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    Clinical Trial Results:
    MEDI4736-MM-005 (FUSION MM-005): A Multicenter, Single-arm, Phase 2 Study to Determine the Efficacy of the Combination of Daratumumab (DARA) Plus Durvalumab (DURVA) (D2) in Subjects With Relapsed and Refractory Multiple Myeloma (RRMM) who have Progressed on DARA While on a DARA-containing Regimen as the Most Recent MM Therapy.

    Summary
    EudraCT number
    2016-003801-32
    Trial protocol
    DE   SE   ES   GR   NL   AT   IT  
    Global end of trial date
    04 Dec 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    23 Nov 2018
    First version publication date
    23 Nov 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    MEDI4736-MM-005
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03000452
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Celgene Corporation
    Sponsor organisation address
    86 Morris Avenue, Summit, United States, 07901
    Public contact
    Clinical Trial Disclosure, Celgene Corporation, 01 8882601599, ClinicalTrialDisclosure@Celgene.com
    Scientific contact
    Steven Novick, MD, Celgene Corporation, 01 (908) 6084596, snovick@celgene.com
    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
    04 Dec 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    04 Dec 2017
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To determine the efficacy of daratumumab plus durvalumab (DURVA) in subjects with relapsed and refractory multiple myeloma who have progressed on daratumumab while on a daratumumab-containing regimen as the most multiple myeloma recent treatment.
    Protection of trial subjects
    The study was conducted in accordance with the guidelines of current Good Clinical Practice including the archiving of essential documents and informed consent.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    03 Mar 2017
    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
    Spain: 5
    Country: Number of subjects enrolled
    Sweden: 2
    Country: Number of subjects enrolled
    United States: 6
    Country: Number of subjects enrolled
    Greece: 5
    Worldwide total number of subjects
    18
    EEA total number of subjects
    12
    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)
    9
    From 65 to 84 years
    9
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at 8 sites in 4 countries including Greece, Spain, Sweden and the United States, from 03 March 2017 to 04 December 2017

    Pre-assignment
    Screening details
    Eligible participants included those with relapsed and refractory multiple myeloma (RRMM) who progressed on daratumumab (DARA) while on a DARA-containing regimen as the most recent multiple myeloma (MM) therapy. Participants had to have received at least 3 prior anti-myeloma therapies.

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

    Arms
    Arm title
    Daratumumab and Durvalumab
    Arm description
    Participants received intravenous daratumumab at 16 mg/kg on the same dosing schedule (weekly, every 2 weeks, or every 4 weeks of each 28-day treatment cycle) on their last prior therapy containing daratumumab regimen. The dosing schedule for daratumumab could be adjusted during the course of the study, provided the participant had a response of stable disease or better. Participants also received IV durvalumab at 1500 mg on Day 2 of Cycle 1 and then on Day 1 of Cycles ≥ 2 of each 28-day treatment cycle. Participants could continue on study treatment until progressive disease or unacceptable toxicity.
    Arm type
    Experimental

    Investigational medicinal product name
    Daratumumab
    Investigational medicinal product code
    Other name
    Darzalex
    Pharmaceutical forms
    Dental gel, Blood fraction modifier, Concentrate for solution for infusion
    Routes of administration
    Intravenous drip use
    Dosage and administration details
    Daratumumab by intravenous (IV) administration at 16 mg/kg on the same dosing schedule (weekly, every 2 weeks, or every 4 weeks of each 28-day treatment cycle) on their last prior therapy containing daratumumab regimen.

    Investigational medicinal product name
    Durvalumab
    Investigational medicinal product code
    Other name
    Imfinzi
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Durvalumab 1500 mg by intravenous administration on Day 2 of Cycle 1 and then on Day 1 of Cycles ≥ 2 of each 28-day treatment cycle.

    Number of subjects in period 1
    Daratumumab and Durvalumab
    Started
    18
    Completed
    0
    Not completed
    18
         Adverse event, serious fatal
    1
         Physician decision
    1
         Progressive Disease (PD)
    14
         Miscellaneous
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Daratumumab and Durvalumab
    Reporting group description
    Participants received intravenous daratumumab at 16 mg/kg on the same dosing schedule (weekly, every 2 weeks, or every 4 weeks of each 28-day treatment cycle) on their last prior therapy containing daratumumab regimen. The dosing schedule for daratumumab could be adjusted during the course of the study, provided the participant had a response of stable disease or better. Participants also received IV durvalumab at 1500 mg on Day 2 of Cycle 1 and then on Day 1 of Cycles ≥ 2 of each 28-day treatment cycle. Participants could continue on study treatment until progressive disease or unacceptable toxicity.

