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    Summary
    EudraCT Number:2017-002245-29
    Sponsor's Protocol Code Number:BB2121-MM-001
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-01-05
    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 number2017-002245-29
    A.3Full title of the trial
    A phase 2, multicenter study to determine the efficacy and safety of bb2121 in subjects with relapsed and refractory multiple myeloma
    Studio di fase 2, multicentrico, per determinare l¿efficacia e la sicurezza di bb2121 in soggetti con mieloma multiplo recidivato e refrattario
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to assess the safety of bb2121 in people who have Myeloma that is not responsive after treatment or who had Myeloma which has returned after a period of treatment.
    Studio per valutare la sicurezza di bb2121 in persone che hanno un mieloma che non risponde dopo il trattamento o che hanno avuto un mieloma che si ¿ ripresentato dopo un periodo di trattamento.
    A.3.2Name or abbreviated title of the trial where available
    n.a.
    n.a.
    A.4.1Sponsor's protocol code numberBB2121-MM-001
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT03361748
    A.5.3WHO Universal Trial Reference Number (UTRN)U1111-1202-5554
    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 SponsorCELGENE CORPORATION
    B.1.3.4CountryUnited States
    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 supportCelgene Corporation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCelgene Corporation
    B.5.2Functional name of contact pointClinicalTrialDisclosure
    B.5.3 Address:
    B.5.3.1Street Address9225 Indian Creek Parkway, Suite 900
    B.5.3.2Town/ cityOverland Park, Kansas
    B.5.3.3Post code66210
    B.5.3.4CountryUnited States
    B.5.4Telephone number0018882601599
    B.5.5Fax number0019132660394
    B.5.6E-mailClinicalTrialDisclosure@celgene.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/3/17/1863
    D.3 Description of the IMP
    D.3.1Product namePopolazione di cellule autologhe arricchite con linfociti T trasdotte con un vettore lentivirale
    D.3.2Product code bb2121
    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 INNCellule T CD3+ autologhe che esprimono il recettore chimerico per l'antigene per il BCMA
    D.3.9.2Current sponsor codebb2121
    D.3.10 Strength
    D.3.10.1Concentration unit Other
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    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) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Yes
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product Yes
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Yes
    D.3.11.3.5.1CAT classification and reference numberEMA/758319/2016
    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) Yes
    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 Yes
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    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 and Refractory Multiple Myeloma
    Mieloma Multiplo Recidivato e Refrattario
    E.1.1.1Medical condition in easily understood language
    Cancer of the bone marrow that recurs or is resistant to treatment
    Cancro del midollo osseo che ricorre o che ¿ resistente al trattamento
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10028228
    E.1.2Term Multiple myeloma
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10067095
    E.1.2Term Multiple myeloma progression
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy, defined as overall response rate (ORR), of bb2121 in subjects with relapsed and refractory multiple myeloma (RRMM)
    Valutare l¿efficacia, definita come tasso di risposta complessiva (ORR), di bb2121 in pazienti con mieloma multiplo recidivante e refrattario (RRMM)
    E.2.2Secondary objectives of the trial
    - Assess safety of bb2121 in subjects with RRMM
    - Assess add efficacy outcomes, including complete response (CR) rate, time to response (TTR), duration of response (DOR), progressionfree
    survival (PFS), time to progression (TTP) and overall survival (OS)
    - Characterize expansion of chimeric antigen receptor (CAR)+ Tcells in the peripheral blood and bone marrow by vector copy number(VCN)(cellular kinetics- pharmacokinetics PK)
    - Evaluate cytokine induction in the blood of subjects after infusion of bb2121
    - Evaluate percentage BCMA+ cells and levels of BCMA surface expression in bone marrow, and circulating soluble BCMA
    - Evaluate develop of an anti-CAR antibody response
    - Evaluate proportion of subjects who attain MRD negative status by EuroFlow and/or NGS
