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    Summary
    EudraCT Number:2016-002122-36
    Sponsor's Protocol Code Number:64007957MMY1001
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Trial now transitioned
    Date on which this record was first entered in the EudraCT database:2021-08-31
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2016-002122-36
    A.3Full title of the trial
    A Phase 1/2, First-in-Human, Open-Label, Dose Escalation Study of Teclistamab, a Humanized BCMA x CD3 Bispecific Antibody, in Subjects with Relapsed or Refractory Multiple Myeloma
    Studio di fase 1/2, svolto per la prima volta sugli esseri umani, in aperto, con incremento della dose di Teclistamab, un anticorpo umanizzato bispecifico per BCMA e CD3, in soggetti affetti da mieloma multiplo recidivante o refrattario.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An Open label Study of Teclistamab in Subjects with Relapsed or Refractory Multiple Myeloma
    Studio in aperto con Teclistamab in soggetti con mieloma multiplo recidivante o refrattario
    A.3.2Name or abbreviated title of the trial where available
    A Phase 1/2, First-in-Human, Open-Label, Dose Escalation Study of Teclistamab, a Humanized BCMA x CD
    Studio di fase 1/2, svolto per la prima volta sugli esseri umani, in aperto, con incremento della do
    A.4.1Sponsor's protocol code number64007957MMY1001
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorJANSSEN CILAG INTERNATIONAL NV
    B.1.3.4CountryBelgium
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportJanssen Research & Development, LLC
    B.4.2CountryUnited States
    B.4.1Name of organisation providing supportJANSSEN CILAG SPA
    B.4.2CountryItaly
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International NV
    B.5.2Functional name of contact pointClinical Registry Group
    B.5.3 Address:
    B.5.3.1Street AddressArchimedesweg 29
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 CM
    B.5.3.4CountryNetherlands
    B.5.4Telephone number0031715242166
    B.5.5Fax number0031715242110
    B.5.6E-mailClinicalTrialsEU@its.jnj.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2331
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameD.3.6.1.1 - valore: Dose iniziale di 0.3 µg/kg_Giorno (D) 1 e 15 in cicli di 28 giorni oppure D1,8 e 15 in cicli di 21 giorni oppure 2 volte a settimana (D1,4,8,11, 15,18); dose di avvio come da schedula D.3.6.1.2 - unità: µg/kg
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnticorpo umanizzato IgG4 bi-specifico contro BCMA e CD3
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2331
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameD.3.6.1.1 - valore: PARTE 1 e 2 : Giorno (D) 1, 8 e 15 in cicli di 21 giorni oppure 2 volte a settimana (D1,4,8,11, 15,18) in cicli di 21 giorni; dose di avvio come da schedula; PARTE 3: SC Teclistamab a 60 e 300 µg/kg (dosi di avvio) seguito da dose di trattamento settimanale 1500 µg/kg
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnticorpo bi-specifico umanizzato IgG4 contro BCMA e CD3
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameD.3.6.1.1 - valore: Dose iniziale di 0.3 µg/kg_ Giorno (D) 1 e 15 in cicli di 28 giorni oppure D1,8 e 15 in cicli di 21 giorni oppure 2 volte a settimana (D1,4,8,11, 15,18); dose di avvio come da schedula D.3.6.1.2 - unità: µg/kg
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number180
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnticorpo humanizzato IgG4 bi-specifico contro BCMA e CD3
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameD.3.6.1.1 - valore: PARTE 1 e 2 : Giorno (D) 1, 8 e 15 in cicli di 21 giorni oppure 2 volte a settimana (D1,4,8,11, 15,18) in cicli di 21 giorni; dose di avvio come da schedula; PARTE 3: SC Teclistamab a 60 e 300 µg/kg (dosi di avvio) seguito da dose di trattamento settimanale 1500 µg/kg
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number180
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnticorpo umanizzato IgG4 bi- specifico contro BCMA e CD3
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2331
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeNJ-64007957
    D.3.9.3Other descriptive nameDose (valore e unità): PARTE 1 e 2 : Giorno (D) 1, 8 e 15 in cicli di 21 giorni oppure 2 volte a settimana (D1,4,8,11, 15,18) in cicli di 21 giorni; dose di avvio come da schedula; PARTE 3: SC Teclistamab a 60 e 300 µg/kg (dosi di avvio) seguito da dose di trattamento settimanale 1500 µg/kg - unità:µg/kg
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number144