    Reporting group values
    Daratumumab and Durvalumab Total
    Number of subjects
    18 18
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    9 9
        From 65-84 years
    9 9
        85 years and over
    0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    62.8 ( 11.41 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    11 11
        Male
    7 7
    Race/Ethnicity, Customized
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    0 0
        Black or African American
    1 1
        White
    15 15
        Not Collected or Reported
    2 2
    Eastern Cooperative Oncology Group (ECOG) Performance Status (PS)
    ECOG PS is used by physicians and researchers to assess how a subject's disease is progressing, and how the disease affects the daily living activities and determine appropriate treatment and prognosis. 0 = Fully Active, able to carry on all pre-disease performance without restriction; 1 = Restricted, in physically strenuous activity but ambulatory; 2 = Ambulatory and capable of all self-care; unable to carry out work activities. 3 = Capable of only limited self-care, confined to bed or chair >50% of waking hours 4 = Completely Disabled, cannot carry on any self-care 5 = Dead
    Units: Subjects
        0 = Fully Active
    12 12
        1 = Restrictive but ambulatory
    5 5
        2 = Ambulatory but unable to work
    1 1
        3 = Limited Self-Care
    0 0
    International Staging System Multiple Myeloma Stage at Entry
    The International Staging System divides myeloma into 3 stages based only on the serum beta-2 microglobulin and serum albumin levels. Stage I: Serum beta-2 microglobulin is less than 3.5 (mg/L) and the albumin level is above 3.5 (g/L); Stage II: Neither stage I or III, meaning that either: # The beta-2 microglobulin level is between 3.5 and 5.5 (with any albumin level), OR # The albumin is below 3.5 while the beta-2 microglobulin is less than 3.5 Stage III: Serum beta-2 microglobulin is greater than 5.5.
    Units: Subjects
        Stage I
    5 5
        Stage II
    4 4
        Stage III
    9 9
        Missing
    0 0
    Number of Prior Regimens
    Units: Regimens
        median (full range (min-max))
    4.5 (3 to 16) -

    End points

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    End points reporting groups
    Reporting group title
    Daratumumab and Durvalumab
    Reporting group description
    Participants received intravenous daratumumab at 16 mg/kg on the same dosing schedule (weekly, every 2 weeks, or every 4 weeks of each 28-day treatment cycle) on their last prior therapy containing daratumumab regimen. The dosing schedule for daratumumab could be adjusted during the course of the study, provided the participant had a response of stable disease or better. Participants also received IV durvalumab at 1500 mg on Day 2 of Cycle 1 and then on Day 1 of Cycles ≥ 2 of each 28-day treatment cycle. Participants could continue on study treatment until progressive disease or unacceptable toxicity.

    Primary: Numberof Participants With an Objective Response According to International Myeloma Working Group (IMWG) Uniform Response Criteria

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    End point title
    Numberof Participants With an Objective Response According to International Myeloma Working Group (IMWG) Uniform Response Criteria [1]
    End point description
    Objective response is defined as a best overall response of stringent complete response (sCR), complete response (CR), very good partial response (VGPR) or partial response (PR) based on the investigator assessment: sCR: CR and normal free light chain (FLC) ratio and no clonal cells in bone marrow; CR: Negative serum and urine on immunofixation, disappearance of any soft tissue plasmacytomas and ≤ 5% plasma cells in bone marrow; VGPR: Serum and urine M-protein detectable by immunofixation but not on electrophoresis or ≥ 90% reduction in serum M-protein and urine M-protein level < 100 mg/24 hours; PR: ≥ 50% reduction of serum M-Protein and reduction in urinary M-protein by ≥ 90% or to < 200 mg/24 hours. In addition to the above, if present at baseline a ≥ 50% reduction in the size of soft tissue plasmacytomas is also required. The population analyzed included the full analysis set (FAS), meaning all participants who enrolled in the study.
    End point type
    Primary
    End point timeframe
    From randomization until the data cut-off date of 17 April 2018. The median duration of treatment for durvalumab and daratumumab was 7.9 weeks and 8.0 weeks respectively.
    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: No statistical analysis was performed as no subject achieved a best response better than stable disease of the study. Following the DMC review of the data from Part 1 Stage 1 and prior to the first formal interim analysis, the sponsor decided based on DMC recommendation, to close the study as the number of responses was not reached.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    18
    Units: Number of participants
    0
    No statistical analyses for this end point