    - Describe changes in health-related quality of life using European Organization for Research and Treatment of Cancer questionnaires[EORTC-QLQ-C30, EQ-5D-5L] and the European Quality of Life Multiple Myeloma Module(EORTC-QLQ-MY20)
    -Valutare ult esiti di effic,tra cui tasso di risp. compl.CR,tempo alla risp.TTR,durata della risp.DOR,sopravv. libera da progress.PFS,tempo alla progress.TTP e sopravviv. tot.OS
    -Valutare sicurezza di bb2121 in sogg. con RRMM
    -Caratterizz. espans. delle cell.T CAR+ nel sangue perif e nel m. osseo mediante num. di copie del vettore VCN (cinetica farmacocinetica cellulare PK)
    -Valutare induz. delle citochine nel sangue dei sogg. dopo infus. di bb2121
    -Valutare % di cell. B posit. per l¿antig. di maturaz. delle cell.B(BCMA+),i liv. di espress. superfic. di BCMA nel m. osseo e il liv. di BCMA solub. circolante
    -Valutare svil. di una risp. anticorpale anti-CAR
    -Valutare % di sogg. che raggiungono lo stato neg. di malattia residua min. MRD mediante EuroFlow/Next generation sequencing NGS
    -Descrivere le variaz. della qual. della vita relativa allo stato di salute HRQoL utilizzando il question. EORTC-QLQ-C30,il question. EQ-5D-5L e il mod. europ. sulla qual. della vita con MM EORTC-QLQ-MY20
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    For updates please refer to section of updated Protocol. Eligibility is determined prior to leukapheresis. Subjects must satisfy the following criteria to be enrolled in the study:
    1. Subject is = 18 years of age at the time of signing the informed consent form (ICF).
    2. Documented diagnosis of multiple myeloma
    - Must have received at least 3 prior MM treatment regimens. Note:induction with or without hematopoietic stem cell transplant and with or
    without maintenance therapy is considered a single regimen.
    - Must have undergone at least 2 consecutive cycles of treatment for each regimen, unless PD was the best response to the regimen.
    - Must have received a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 antibody.
    - Must be refractory to the last treatment regimen. Refractory is defined as documented progressive disease during or within 60 days (measured
    from the last dose) of completing treatment with the last anti-myeloma drug regimen before study entry.
    3. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
    4. Subjects must have measurable disease, including at least one of the criteria below:
    - Serum M-protein greater or equal to 1.0 g/dL
    - Urine M-protein greater or equal to 200 mg/24 h
    - Serum free light chain (FLC) assay: involved FLC level greater or equal to 10 mg/dL (100 mg/L) provided serum FLC ratio is abnormal
    - Bone marrow plasma cells > 30% of total bone marrow cells
    5. Recovery to Grade 1 or baseline of any non-hematologic toxicities due to prior treatments, excluding alopecia and Grade 2 neuropathy.
    6. Subject must understand and voluntarily sign an ICF prior to any study-related assessments/procedures being conducted.
    7. Subject is willing and able to adhere to the study visit schedule and other protocol requirements within this protocol as well as agrees to continued follow-up for up to 15 years as mandated by the regulatory
    guidelines for gene therapy trials.
    8. Females of childbearing potential (FCBP (see note 1 below)) must:
    - Have a negative pregnancy test as verified by the Investigator, one negative serum beta human chorionic gonadotropin [ß-hCG] pregnancy test result at screening, prior to LD chemotherapy. This applies even if the subject practices true abstinence* from heterosexual contact.
    - Either commit to true abstinence* from heterosexual contact or agree to use, and be able to comply with, effective measures of contraception without interruption, from screening through at least 1 year following lymphodepleting chemotherapy. ref to Protocol
    - Agree to abstain from breastfeeding during study participation. There are insufficient exposure data to provide any recommendation concerning the total duration of abstaining from breastfeeding following treatment with bb2121. Ref to Protocol
    - Refrain from tissue donation including egg donation or any other tissue/blood/organ donations for at least 1 year following lymphodepleting chemotherapy. There are insufficient exposure data to provide any recommendation concerning the duration of refraining from tissue donation following treatment with bb2121. Ref to protocol
    Note 1: A female of childbearing potential is a female who: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (ie, has had menses at any time in the preceding 24 consecutive months).
