A Study to Examine the Effects of Novel Therapy Linvoseltamab in Combination With Other Cancer Treatments for Adult Participants With Multiple Myeloma That is Resistant to Current Standard of Care Treatments

Phase
Recruitment status
Participants
Lead sponsor
Regeneron Pharmaceuticals
Start date
Number of sites

Summary
This study is researching an experimental drug called linvoseltamab in combination with other drugs for the treatment of a blood cancer called multiple myeloma. Linvoseltamab has previously been studied as a single agent (without other cancer treatments) in participants with multiple myeloma that returned after prior therapies and needed to be treated again. In the initial study, some participants treated with linvoseltamab had improvement of their myeloma, including complete responses (no evidence of myeloma in their bodies). This study is the first time linvoseltamab will be combined with other cancer therapies. The main goal is to understand if linvoseltamab can be given safely with other cancer treatments, and if so, what dose of linvoseltamab should be used for each combination. The study is looking at several other research questions, including: * How many participants treated with linvoseltamab in combination with each of the other cancer treatments have improvement of their multiple myeloma * What side effects may happen from taking linvoseltamab together with another cancer treatment * How much study drug is in the blood at different times * Whether the body makes antibodies against the study drug(s) (which could make the study drug(s) less effective or could lead to side effects)
Short title
A Study to Examine the Effects of Novel Therapy Linvoseltamab in Combination With Other Cancer Treatments for Adult Participants With Multiple Myeloma That is Resistant to Current Standard of Care Treatments
Official title
Phase 1b Study of REGN5458 (Anti-BCMA x Anti-CD3 Bispecific Antibody) Plus Other Cancer Treatments for Patients With Relapsed/Refractory Multiple Myeloma

Control arm
Registry reports results
Listing at source
Recruitment status
Phase
Study type
Interventional

Completion date
First posted
Registry last updated
Primary completion date
Start date

Participants
Participant count basis
Planned participants
Protocol amendments
Number of sites

Data monitoring committee
Registry sponsor category
Lead sponsor
Regeneron Pharmaceuticals
Source registry
ClinicalTrials.gov

Registry ID
ClinicalTrials.gov ID
Registry record
Open registry record

Allocation
Not randomised
Model
Sequential
Purpose
Treatment
Masking
No masking
Sources for study design

  1. Incidence of Dose Limiting Toxicities (DLTs) for each study regimen during the observation period

    Timeframe: Up to 28 Days

    Dose finding portion only

  2. Incidence of Treatment-Emergent Adverse Events (TEAEs)

    Timeframe: Up to 5 Years

  3. Severity of TEAEs

    Timeframe: Up to 5 Years

  4. Incidence of Serious Adverse Events (SAEs)

    Timeframe: Up to 5 Years

  5. Severity of SAEs

    Timeframe: Up to 5 Years

  6. Incidence of Adverse Events of Special Interest (AESIs)

    Timeframe: Up to 5 Years

  7. Severity of AESIs

    Timeframe: Up to 5 Years

  8. Incidence of laboratory abnormalities

    Timeframe: Up to 5 Years

    ≥ grade 3 per National Cancer Institute-Common Terminology Criteria for Adverse Events \[NCI-CTCAE v5.0\]

  1. Overall Response Rate (ORR) as measured by International Myeloma Working Group (IMWG) criteria

    Timeframe: Up to 5 Years

  2. Duration of Response (DOR) by IMWG criteria

    Timeframe: Up to 5 Years

  3. Progression-Free Survival (PFS) as measured by IMWG criteria

    Timeframe: Up to 5 Years

  4. Rate of Minimal Residual Disease (MRD) negative status by IMWG criteria

    Timeframe: Up to 5 Years

  5. Concentrations of total linvoseltamab in serum over time

    Timeframe: Up to 5 Years

  6. Incidence over time of Anti-Drug Antibodies (ADAs) to linvoseltamab

    Timeframe: Up to 5 Years

  7. Overall Survival (OS)

    Timeframe: Up to 5 Years

Sources for outcomes

Sex
All
Age groups
Adults, Older adults
Minimum age
18 Years
Healthy volunteers
No

General Key Inclusion Criteria:

  1. Eastern Cooperative Oncology Group (ECOG) performance status ≤1
  2. Participants must have measurable disease as defined in the protocol according to IMWG consensus criteria
  3. Adequate creatinine clearance, hematologic function and hepatic function, as defined in protocol
  4. Life expectancy of at least 6 months

Cohort Specific Inclusion Criteria:

For cohorts 1-6, each participant must have RRMM with progression following at least 3 lines of therapy, or at least 2 lines of therapy and either prior exposure to at least 1 anti-CD38 antibody, 1 immunomodulatory imide drug (IMiD) and 1 Proteasome Inhibitor (PI), or double-refractory to 1 PI and 1 IMiD, or the combination of 1 PI and 1 IMiD Cohort 1: Prior treatment with daratumumab is allowed if previously tolerated, as described in the protocol Cohort 2: Prior treatment with carfilzomib is allowed if previously tolerated at the approved full dose, as described in the protocol Cohort 3: Prior treatment with lenalidomide is allowed if previously tolerated at the approved full dose, as described in the protocol Cohort 4: Prior treatment with bortezomib is allowed if previously tolerated at the approved full dose, as described in the protocol Cohort 5: Prior treatment with pomalidomide is allowed if previously tolerated at the approved full dose, as described in the protocol Cohort 6: Prior treatment with isatuximab is allowed if previously tolerated, as described in the protocol

Cohort 7 and 8:

  1. For participants without measurable disease by biochemical parameters [serum or urine M-protein, or serum involved Free Light Chain (FLC)], presence of at least 1 soft tissue plasmacytoma with a single diameter of ≥2 cm
  2. RRMM with progressive disease and received at least 3 lines of therapy including exposure to at least 1 anti-CD38 antibody, 1 IMiD, and 1 PI or triple-class refractory disease (anti-CD38 antibody, IMiD, PI) Cohort 9: Progressive RRMM in participants with triple-class refractory disease (anti-CD38 antibody, IMiD, PI) after at least 3 lines of therapy Cohort 10: Progressive RRMM after at least 3 lines of therapy including exposure to at least 1 anti-CD38 antibody, 1 IMiD, and 1 PI

General Key Exclusion Criteria:

  1. Diagnosis of plasma cell leukemia, primary light-chain amyloidosis (excluding myeloma associated amyloidosis), Waldenström macroglobulinemia (lymphoplasmacytic lymphoma), or POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, and Skin changes)
  2. Participants with known MM brain lesions or meningeal involvement
  3. Treatment with any systemic anti-myeloma therapy within 5 half-lives or within 21 days prior to first administration of study drug regimen, whichever is shorter
  4. History of allogeneic and autologous stem cell transplantation, as described in the protocol
  5. Unless stated otherwise in a specific sub-protocol, prior treatment with a T cell-based immunotherapy directed against B-Cell Maturation Antigen (BCMA) bispecific antibodies and Bispecific T-cell Engagers (BiTEs), and BCMA Chimeric Antigen Receptor (CAR) T cells (Note: BCMA antibody-drug conjugates are not excluded)
  6. History of progressive multifocal leukoencephalopathy, neurodegenerative condition or Central Nervous System (CNS) movement disorder or participants with a history of seizure within 12 months prior to study enrollment are excluded
  7. Live or attenuated vaccination within 28 days prior to first study drug regimen administration with a vector that has replicative potential
  8. Cardiac ejection fraction <40% by Echocardiogram (Echo) or Multigated Acquisition (MUGA) scan

Cohort Specific Exclusion Criteria:

Cohort 2: Dose expansion: Prior treatment with a BCMA-directed CAR T-cell therapy will not be exclusionary if completed at least 12 weeks prior to first study treatment Cohort 3: Known malabsorption syndrome or pre-existing gastrointestinal (GI) condition that may impair absorption of lenalidomide; delivery of lenalidomide via nasogastric tube or gastrostomy tube is not allowed Cohort 4: Peripheral neuropathy grade ≥2 Cohort 5: Known malabsorption syndrome or pre-existing GI conditions that may impair absorption of pomalidomide; delivery of pomalidomide via nasogastric tube or gastrostomy tube is not allowed

Cohort 7:

  1. Prior treatment with anti-Lymphocyte Activation Gene 3 (LAG-3) agents. Prior exposure to vaccine therapies or other immune checkpoint modulating therapies such as anti-Programmed cell Death Protein 1 (PD-1) antibodies is permitted, as described in the protocol
  2. Ongoing or recent (within 2 years) evidence of an autoimmune disease that has required systemic treatment with immunosuppressive agents, as described in the protocol
  3. Prior solid organ transplant
  4. History of grade ≥3 immune-mediated adverse events (with the exclusion of endocrinopathies that are fully controlled by hormone replacement) from prior checkpoint inhibitor therapies

Cohort 8:

  1. Prior treatment with anti-PD-1 or anti-PD-L1 agents. Prior exposure to vaccine therapies or other immune checkpoint modulating therapies such as anti-Cytotoxic T Lymphocyte-Associated Antigen 4 (CTLA-4) antibodies is permitted, as described in the protocol
  2. Encephalitis or meningitis in the year prior to enrollment
  3. History of interstitial lung disease (eg, idiopathic pulmonary fibrosis or organizing pneumonia), of active, noninfectious pneumonitis that required immune-suppressive doses of glucocorticoids to assist with management, or of pneumonitis within the last 5 years. A history of radiation pneumonitis in the radiation field is permitted as long as pneumonitis resolved ≥6 months prior to enrollment
  4. Ongoing or recent (within 2 years) evidence of an autoimmune disease that has required systemic treatment with immunosuppressive agents, as described in the protocol.
  5. Prior solid organ transplant
  6. History of grade ≥3 immune-mediated adverse events (with the exclusion of endocrinopathies that are fully controlled by hormone replacement) from prior checkpoint inhibitor therapies

Cohort 9:

  1. Abnormal QT interval corrected by Fridericia's formula (QTcF), as described in the protocol
  2. Use of concomitant medications that are known to prolong the QT/QTcF interval including Class Ia and Class III antiarrhythmics at the time of informed consent
  3. Ongoing use or anticipated use of food or drugs that are known strong/moderate cytochrome P450 (CYP)3A4 inhibitors, or strong CYP3A inducers within 14 days prior to first dose of nirogacestat
  4. Known malabsorption syndrome or existing gastrointestinal GI condition that may impair absorption of nirogacestat; delivery of nirogacestat via nasogastric tube or gastrostomy tube is not allowed

Cohort 10:

  1. Known or suspected active Epstein-Barr Virus (EBV) infection
  2. Known history of Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome (HLH/MAS)
  3. Prior treatment with cevostamab or another agent with the same target [Fragment crystallizable Receptor-like 5 (FcRH5)]

Dose finding portion: Prior treatment with any BCMA-directed immunotherapy will not be exclusionary, as described in the protocol Dose expansion portion: Prior treatment with any T cell-engaging bispecific antibody directed against BCMA will be exclusionary, as described in the protocol

NOTE: Other protocol defined inclusion/exclusion criteria apply

Sources for eligibility

  • Scripps Clinic Torrey PinesLa Jolla, United StatesRecruiting
  • Winship Cancer Institute of Emory UniversityAtlanta, United StatesRecruiting
  • Indiana University Health Simon Cancer CenterIndianapolis, United StatesRecruiting
  • Dana Farber/Harvard Cancer CenterBoston, United StatesRecruiting
  • Karmanos Cancer InstituteDetroit, United StatesRecruiting
  • Mayo ClinicRochester, United StatesRecruiting
  • Weill Cornell Medicine/New York Presbyterian HospitalNew York, United StatesRecruiting
  • New York Presbyterian Hospital Columbia University Medical CenterNew York, United StatesRecruiting
  • University of North Carolina at Chapel HillChapel Hill, United StatesRecruiting
  • Wake Forest University Health SciencesWinston-Salem, United StatesRecruiting
  • The Ohio State University James Cancer HospitalColumbus, United StatesRecruiting
  • University of Texas SouthwesternDallas, United StatesRecruiting
  • VA Puget Sound Health Care SystemSeattle, United StatesRecruiting
  • Centre Hospitalier Universitaire (CHU) de PoitiersPoitiers, FranceRecruiting
  • CHU de Lille - Rue Michel PolonovskiLille, FranceSuspended
  • Nantes University HospitalNantes, FranceRecruiting
  • Centre Hospitalier Universitaire AngersAngers, FranceRecruiting
  • CHU Montpellier - Departement D'HematologieMontpellier, FranceRecruiting
  • Saint Antoine HospitalParis, FranceRecruiting
  • Institut Gustave RoussyVillejuif, FranceRecruiting
  • Hospital Henri MondorCréteil, FranceRecruiting
  • Saint Louis HospitalParis, FranceRecruiting
  • Hopital NeckerParis, FranceRecruiting
  • Evangelismos General HospitalAthens, GreeceRecruiting
  • General Hospital of Athens AlexandraAthens, GreeceRecruiting

And 17 more, listed on the interactive page.

Sources for sites

  • 2023
  • 2023-506247-42-00
  • 2020-004638-39
Sources for references

Related records

Drugs (11)

Lead sponsors (1)

Conditions (1)

Targets (51)