    Secondary: Time-to-Response (TTR)

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    End point title
    Time-to-Response (TTR)
    End point description
    TTR was defined as the time from treatment initiation to the first documentation of response (PR or greater) based on IMWG criteria. sCR: CR and normal free light chain (FLC) ratio and no clonal cells in bone marrow (BM); CR: Negative serum and urine on immunofixation (IFX), disappearance of any soft tissue plasmacytomas and ≤5% plasma cells in BM; VGPR: Serum and urine M-protein detectable by IFX but not on electrophoresis or ≥90% reduction in serum and urine M-protein levels <100 mg/24 hours; PR: ≥50% reduction of serum M-Protein and reduction in urinary M-protein by ≥90% or to <200 mg/24 hours. A ≥50% decrease in the difference between involved and uninvolved FLC levels in place of the M-protein basis or a ≥50% reduction in plasma cells in place of M-protein if baseline was ≥30%. If present at baseline a ≥50% reduction in size of soft tissue plasmacytomas. Analyses was not conducted for TTR due to no subject achieving a response better than stable disease in Stage 1 of the study.
    End point type
    Secondary
    End point timeframe
    From randomization until the data cut-off date of 17 April 2018. The median duration of treatment for durvalumab and daratumumab was 7.9 weeks and 8.0 weeks respectively.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    0 [2]
    Units: weeks
        median (full range (min-max))
    ( to )
    Notes
    [2] - No subject achievied a response better than SD
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    Duration of response was defined as time from the first documentation of response (PR or greater) to the first documentation of PD or death, whichever is earlier, based on the investigator assessments according to the IMWG Uniform Response Criteria. Analyses was not conducted for duration of response due to no subject achieving a response better than stable disease in Stage 1 of the study.
    End point type
    Secondary
    End point timeframe
    From randomization until the data cut-off date of 17 April 2018. The median duration of treatment for durvalumab and daratumumab was 7.9 weeks and 8.0 weeks respectively.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    0 [3]
    Units: weeks
        median (full range (min-max))
    ( to )
    Notes
    [3] - No subject achieving a response better than stable disease
    No statistical analyses for this end point

    Secondary: Progression Free Survival

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    End point title
    Progression Free Survival
    End point description
    Progression free survival was defined as the time from treatment initiation to the first documentation of PD or death from any cause during study, whichever occurred earlier. Time to event analysis for PFS and was not analyzed due to insufficient follow up time because of early termination of the trial.
    End point type
    Secondary
    End point timeframe
    From randomization until the data cut-off date of 17 April 2018. The median duration of treatment for durvalumab and daratumumab was 7.9 weeks and 8.0 weeks respectively.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    0 [4]
    Units: weeks
        median (full range (min-max))
    ( to )
    Notes
    [4] - Time to event analysis for PFS and was not analyzed due to early termination
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Overall Survival was defined as the time from treatment initiation to death due to any cause. Time to event analysis for overall survival was not analyzed due to insufficient follow up time because of early termination of the trial.
    End point type
    Secondary
    End point timeframe
    From randomization until the data cut-off date of 17 April 2018. The median duration of treatment for durvalumab and daratumumab was 7.9 weeks and 8.0 weeks respectively.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    0 [5]
    Units: weeks
        median (full range (min-max))
    ( to )
    Notes
    [5] - Time to event analysis for overall survival was not analyzed due to early termination.
    No statistical analyses for this end point

    Secondary: Area Under the Plasma Concentration-time Curve from Time 0 to the Time of the Last Quantifiable Concentration Of Durvalumab

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    End point title
    Area Under the Plasma Concentration-time Curve from Time 0 to the Time of the Last Quantifiable Concentration Of Durvalumab
    End point description
    Area under the plasma concentration-time curve from time 0 to the time of the last quantifiable concentration, calculated by linear trapezoidal method when concentrations are increasing and the logarithmic trapezoidal method when concentrations are decreasing. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    14
    Units: day*μg/L
        geometric mean (geometric coefficient of variation)
    3145469.40 ( 43.3 )
    No statistical analyses for this end point

    Secondary: Area Under the Plasma Concentration-time Curve from Time 0 to Extrapolated to Infinity (AUC-inf) of Durvalumab