    Male subjects must:
    - Practice true abstinence* or agree to use a condom during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, even if he has undergone a successful
    vasectomy. Subjects will be followed from screening until at least 1 year following last bb2121 infusion and until CAR T cells are no longer present by qPCR on two consecutive tests, whichever occurs last.
    Per aggiornamenti fare riferimento alla sezione del Protcoollo aggiornato. L'idoneità si determina prima della leucaferesi. Per essere arruolati nello studio i soggetti devono soddisfare i seguenti criteri:
    1. Il soggetto ha almeno 18 anni di età al momento della firma del modulo di consenso informato (MCI).
    2. Diagnosi documentata di mieloma multiplo
    - Deve avere ricevuto almeno 3 precedenti regimi di trattamento per il MM. Nota:
    l'induzione con o senza trapianto di cellule staminali ematopoietiche e con o senza terapia di mantenimento è considerata un singolo regime.
    - Deve essere stato sottoposto ad almeno 2 cicli consecutivi di trattamento per ciascun regime, salvo che la migliore risposta al regime sia stata la PD.
    - Deve avere ricevuto un inibitore del proteasoma, un agente immunomodulante e un anticorpo anti-CD38.
    - Deve essere refrattario all'ultimo regime di trattamento. La refrattarietà è definita come malattia progressiva documentata durante o entro 60 giorni (calcolati dall'ultima dose) dal completamento del trattamento con l'ultimo regime farmacologico anti-mieloma prima dell'ingresso nello studio.
    3. Performance status ECOG (Eastern Cooperative Oncology Group) di 0 o 1.
    4. I soggetti devono avere una malattia misurabile, che includa almeno uno dei seguenti criteri:
    - Proteina M nel siero superiore o uguale a 1,0 g/dl
    - Proteina M nelle urine superiore o uguale a 200 mg/24 h
    - Saggio delle catene leggere libere (FLC, free light chain) nel siero: livello delle FLC coinvolte superiore o uguale a 10 mg/dl (100 mg/l) purché il rapporto FLC nel siero sia anomalo
    - Plasmacellule nel midollo osseo > 30% del totale delle cellule midollari
    5. Ritorno al grado 1 o alla condizione basale di qualunque tossicità non ematologica dovuta ai trattamenti precedenti, con esclusione dell'alopecia e della neuropatia di grado 2.
    6. Il soggetto deve comprendere e firmare volontariamente un MCI prima che siano condotte valutazioni/procedure connesse allo studio.
    7. Il soggetto è disposto e in grado di aderire al programma di visite dello studio e ad altri requisiti del protocollo nell'ambito del presente protocollo; acconsente inoltre al follow-up continuo per un massimo di 15 anni come previsto dalle linee guida regolatorie per le sperimentazioni sulla terapia genica.
    8. Le donne in età fertile (FCBP, females of childbearing potential (vedi nota 1 più sotto)) devono:
    - Avere un test di gravidanza negativo verificato dallo sperimentatore, un risultato negativo del test di gravidanza sulla gonadotropina corionica umana beta [ß-hCG] nel siero allo screening, prima della chemioterapia LD. Questo vale anche se il soggetto pratica una reale astinenza* dai contatti eterosessuali.
    - Impegnarsi a praticare astinenza completa* dal contatto eterosessuale o accettare di utilizzare, ed essere in grado di rispettare, misure contraccettive efficaci senza interruzione, dallo screening fino ad almeno 1 anno dopo la chemioterapia linfodepletiva. Vedere Protocollo per testo completo.
