Multiple Myeloma Clinical Trial
A Study Evaluating the Efficacy and Safety of Cevostamab in Prior B Cell Maturation Antigen (BCMA)-Exposed Participants With Relapsed/Refractory Multiple Myeloma
Summary
This study will evaluate the efficacy, safety, and pharmacokinetics of cevostamab in participants with refractory multiple myeloma (R/R MM) via intravenous (IV) infusion.
Eligibility Criteria
Inclusion Criteria:
Documented diagnosis of MM based on standard International Myeloma Working Group (IMWG) criteria
Evidence of progressive disease based on investigators determination of response by IMWG criteria on or after their last dosing regimen
Prior BCMA ADC or CAR-T Cohort: participants who have received a BCMA-targeted CAR-T or ADC therapy and are triple-class refractory
Prior BCMA Bispecific Cohort: participants who have received a BCMA-targeting T-cell-dependent bispecific (TDB) antibody and are triple-class refractory
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
Life expectancy is at least 12 weeks
Agreement to protocol-specified assessments, including bone marrow biopsy and aspirate samples as detailed in the protocol
Resolution of AEs from prior anti-cancer therapy to Grade =< 1
For female participants of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception during the treatment period and for at least 5 months after the final dose of cevostamab and for 3 months after the last dose of tocilizumab was administered
For male participants: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agree to refrain from donating sperm during the treatment period and for at least 2 months after the final dose of tocilizumab (if applicable) to avoid exposing the embryo
Exclusion Criteria:
Inability to comply with protocol-mandated hospitalization
Pregnancy or breastfeeding, or intention of becoming pregnant during the study or within 5 months after the final dose of cevostamab or tocilizumab or within 3 months after the last dose of tocilizumab (if applicable)
Prior treatment with cevostamab or another agent with the same target
Prior BCMA ADC or CAR-T Cohort: prior treatment with any T cell dependent bi-specific antibody (TDB) antibody including non BCMA targeting TDB
Prior use of any monoclonal antibody (mAb), radioimmunoconjugate, or ADC as anti-cancer therapy within 4 weeks before first study treatment, except for the use of non-myeloma therapy
Prior treatment with systemic immunotherapeutic agents
Prior treatment with CAR-T cell therapy within 12 weeks before first cevostamab infusion
Known treatment-related, immune-mediated adverse events associated with prior checkpoint inhibitors
Treatment with radiotherapy, any chemotherapeutic agent, or treatment with any other anti-cancer agent within 4 weeks or 5 half-lives of the drug, whichever is shorter, prior to first study treatment
Autologous stem cell transplantation (SCT) within 100 days prior to first study treatment
Prior allogeneic SCT
Circulating plasma cell count exceeding 500/ microliter (µL) or 5% of the peripheral blood white cells
Prior solid organ transplantation
History of autoimmune disease
History of confirmed progressive multifocal leukoencephalopathy
History of severe allergic or anaphylactic reactions to mAb therapy
Known history of amyloidosis
Lesions in proximity of vital organs that may develop sudden decompensation/deterioration in the setting of a tumor flare
History of other malignancy within 2 years prior to screening, except those with negligible risk of metastasis or death, such as ductal carcinoma in situ not requiring chemotherapy, appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, low-grade, localized prostate cancer not requiring treatment or appropriately treated Stage I uterine cancer
Current or past history of central nervous system (CNS) disease, such as stroke, epilepsy, CNS vasculitis, neurodegenerative disease, or CNS involvement by MM
Significant cardiovascular disease that may limit a potential participant's ability to adequately respond to a cytokine release syndrome (CRS) event
Symptomatic active pulmonary disease or requiring supplemental oxygen
Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection at study enrollment, or any major episode of infection requiring treatment with IV (intravenous) antimicrobials where the last dose of IV antimicrobial was given within 14 days prior to first study treatment
Active symptomatic COVID-19 infection at study enrollment or requiring treatment with IV antiviral where the last dose of IV antiviral treatment was given within 14 days prior to first study treatment. Participants with active COVID-19 infection must have clinical recovery and two negative antigen tests at least 24 hours apart prior to first study treatment
Positive and quantifiable Epstein-Barr virus (EBV) polymerase chain reaction (PCR) or cytomegalovirus (CMV) PCR prior to first study treatment
Known or suspected chronic active EBV infection
Known history of Grade >=3 CRS or immune effector cell-associated neurotoxicity syndrome (ICANS) with prior bispecific therapies
Known history of hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS)
Recent major surgery within 4 weeks prior to first study treatment
Positive serologic or PCR test results for acute or chronic hepatitis B virus (HBV) infection
Acute or chronic hepatitis C virus (HCV) infection
Known history of human immunodeficiency virus (HIV) seropositivity
Administration of a live, attenuated vaccine within 4 weeks before first study treatment or anticipation that such a live attenuated vaccine will be required during the study
Treatment with systemic immunosuppressive medications, with the exception of corticosteroid treatment <= 10 mg/day prednisone or equivalent, within 2 weeks prior to first study treatment
History of illicit drug or alcohol abuse within 12 months prior to screening, in the investigator's judgment
Any medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the participant's safe participation in and completion of the study, or which could affect compliance with the protocol or interpretation of results
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There are 25 Locations for this study
Phoenix Arizona, 85054, United States
Jacksonville Florida, 32224, United States
Boston Massachusetts, 02215, United States
Rochester Minnesota, 55905, United States
New York New York, 10029, United States
New York New York, 10065, United States
Nashville Tennessee, 37203, United States
San Antonio Texas, 78229, United States
Salt Lake City Utah, 84112, United States
Waratah New South Wales, 2298, Australia
Melbourne Victoria, 3065, Australia
Leuven , 3000, Belgium
Hamburg , 20246, Germany
Jerusalem , 91120, Israel
Ramat Gan , 52621, Israel
Tel-Aviv , 64239, Israel
Bologna Emilia-Romagna, 40138, Italy
Bergamo Lombardia, 24127, Italy
Milano Lombardia, 20133, Italy
Torino Piemonte, 10126, Italy
Pamplona Navarra, 31008, Spain
Barcelona , 08036, Spain
Madrid , 28027, Spain
Madrid , 28041, Spain
Valencia , 46026, Spain
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