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    End point title
    Area Under the Plasma Concentration-time Curve from Time 0 to Extrapolated to Infinity (AUC-inf) of Durvalumab
    End point description
    Area under the plasma concentration-time curve from time 0 extrapolated to infinity, calculated as [AUCt + Ct/ λz]. Ct is the last quantifiable concentration. No AUC extrapolation was performed with unreliable λz. If AUC %Extrap was ≥25%, AUC inf was not reported. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    10
    Units: day*μg/L
        geometric mean (geometric coefficient of variation)
    5634957.81 ( 86.8 )
    No statistical analyses for this end point

    Secondary: Maximum Observed Concentration (Cmax) Of Durvalumab

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    End point title
    Maximum Observed Concentration (Cmax) Of Durvalumab
    End point description
    Maximum observed plasma concentration, obtained directly from the observed concentration versus time data. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    14
    Units: μg/L
        geometric mean (geometric coefficient of variation)
    349391.46 ( 32.2 )
    No statistical analyses for this end point

    Secondary: Time to Reach Maximum Concentration (Tmax) of Durvalumab

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    End point title
    Time to Reach Maximum Concentration (Tmax) of Durvalumab
    End point description
    Time to Cmax, obtained directly from the observed concentration versus time data. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    14
    Units: days
        median (full range (min-max))
    0.0476 (0.003 to 0.058)
    No statistical analyses for this end point

    Secondary: Terminal Half-Life (T1/2) of of Durvalumab

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    End point title
    Terminal Half-Life (T1/2) of of Durvalumab
    End point description
    Terminal phase half-life in plasma, calculated as [(ln 2)/λz]. t1/2 was only calculated when a reliable estimate for λz could be obtained. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK Durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    10
    Units: days
        geometric mean (geometric coefficient of variation)
    15.71 ( 75.4 )
    No statistical analyses for this end point

    Secondary: Apparent Total Clearance (CL/F) of of Durvalumab

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    End point title
    Apparent Total Clearance (CL/F) of of Durvalumab
    End point description
    Apparent total clearance, calculated as [Dose/AUCinf]. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK Durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    10
    Units: L/day
        geometric mean (geometric coefficient of variation)
    0.27 ( 86.8 )
    No statistical analyses for this end point

    Secondary: Apparent Volume of Distribution (Vz/F) of Durvalumab

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    End point title
    Apparent Volume of Distribution (Vz/F) of Durvalumab
    End point description
    Apparent volume of distribution, calculated as [(CL/F)/λz]. The pharmacokinetic population included participants who received at least 1 dose of study medication and had evaluable plasma PK Durvalumab profiles.
    End point type
    Secondary
    End point timeframe
    Pharmacokinetic samples were drawn on Cycle 1 on Day 2 (C1D2) pre-dose, at the end of the infusion, on Day 8 at 144 hour post dose, on Day 15 at 312 hours post dose and on Day 22 at 480 hours post C1D2 infusion.
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    10
    Units: Liters
        geometric mean (geometric coefficient of variation)
    5.48 ( 25.1 )
    No statistical analyses for this end point

    Secondary: Participants with Treatment-Emergent Adverse Events (TEAEs)