    - Evitare la donazione di tessuti, compresa la donazione di ovuli o qualsiasi altra donazione di tessuti, sangue od organi per almeno 1 anno dopo la chemioterapia linfodepletiva. Non ci sono dati di esposizione sufficienti a fornire raccomandazioni sulla durata dell'astensione dalla donazione di tessuti dopo il trattamento con bb2121. Qualsiasi decisione riguardante la donazione di tessuti dopo l'infusione di bb2121 deve essere discussa con il medico che si occupa del trattamento.
    Nota 1: Si definisce in età fertile una donna che: 1) a un certo momento abbia raggiunto il menarca, 2) non si sia stata sottoposta a isterectomia od ooforectomia bilaterale o 3) non sia naturalmente in post-menopausa (l'amenorrea che segue la terapia antitumorale non esclude la fertilità) da almeno 24 mesi consecutivi (abbia avuto il ciclo mestruale in qualunque momento dei precedenti 24 mesi consecutivi).
    E.4Principal exclusion criteria
    Please refers to the specific Protocol updates Section. The presence of any of the following will exclude a subject from enrollment:
    1. Subjects with known central nervous system involvement with myeloma.
    2. History or presence of clinically relevant central nervous system (CNS) pathology such as epilepsy, seizure, paresis, aphasia, stroke, subarachnoid hemorrhage or other CNS bleed, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, or psychosis. (Note: this criterion does not apply to subjects
    undergoing retreatment unless Grade 4 neurotoxicity was observed following prior treatment with bb2121).
    3. Subjects with plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly,
    endocrinopathy, monoclonal protein, and skin changes), or clinically significant amyloidosis.
    4. Subjects with solitary plasmacytomas or non-secretory myeloma without other evidence of measurable disease.
    5. Inadequate hepatic function defined by AST and/or ALT > 2.5 × upper limit of normal (ULN) and total bilirubin > 1.5 × ULN (unless due to Gilbert's syndrome and direct bilirubin is = 1.5 x ULN).
    6. Inadequate renal function defined by CrCl = 45 ml/min using Cockcroft-Gault equation.
    7. International ratio (INR) or partial thromboplastin time (PTT) > 1.5 × ULN, or history of Grade =2 hemorrhage within 30 days, or subject requires ongoing treatment with chronic, therapeutic dosing of anticoagulants (eg, warfarin, low molecular weight heparin, or Factor Xa inhibitors).
    8. Inadequate bone marrow function defined by absolute neutrophil count (ANC) < 1000 cells/mm3 in the absence of growth factor support (filgrastim within 7 days or peg-filgrastim within 14 days of screening) and platelet count < 50,000 mm3 in the absence of transfusion support (platelet transfusion within 7 days of screening).
    9. Echocardiogram or MUGA with left ventricular ejection fraction < 45%.
    10. Inadequate pulmonary function as defined as oxygen saturation (Sa02) < 92 % on room air.
    11. Ongoing treatment with chronic immunosuppressants (eg, cyclosporine or systemic steroids at any dose). Intermittent topical, inhaled or intranasal corticosteroids are allowed.
    12. Previous history of an allogeneic hematopoietic stem cell transplantation or treatment with any gene therapy-based therapeutic for cancer or investigational cellular therapy for cancer or BCMA targeted therapy.
    13. Evidence of human immunodeficiency virus (HIV) infection.
    14. Seropositive for and with evidence of active viral infection with hepatitis B virus (HBV)
    - Subjects who are hepatitis B surface antigen (HBsAg) negative and HBV viral DNA negative are eligible
    - Subjects who had hepatitis B but have received an antiviral treatment and show non-detectable viral DNA for 6 months are eligible
    - Subjects who are seropositive because of hepatitis B virus vaccine are eligible
    - Subjects with known HBV infection should have undetectable HBV viral load and be maintained on anti-viral therapy to prevent HBV reactivation.
    15. Seropositive for and with active viral infection with hepatitis C virus (HCV)
    - Subjects who had hepatitis C but have received an antiviral treatment and show no detectable HCV viral RNA for 6 months are eligible.
    .......
