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    Clinical Trial Results:
    A Multicentre Open label Phase II study of Daratumumab in AL Amyloidosis Patients not in VGPR or Better

    Summary
    EudraCT number
    2016-000287-42
    Trial protocol
    FR   IT  
    Global end of trial date
    27 Sep 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Feb 2021
    First version publication date
    27 Feb 2021
    Other versions
    Summary report(s)
    results
    Table1-Demographics and Baseline Characteristics

    Trial information

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    Trial identification
    Sponsor protocol code
    I15015
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02816476
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    CHU de Limoges
    Sponsor organisation address
    2 Avenue Martin Luther King, LImoges, France, 87042
    Public contact
    Abdeslam BENTALEB, CHU de Limoges, 33 0555058616, drc@chu-limoges.fr
    Scientific contact
    Arnaud JACCARD, CHU de Limoges, +33 0555058637, arnaud.jaccard@chu-limoges.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    02 Dec 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Sep 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To Assess Overall Hematologic Response Rate (CR + VGPR) at the completion of 6 cycles of Daratumumab in patients with AL Amyloidosis not in CR or VGPR after any previous therapy
    Protection of trial subjects
    The informed consent of a patient is obtained prior to any study related procedures as per Good Clinical Practices (GCP) as set forth in the ICH guidelines. Documentation that informed consent occurred prior to the patient’s entry into the study and of the informed consent process should be recorded in the patient’s source documents. In addition, if a protocol is amended and it impacts on the content of the informed consent, patients participating in the study when the amended protocol isimplemented must be re-consented with the revised version of the informed consent. The infusion is done under medical supervision and during hospitalization. Premedication and post medication are scheduled to avoid Infusion-related reactions. If infusion-related reactions occur, the infusion is paused/stoped Finally, a DSMB was set up to monitor the progress of the trial and the adverse effects.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Jun 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 36
    Country: Number of subjects enrolled
    Italy: 4
    Worldwide total number of subjects
    40
    EEA total number of subjects
    40
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    12
    From 65 to 84 years
    28
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This multicenter, single-arm, open-label, phase II study was conducted at 14 Intergroupe Francophone du Myélome (IFM) centers and one center in Italy, and enrolled between September 2016 and April 2018

    Pre-assignment
    Screening details
    Patients with biopsy proven systemic AL and measurable disease with a difference between serum involved and uninvolved free light chain (dFLC) > 50 mg/l were included in this trial provided they were in relapse or did not reach Very Good Partial Response (VGPR: dFLC<40 mg/l) after the last therapy. Patients with concomitant symptomatic MM, bone mar

    Period 1
    Period 1 title
    Treated patients (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Treated patients
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    daratumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Treatment comprised six 4-week cycles of intravenous (IV) daratumumab (16 mg/kg) on days 1, 8, 15 and 22 for the first 2 cycles, then every other week for cycles 3-6

    Number of subjects in period 1
    Treated patients
    Started
    40
    Completed
    40

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Treated patients
    Reporting group description
    -

    Reporting group values
    Treated patients Total
    Number of subjects
    40 40
    Age categorical
    49 patients were screened, 40 patients were included and received at least 4 injections of daratumumab. Table 1 summarizes baseline patient and disease characteristics. Median age was 69 years (range, 45–83). Overall, 24 (60%) patients had cardiac involvement, 26 (65%) had renal involvement, and 26 (65%) had 2 or more organs involved. The median dFLC level at baseline was 164 mg/l (IQR, 112-334) and 16/40 had a dFLC>180 mg/l. Median NT-proBNP at baseline was 916 ng/L (IQR, 285-2302). Twenty-one (52.5%) patients had a creatinine clearance below 60 ml/min. Median time from
    Units: Subjects
        Adults (18-64 years)
    1 1
        From 65-84 years
    39 39
    Age continuous
    Units: years
        median (standard deviation)
    69 ± 2.87 -
    Gender categorical
    Units: Subjects
        Female
    15 15
        Male
    25 25

    End points

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    End points reporting groups
    Reporting group title
    Treated patients
    Reporting group description
    -

    Primary: VGPR or better at the completion of 6 daratumumab cycles

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    End point title
    VGPR or better at the completion of 6 daratumumab cycles [1]
    End point description
    End point type
    Primary
    End point timeframe
    After 6 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Statistics reported for single cohort. No statistics for arms.
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: Number of patients
        number (not applicable)
    19
    No statistical analyses for this end point

    Secondary: Time to hematological response

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    End point title
    Time to hematological response
    End point description
    End point type
    Secondary
    End point timeframe
    at the completion of 6 cycles of Daratumumab
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: Days
        number (not applicable)
    7
    No statistical analyses for this end point

    Secondary: Time to best hematological response

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    End point title
    Time to best hematological response
    End point description
    End point type
    Secondary
    End point timeframe
    At six months
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: days
        number (not applicable)
    28
    No statistical analyses for this end point

    Secondary: Cardiac Response

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    End point title
    Cardiac Response
    End point description
    End point type
    Secondary
    End point timeframe
    At six months
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: Number of patients
        number (not applicable)
    7
    No statistical analyses for this end point

    Secondary: Progression-free survival (PFS),

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    End point title
    Progression-free survival (PFS),
    End point description
    End point type
    Secondary
    End point timeframe
    One year
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: percentage
    68
    No statistical analyses for this end point

    Secondary: overall survival (OS).

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    End point title
    overall survival (OS).
    End point description
    End point type
    Secondary
    End point timeframe
    At one year
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: percentage
    90
    No statistical analyses for this end point

    Secondary: Renal Response

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    End point title
    Renal Response
    End point description
    End point type
    Secondary
    End point timeframe
    At six months
    End point values
    Treated patients
    Number of subjects analysed
    40
    Units: Number of patients
        number (not applicable)
    8
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Until 30 days after the last dose of study drug, except for secondary malignancies (all throughout the study).
    Adverse event reporting additional description
    Toxicities were graded according to National Cancer Institute Common Toxicity Criteria of Adverse Events (version 4.0; Bethesda, MD).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22
    Reporting groups
    Reporting group title
    Treated patients
    Reporting group description
    -

    Serious adverse events
    Treated patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 40 (20.00%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vascular disorders
    Orthostatic hypotension
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Surgical and medical procedures
    Cardiac pacemaker insertion
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Ruptured cerebral aneurysm
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal sepsis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Treated patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 40 (72.50%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    5
    Hypotension
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Orthostatic hypotension
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    10 / 40 (25.00%)
         occurrences all number
    10
    Chest pain
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences all number
    1
    Fever
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    6
    Oedema
         subjects affected / exposed
    8 / 40 (20.00%)
         occurrences all number
    10
    Inflammation
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Chills
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    7 / 40 (17.50%)
         occurrences all number
    8
    Dyspnoea
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    6
    Rhinorrhoea
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Congenital, familial and genetic disorders
    Macroglossia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Neuropathy peripheral
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Eye disorders
    Conjunctival haemorrhage
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    9 / 40 (22.50%)
         occurrences all number
    11
    Constipation
         subjects affected / exposed
    6 / 40 (15.00%)
         occurrences all number
    6
    Nausea
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    5
    Vomiting
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Abdominal pain
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    3
    Myalgia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    9 / 40 (22.50%)
         occurrences all number
    9
    Pneumonia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Urinary tract infection
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Rhinitis
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Skin infection
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Hyperkalaemia Iron deficiency
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/32108228
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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