

    Brea Lipe, MD

    Recruiting

Other trials in United States

About this study

Official title: Improving MRD Negativity Rates in Newly Diagnosed Multiple Myeloma Patients: a Response-adaptive Approach of Consolidation With One or Two Bispecific T-cell Engagers Against GPRC5D or BCMA

Multiple myeloma is characterized by a pattern of recurrent relapse and remains an incurable malignancy. Participants with minimal residual disease (MRD) after front line therapy with induction and transplant have worse prognosis than those with MRD negative disease.

Bispecific T-cell-based immunotherapies have the potential to promote further reduction of malignant plasma cells thus improving rates of MRD negativity and improve patient outcomes. In this study, participants who are MRD positive after front line therapy will receive consolidation with GPRC5D-targeted bispecific talquetamab. We will test MRD negative conversion and if MRD negativity was not achieved, the participant will switch to a different target using the B-cell maturation antigen TCE, teclistamab. Consolidation will be continued for up to 1 year in participants who have achieved MRD negativity. After consolidation therapy on this protocol is complete, participants may continue to be treated with standardof- care (SOC) maintenance therapy.

Being tested
Talquetamab, Teclistamab
Keywords
minimal residual disease, ROTATE
Medical subject headings
Multiple Myeloma, Neoplasm, Residual

What participants receive

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

  • TalquetamabDrug

    Talquetamab is a GPRC5DxCD3 bispecific antibody. It is supplied as a sterile, preservative-free solution for subcutaneous administration.

  • TeclistamabDrug

    Teclistamab is a BCMAxCD3 bispecific antibody. It is supplied as a sterile, preservative-free solution for subcutaneous administration.

Study groups in NCT06993675
Study groupRoleWhat they receive
Arm 1ExperimentalTalquetamab is a GPRC5DxCD3 bispecific antibody. It is supplied as a sterile, preservative-free solution for subcutaneous administration. Teclistamab is a BCMAxCD3 bispecific antibody. It is supplied as a sterile, preservative-free solution for subcutaneous administration.
Receives: Drug: Talquetamab; Drug: Teclistamab

What is being measured

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

  1. Rate of MRD Negative Response at 10^-5 Sensitivity Using NGS ClonoSEQ Assay in Participants with Newly Diagnosed Multiple Myeloma Treated with Talquetamab Consolidation With or Without Sequential Teclistamab by 12 Months

    The primary outcome measure will evaluate the efficacy of talquetamab consolidation therapy, with or without the sequential use of teclistamab, by assessing the rate of minimal residual disease (MRD) negative response at a sensitivity level of 10^-5. This evaluation will be conducted using the next-generation sequencing (NGS) ClonoSEQ assay. The primary endpoint is the proportion of participants who achieve MRD negativity at 10^-5 sensitivity after consolidation therapy with talquetamab, with or without the sequential use of teclistamab, by 12 months from the start of treatment. MRD negative response is defined as the absence of detectable myeloma cells in bone marrow, as determined by the highly sensitive NGS ClonoSEQ assay. This measure aims to determine the depth of response and the potential of the treatment regimen to achieve sustained deep remission in participants with newly diagnosed multiple myeloma.

    Measured: 12 months from the start of treatment

Secondary outcomes (5)
  1. Complete Response and MRD-Negative Complete Response in Multiple Myeloma Patients Treated with Talquetamab Consolidation, With or Without Sequential Teclistamab

    To evaluate the achievement of complete response (CR) or better, including MRD-negative complete response, in patients with multiple myeloma who are treated with talquetamab as a consolidation therapy. The assessment will include both scenarios: talquetamab used alone and talquetamab followed by sequential teclistamab. This evaluation aims to provide insights into the depth of response and eradication of minimal residual disease in the treated cohorts.

    Measured: At baseline then at Cycle 7, each cycle is 28 days

  2. Assessment of Minimal Residual Disease (MRD) at 10^-6 Sensitivity in Multiple Myeloma Patients

    To assess the level of minimal residual disease (MRD) at a sensitivity threshold of 10^-6 in patients with multiple myeloma undergoing treatment. This high sensitivity assessment aims to determine the extent of disease eradication and to provide a deeper understanding of the effectiveness of the therapeutic regimen in achieving nearly undetectable levels of remaining cancer cells.

    Measured: At baseline then at Cycle 7, each cycle is 28 days

  3. Determination of Sustained MRD-Negative Rate at One Year in Multiple Myeloma Patients

    To determine the sustained minimal residual disease (MRD) negative rate one year post-treatment in patients with multiple myeloma. This measure aims to evaluate the durability of the MRD-negative status over a one-year period, providing insights into the long-term efficacy of the treatment regimen in maintaining deep and persistent disease remission.

    Measured: One year post-treatment

  4. Quality of Life Assessment via Patient-Reported Outcomes in Response to Treatment

    To evaluate the quality of life (QoL) of patients with multiple myeloma through patient-reported outcome measures in response to the treatment regimen. This assessment aims to capture the subjective experiences of patients, including physical, emotional, and social well-being, to gain a comprehensive understanding of how the treatment impacts their overall quality of life. Patient-reported outcomes will provide valuable insights into the effectiveness of the therapy from the perspective of those undergoing treatment.

    Measured: Day 1 of Cycles 1-6, where each cycle is 28 days, then at EOT(treatment durations is 15-24 months) and Safety Follow-Up visits(patients will be followed for 6 months)

  5. Assessment of Treatment-Related Adverse Events in Multiple Myeloma Patients

    To assess the incidence and severity of treatment-related adverse events in patients with multiple myeloma undergoing the specified therapeutic regimen. This evaluation aims to systematically document and analyze any negative side effects or complications associated with the treatment, providing crucial safety data and helping to weigh the risks against the potential benefits of the therapy.

    Measured: From baseline till the first safety follow-up visit; approximately 15-24 months

Timeline

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

  1. First posted29 May 2025
  2. Study start21 Aug 2025
  3. Primary completionAug 2029 (estimated)
  4. Study completionAug 2029 (estimated)

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06993675
Sponsor's protocol ID
2000038510
Acronym
ROTATE
Status last verified
Nov 2026
First submitted
12 May 2025
Last updated
6 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Talquetamab and Teclistamab in people with Multiple Myeloma, run by Noffar Bar at 3 sites in United States.

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 29 inclusion and 45 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: looking for participants now, as of the sponsor's last update on 6 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. 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 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Carole Ramm (203-785-5702, carole.ramm@yale.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of MRD Negative Response at 10^-5 Sensitivity Using NGS ClonoSEQ Assay in Participants with Newly Diagnosed Multiple Myeloma Treated with Talquetamab Consolidation With or Without Sequential Teclistamab by 12 Months (time frame: 12 months from the start of treatment). 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 6 Nov 2026.

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