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnticorpo umanizzato IgG4 bi-specifico contro BCMA e CD3
    D.IMP: 6
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2331
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameDose (valore e unità): PARTE 1 e 2 : Giorno (D) 1, 8 e 15 in cicli di 21 giorni oppure 2 volte a settimana (D1,4,8,11, 15,18) in cicli di 21 giorni; dose di avvio come da schedula; PARTE 3: SC Teclistamab a 60 e 300 µg/kg (dosi di avvio) seguito da dose di trattamento settimanale 1500 µg/kg - unità:µg/kg
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnticorpo umanizzato IgG4 bi-specifico contro BCMA e CD3
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Relapsed or Refractory Multiple Myeloma
    Mieloma Multiplo Recidivante o Refrattario
    E.1.1.1Medical condition in easily understood language
    Multiple Myeloma
    Mieloma Multiplo
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level HLGT
    E.1.2Classification code 10005330
    E.1.2Term Blood and lymphatic system disorders congenital
    E.1.2System Organ Class 10010331 - Congenital, familial and genetic disorders
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    •Part 1 (Dose Escalation): To identify the recommended Phase 2 dose(s) and schedule assessed to be safe for JNJ-64007957
    •Part 2 (Dose Expansion): To characterize the safety and tolerability of JNJ-64007957 at the recommended Phase 2 dose(s) (RP2Ds)
    •Part 3 (Phase 2): To evaluate the efficacy of teclistamab at the RP2D
    • Parte 1 (incremento della dose): Identificare la/le RP2D proposta/e e programmare la valutazione di sicurezza per teclistamab
    • Parte 2 (espansione della dose): Caratterizzare la sicurezza e la tollerabilità di teclistamab alla/e RP2D proposta/e
    • Parte 3 (Fase 2): Valutare l’efficacia di teclistamab alla RP2D
    E.2.2Secondary objectives of the trial
    •To characterize the pharmacokinetics and pharmacodynamics of JNJ-64007957
    •To assess the immunogenicity of JNJ 64007957
    •To evaluate the preliminary antitumor activity of JNJ 64007957 at the RP2D(s) in Part 2
    Part 3:
    •To further assess the efficacy of teclistamab at the RP2D
    •To evaluate MRD at the RP2D
    •To further assess the safety and tolerability of teclistamab at the RP2D
    • Caratterizzare la farmacocinetica e la farmacodinamica di teclistamab
    • Valutare l’attività antitumorale preliminare di teclistamab alla/e RP2D proposta/e nella Parte
    • Valutare l'attività antitumorale preliminare di JNJ 64007957 all'RP2D (s) nella Parte 2
    Parte 3:
    • Valutare ulteriormente l’efficacia di teclistamab alla RP2D
    • Valutare MRD alla RP2D
    • Valutare ulteriormente la sicurezza e la tollerabilità di teclistamab alla RP2D
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. >=18 years of age.
    2. Documented diagnosis of MM according to IMWG diagnostic criteria.
    3. Part 1 and Part 2
    Measurable MM that is relapsed or refractory to established therapies with known clinical benefit in relapsed/refractory MM or be intolerant of those established MM therapies, and a candidate for teclistamab treatment in the opinion of the treating physician. Prior lines of therapy must include a PI, an IMiD and an anti-CD38 monoclonal antibody in any order during the course of treatment. Subjects who could not tolerate a PI, IMiD, or an anti-CD38 monoclonal antibody are allowed. In Part 2 (dose expansion), in addition to above criteria, MM must be measurable central lab assessment is not available, relevant local lab measurement must exceed the minimum required level by at least 25%.
    Part 3
    Measurable disease
    Cohort A, B,C: MM must be measurable by central lab assessment:
    • Serum monoclonal paraprotein (M-protein) level =1.0 g/dL or urine Mprotein level =200 mg/24 hours; or
    • Light chain MM without measurable disease in the serum or the urine:
    Serum immunoglobulin free light chain (FLC) =10 mg/dL and abnormal serum immunoglobulin kappa lambda FLC ratio. If central lab assessments are not available, relevant local lab measurements must exceed the min required level by at least 25%.
    Prior treatment:
    • Cohort A: Subjects must have 1) received >=3 prior lines of therapy or be double refractory to a PI and IMiD and 2) previously received a PI, an IMiD, and an anti-CD38 monoclonal antibody
    - Cohort B: received >=4 prior lines of therapy and whose disease is penta-drug refractory to an anti-CD38 monoclonal antibody, =2 PIs, =2 IMiDs (refractory multiple myeloma as defined by IMWG consensus criteria).