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    End point title
    Participants with Treatment-Emergent Adverse Events (TEAEs)
    End point description
    TEAEs include AEs between the earliest of the first dose date of either study drug and 90 days after the last dose of either study drug. In addition, an AE that occurred beyond the timeframe and was assessed by the doctor as possibly related to IP was considered to be treatment-emergent. Severity was assessed using National Cancer Institute Common Toxicity Terminology Criteria for AEs (NCI CTCAE) version 4.03, where 1= Mild; 2= Moderate; 3= Severe; 4= Life-threatening; 5= Death related to AE. Serious AEs resulted in death, were life-threatening, required or prolonged inpatient hospitalization, resulted in persistent or significant disability/incapacity, congenital anomaly, or resulted in a medical event that may have jeopardized the patient or required medical or surgical intervention to prevent one of the outcomes above. The safety population consisted of all participants who received at least one dose of Durvalumab (Durva) or Daratumumab (Dara
    End point type
    Secondary
    End point timeframe
    From the date of the first dose of study drug until 90 days after the last dose of durvalumab or daratumumab , whichever is later. Maximum overall time on treatment was 16 weeks for daratumumab and durvalumab
    End point values
    Daratumumab and Durvalumab
    Number of subjects analysed
    18
    Units: participants
        TEAE|
    18
        TEAE Related to Durva|
    1
        TEAE Related to Dara|
    4
        TEAE Related to Durva or Dara|
    4
        TEAE with CTCAE Grade (Gr) 3-4|
    11
        TEAE with CTCAE Grade 3-4 Related to Durva|
    1
        TEAE with CTCAE Grade 3-4 Related to Dara|
    2
        TEAE with CTCAE Gr 3-4 Related to Durva or Dara|
    2
        TEAE with CTCAE Grade 5|
    4
        TEAE with CTCAE Grade 5 Related to Durva|
    0
        TEAE with CTCAE Grade 5 Related to Dara|
    0
        TEAE with CTCAE Gr 5 Related to Durva or Dara|
    0
        Serious AE|
    7
        Serious AE Related to Durva|
    0
        Serious AE Related to Dara|
    0
        Serious AE Related to Durva or Dara|
    0
        TEAE leading to Interruption of Durva|
    1
        TEAE leading to Interruption of Dara|
    1
        TEAE leading to Interruption of Durva or Dara|
    1
        TEAE interruption of Durva-without infusion delay|
    1
        TEAE interruption of Dara-without infusion delay|
    1
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From the date of the first dose of study drug until 90 days after the last dose of durvalumab or daratumumab , whichever is later. Maximum overall time on treatment was 16 weeks for daratumumab and durvalumab
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    V20.0
    Reporting groups
    Reporting group title
    Daratumab and Durvalumab
    Reporting group description
    Participants received intravenous daratumumab at 16 mg/kg on the same dosing schedule (weekly, every 2 weeks, or every 4 weeks of each 28-day treatment cycle) on their last prior therapy containing daratumumab regimen. The dosing schedule for daratumumab could be adjusted during the course of the study, provided the participant had a response of stable disease or better. Participants also received IV durvalumab at 1500 mg on Day 2 of Cycle 1 and then on Day 1 of Cycles ≥ 2 of each 28-day treatment cycle. Participants could continue on study treatment until progressive disease or unacceptable toxicity.

    Serious adverse events
    Daratumab and Durvalumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    7 / 18 (38.89%)
         number of deaths (all causes)
    4
         number of deaths resulting from adverse events
    0
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    1 / 18 (5.56%)
         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
    4 / 18 (22.22%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 4
    Pyrexia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 18 (5.56%)
         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
    Daratumab and Durvalumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    17 / 18 (94.44%)
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Hypertension
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Chest discomfort
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Fatigue
         subjects affected / exposed
    9 / 18 (50.00%)
         occurrences all number
    13
    General physical health deterioration
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Oedema peripheral
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Localised oedema
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Catarrh
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Cough
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Dyspnoea
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    3
    Dyspnoea exertional
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Epistaxis
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Anxiety
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Disorientation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Amylase increased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Blood fibrinogen decreased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Blood creatinine increased
         subjects affected / exposed
    6 / 18 (33.33%)
         occurrences all number
    8
    Lipase increased
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    3
    Weight decreased
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    3
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Nervous system disorders
    Neuralgia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Tremor
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Somnolence
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    12 / 18 (66.67%)
         occurrences all number
    28
    Lymphopenia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Neutropenia
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    6
    Thrombocytopenia
         subjects affected / exposed
    7 / 18 (38.89%)
         occurrences all number
    12
    Eye disorders
    Cataract
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Constipation
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Vomiting
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Acute kidney injury
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Back pain
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Bone pain
         subjects affected / exposed
    5 / 18 (27.78%)
         occurrences all number
    5
    Muscle spasms
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Musculoskeletal pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Neck pain
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Pain in extremity
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2
    Pathological fracture
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Infections and infestations
    Herpes zoster
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Respiratory tract infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    3
    Hypercalcaemia
         subjects affected / exposed
    2 / 18 (11.11%)
         occurrences all number
    2
    Hyperuricaemia
         subjects affected / exposed
    3 / 18 (16.67%)
         occurrences all number
    5
    Hyponatraemia
         subjects affected / exposed
    1 / 18 (5.56%)
         occurrences all number
    2

    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? Yes
    Date
    Interruption
    Restart date
    05 Sep 2017
    Study MEDI4736-MM-005 was placed on Partial Clinical Hold. As a result of the Partial Clinical Hold no further enrollment into the study was allowed and only subjects who were receiving clinical benefit, based on the discretion of the Investigator, could remain on study treatment after being re-consented.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    An independent DMC reviewed data from Part 1 Stage 1 of the study on 26 Oct 2017; based on their recommendations, Celgene decided to close the study due to unfavorable efficacy results (number of responses to move to Stage 2 was not reached).
    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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