    - Cohort C: received >=3 prior lines of therapy that included a PI, an IMiD, an anti-CD38 monoclonal antibody, and an anti-BCMA treatment (with CAR-T cells or an ADC).

    For full inclusion criteria, refer to section 4.1 inclusion criteria of the protocol.
    Ogni potenziale soggetto deve soddisfare tutti i seguenti criteri per essere arruolato nello studio:
    1. Età >=18 anni
    2. Diagnosi documentata di mieloma multiplo secondo i criteri diagnostici dell’IMWG
    (Allegato 8).
    3. Parte 1 e Parte 2
    il soggetto deve avere diagnosi di mieloma multiplo misurabile, recidivante/refrattario alle terapie con consolidato beneficio clinico nella suddetta patologia o intollerante a tali terapie stabilite per il mieloma multiplo, e deve essere un candidato per il trattamento con teclistamab, secondo il parere del medico. Le linee di terapia precedenti devono includere un inibitore della proteasi (Protease Inhibitor, PI), un farmaco immide immunomodulatorio (Immunomodulatory imide Drug, IMiD) e un anticorpo monoclonale anti-CD38 in qualsiasi ordine durante il corso del trattamento (Allegato 9). I soggetti che non possono tollerare un PI, un IMiD o un anticorpo monoclonale anti-CD38 sono consentiti.
    Nella Parte 2 (espansione della dose), oltre ai criteri sopra indicati, il mieloma multiplo deve essere misurabile secondo le linee guida pubblicate dall’International Myeloma Working Group (IMWG) attualmente in vigore mediante valutazione del laboratorio centrale. Se la valutazione del laboratorio centralizzato non è disponibile, la misurazione locale laboratorio pertinente deve superare il livello minimo richiesto di almeno il 25%.
    Parte 3
    Malattia misurabile
    Coorte A, Coorte B e Coorte C: Il mieloma multiplo deve essere misurabile mediante valutazione del laboratorio centrale:
    - Livello sierico di paraproteina monoclonale (proteina M) >=1,0 g/dL o livello urinario di proteina M >=200 mg/24 ore; oppure
    - Mieloma multiplo a catena leggera senza malattia misurabile nel siero o nelle urine:
    Immunoglobuline sieriche a catena leggera libera (Free Light Chain, FLC) >=10 mg/dL e rapporto FLC kappa/lambda delle immunoglobuline sieriche anomalo.
    Se le valutazioni del laboratorio centrale non sono disponibili, le misurazioni del laboratorio locale pertinenti devono superare il livello minimo richiesto di almeno il 25%.
    Trattamento precedente
    • Coorte A: i soggetti devono avere 1) ricevuto >=3 linee di terapia precedenti e 2) ricevuto in precedenza un PI, un IMiD e un anticorpo monoclonale anti-CD38 (mieloma multiplo refrattario come definito dai criteri dell’IMWG).
    • Coorte B: devono aver ricevuto =4 linee di terapia precedenti e con una malattia penta-refrattaria ad un anticorpo monoclonale anti-CD38, =2 PI, =2 IMiD
    (mieloma multiplo refrattario secondo i criteri dell’IMWG).
    • Coorte C: devono aver ricevuto =3 linee di terapia precedenti che includono un PI, un IMiD, un anticorpo monoclonale anti-CD38, e una terapia anti-BCMA (che impiega cellule T CAR-T o un anticorpo farmaco-coniugato ADC).

    Per l'elenco completo dei criteri d'inclusione si prega di fare riferimento alla sezione 4.1 criteri di inclusione del protocollo.
    E.4Principal exclusion criteria
    1. Prior treatment with any BCMA-targeted therapy with the exception of Cohort C in Part 3.
    2. Prior antitumor therapy as follows, before the first dose of study drug:
    -Targeted therapy, epigenetic therapy, or treatment with an investigational drug or used an invasive investigational medical device within 21 days or at least 5 half-lives, whichever is less.
    -Monoclonal antibody treatment for multiple myeloma within 21 days
    -Cytotoxic therapy within 21 days
    -Proteasome inhibitor therapy within 14 days
    -Immunomodulatory agent therapy within 7 days
    -Gene modified adoptive cell therapy (eg, chimeric antigen receptor modified T cells, natural killer [NK] cells) within 3 months
    -Radiotherapy within 14 days or focal radiation within 7 days.
    3. Toxicities from previous anticancer therapies that have not resolved to baseline levels or to Grade 1 or less except for alopecia or peripheral neuropathy.
    4. Received a cumulative dose of corticosteroids equivalent to >=140 mg of prednisone within the 14-day period before the first dose of study drug. (does not include pretreatment medication)
    5. Stem cell transplantation:
    -An allogeneic stem cell transplant within 6 months. Subjects who received an allogeneic transplant must be off all immunosuppressive medications for 6 weeks without signs of graft-versus-host disease.
    -Received an autologous stem cell transplant <=12 weeks before the first dose of study drug.
    6. Known active CNS involvement or exhibits clinical signs of meningeal involvement of multiple myeloma.
    7. Plasma cell leukemia (>2.0 x 10 to the 9th/L plasma cells by standard differential), Waldenström's macroglobulinemia, POEMS syndrome
    (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes), or primary amyloid light-chain amyloidosis.
    8. Known to be seropositive for human immunodeficiency virus or acquired immune deficiency syndrome
    9. Hepatitis B infection or at risk for hepatitis B virus reactivation as defined according to the American Society of Clinical Oncology guidelines.2,22 Eligibility will be determined by the investigator as described in Attachment 14. In the event the infection status is unclear, quantitative levels are necessary to determine the
    infection status (Attachment 14). Active Hepatitis C infection as measured by positive hepatitis C virus (HCV)-RNA testing. Subjects with a history of HCV antibody positivity must undergo HCV-RNA testing.
    10. Pulmonary compromise requiring supplemental oxygen use to maintain adequate oxygenation.
    11. Known allergies, hypersensitivity, or intolerance to excipients of the study drug (teclistamab) or its excipients.

    For full exclusion criteria, refer to pg 117-121 of the protocol.
    Sarà escluso dalla partecipazione ogni potenziale soggetto che soddisfi uno dei seguenti
    criteri in qualsiasi parte dello studio:
    1. Precedente trattamento con qualsiasi terapia mirata a BCMA, ad eccezione della Coorte C nella Parte 3.
    2. Precedente terapia antitumorale come segue, prima della prima dose del farmaco distudio:
    • Terapia mirata, terapia epigenetica o trattamento con un farmaco sperimentale o uso di un dispositivo medico sperimentale invasivo entro 21 giorni o almeno 5 emivite, a seconda di quale sia il periodo più breve.
    • Trattamento con anticorpi monoclonali per il mieloma multiplo entro 21 giorni.
    • Terapia citotossica entro 21 giorni.
    • Terapia con inibitori del proteasoma entro 14 giorni.
    • Terapia immunomodulatoria entro 7 giorni.
    • Terapia di cellule adottive modificate geneticamente (Es., cellule T, cellule natural killer [NK] modificate dal recettore chimerico dell'antigene) entro 3 mesi
    • Radioterapia entro 14 giorni o radioterapia focale entro 7 giorni.
    3. Tossicità da precedenti terapie antitumorali che non si sono stabilizzate ai livelli basali o al Grado 1 o meno, ad eccezione dell’alopecia o della neuropatia periferica.
    4. Ha ricevuto una dose cumulativa di corticosteroidi equivalente a >=140 mg di prednisone entro 14 giorni antecedenti la prima dose del farmaco dello studio (non include i farmaci di pre-trattamento) (Allegato 13).
    5. Trapianto di cellule staminali:
    • Un trapianto allogenico di cellule staminali entro 6 mesi. I soggetti che hanno ricevuto un trapianto allogenico devono aver sospeso tutti i farmaci immunosoppressori da 6 settimane senza segni di malattia del trapianto contro l’ospite.
    • Ha ricevuto un trapianto autologo di cellule staminali <=12 settimane prima della prima dose del farmaco dello studio.
    6. Noto coinvolgimento attivo del SNC o mostra segni clinici di coinvolgimento meningeale del mieloma multiplo.
    7. Leucemia da plasmacellule (>2,0×10^9/l plasmacellule in base al differenziale standard), macroglobulinemia di Waldenström, sindrome POEMS [Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Protein and skin changes (polineuropatia, organomegalia, endocrinopatia, proteina monoclonale e alterazioni cutanee)] o amiloidosi primaria da amiloide a catena leggera.
    8. Nota sieropositività al virus dell’immunodeficienza umana o sindrome da immunodeficienza acquisita.
    9. Infezione da epatite B o a rischio di riattivazione del virus dell’epatite B secondo le linee guida dell’American Society of Clinical Oncology.2,22 L’idoneità sarà determinata dallo sperimentatore come descritto nell’Allegato 14. Nel caso in cui lo stato dell’infezione non sia chiaro, sono necessari livelli quantitativi per determinare lo stato dell’infezione (Allegato 14). Infezione da epatite C attiva misurata mediante test positivo del virus dell’epatite C (Hepatitis C Virus, HCV). I soggetti con un’ anamnesi di positività agli anticorpi anti-HCV devono sottoporsi al test dell’RNA dell’ HCV.
    10. Compromissione polmonare che richiede un uso di ossigeno supplementare per mantenere un’ossigenazione adeguata.
    11. Allergie note, ipersensibilità o intolleranza al farmaco dello studio (teclistamab) o ai suoi eccipienti.

    Per l'elenco completo dei criteri di esclusione fare riferimento al protocollo pag.117- 121.
    E.5 End points
    E.5.1Primary end point(s)
    •Part 1 (Dose Escalation): Frequency and type of dose-limiting toxicity (DLT)
    •Part 2 (Dose Expansion): Occurrence and severity of adverse events, serious adverse events, and laboratory values
    •Part 3 (Phase 2): ORR (PR or better) as defined by the IMWG criteria
    • Parte 1 (incremento della dose): Frequenza e tipo di DLT
    • Parte 2 (espansione della dose): Manifestazione e gravità di eventi avversi, eventi avversi seri e valori di laboratorio
    • Parte 3 (Fase 2) ORR (PR o migliore) come definito dai criteri dell’IMWG
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to day 21 for standard dose and up to day 28 for priming dose
    2. From signing of Informed Consent Form (ICF) up to follow up (approximately up to 6 months)
    3. Up to 2 years
    1. Fino al giorno 21 per la dose standard e fino al giorno 28 per la dose di avvio
    2. Dalla firma del Modulo di consenso informato (ICF) al follow-up (fino a 6 mesi circa)
    3. Fino a 2 anni
    E.5.2Secondary end point(s)
    Parts 1 & 2:
    1. Pharmacokinetic parameters and pharmacodynamic markers including but not limited to depletion of BCMA expressing cells, systemic cytokine concentrations, and markers of T cell activation
    2. Assess response rate including ORR as defined by IMWG response criteria
    3. progression-free survival (PFS)
    4. overall survival (OS)
    Part 3:
    1. DOR
    2. Assess additional response parameters as defined by IMWG response criteria
    3. PFS
    4. OS
    5. MRD-negative status
    6. Occurence and severity of adverse events, serious adverse events, and laboratory values
    Parti 1 e 2:
    1.Parametri farmacocinetici e marcatori farmacodinamici, inclusi, ma non limitati alla deplezione delle cellule che esprimono BCMA, alle concentrazioni di citochine sistemiche e ai marcatori dell’attivazione delle cellule T
    2. Valutare il tasso di risposta come l’ORR come definito dai criteri di risposta dell’IMWG
    3.Sopravvivenza libera da proressione (PFS)
    4. Sopravvivenza Complessiva (OS)
    Parte 3:
    1. DOR
    2.Valutare i parametri di risposta aggiuntivi come definiti dai criteri di risposta dell’IMWG
    3. PFS
    4. OS
    5. Stato di MRD negativo
    6.Manifestazione e gravità degli eventi avversi, eventi avversi seri e valori di laboratorio
    E.5.2.1Timepoint(s) of evaluation of this end point
    All endpoints: Up to 2 years
    Tutti gli endpoint: fino a 2 anni
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity,Biomarker,Immunoregulatory activity
    Immunogenicità,Biomarcatori,Attività immunoregolatoria
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans Yes
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Si specifia che lo studio è in Aperto. Incremento della dose (parte 1) ed espansione (parte 2) e (pa
    Dose escalation (Part 1) and expansion (Part 2) and (Part 3) Phase 2 dose expansion
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA40
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    United States
    Belgium
    France
    Germany
    Italy
    Netherlands
    Spain
    Sweden
    United Kingdom
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months7
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months7
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 182
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 46
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state6
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 135
    F.4.2.2In the whole clinical trial 228
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    The sponsor will ensure that subjects who continue to benefit from treatment with study drug will be able to continue treatment after the end of the study per local regulations.
    Lo sponsor garantirà che i soggetti che continuano a trarre beneficio dal trattamento con il farmaco in studio potranno continuare il trattamento dopo la fine dello studio in accordo alle normative locali.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-12-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-10-16
    P. End of Trial
    P.End of Trial StatusTrial now transitioned
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