    Fare riferimento alla sezione del Protocollo aggiornata. La presenza di una qualsiasi delle seguenti condizioni escluderà un sogg. dall'arruolamento:
    1.Sogg. con coinvolgimento noto del sist. nervoso centrale nel mieloma
    2.Patologia del sist. nervoso centrale SNC clinicam. rilevante nell'anamnesi o in atto, come epilessia, convulsioni, paresi, afasia, ictus, emorragia subaracnoidea o altro sanguinamento del SNC, lesioni cerebrali gravi, demenza, morbo di Parkinson, malattia cerebellare, sindrome cerebrale organica o psicosi. (Nota: questo criterio non si applica ai soggetti sottoposti a un nuovo trattamento a meno che prima del precedente trattamento con bb2121 non sia stata osservata neurotossicità di grado 4)
    3.Sogg. con leucemia plasmacellulare, macroglobulinemia di Waldenstrom, sindrome POEMS (polineuropatia, organomegalia, endocrinopatia, proteina monoclonale e alterazioni cutanee) o amiloidosi clinicamente significativa.
    4.Sogg. con plasmocitoma solitario o mieloma non secernente senza altra evidenza di malattia misurabile
    5.Funzione epatica inadeguata definita da AST e/o ALT > 2,5 volte il limite superiore della norma (LSN) e bilirubina totale > 1,5 volte il LSN (a meno che non si tratti della sindrome di Gilbert e la bilirubina diretta sia = 1,5 volte il LSN)
    6.Funzione renale inadeguata definita da CrCl = 45 ml/min utilizzando l'equazione di Cockcroft-Gault
    7.Rapporto internazionale (INR) o tempo di tromboplastina parziale (PTT) > 1,5 volte il LSN, o precedente emorragia di grado = 2 entro 30 giorni, o soggetto che richiede un trattamento continuato con dosaggio cronico terapeutico di anticoagulanti (es. warfarin, eparina a basso peso molecolare o inibitori del fattore Xa)
    8.Funzione midollare inadeguata definita da conta assoluta dei neutrofili (CAN) < 1000 cellule/mm3 in assenza del supporto di un fattore di crescita (filgrastim entro 7 giorni o peg-filgrastim entro 14 giorni dallo screening) e conta piastrinica < 50.000/mm3 in assenza di supporto trasfusionale (trasfusione di piastrine entro 7 giorni dallo screening)
    9.Ecocardiogramma o MUGA con frazione di eiezione ventricolare sinistra < 45%
    10.Funzione polmonare inadeguata definita da una saturazione di ossigeno (Sa02) < 92% nell'aria ambiente
    11.Trattamento in corso con immunosoppressivi cronici (es. ciclosporina o steroidi sistemici a qualunque dosaggio). Sono consentiti i corticosteroidi topici, inalati o intranasali intermittenti
    12.Precedente trapianto allogenico di cellule stamin. ematopoietiche o qualunque trattamento antineoplastico basato sulla terapia genica o terapia antineoplastica cellulare sperimentale o terapia mirata sul BCMA
    13.Evidenza di infezione da virus dell’immunodeficienza umana HIV
    14.Sieropositività ed evidenza di infezione virale attiva da virus dell'epatite B HBV
    -Sono idonei i sogg. con negatività per l’antigene di superficie dell'epatite B (HBsAg) e per il DNA virale dell'HBV
    -Sono idonei i sogg. che hanno avuto un’epatite B ma hanno ricevuto un trattamento antivirale e che da 6 mesi presentano un DNA virale non rilevabile
    -Sono idonei i sogg. sieropositivi a causa di vaccino per il virus dell'epatite B
    -I sogg. con infezione nota da HBV devono avere un carico virale HBV non rilevabile ed essere sottoposti a una terapia antivirale di mantenimento per prevenire la riattivazione dell'HBV
    15.Sieropositività e infezione virale attiva da virus dell'epatite C (HCV).
    -Sono idonei i sogg. che hanno avuto l’epatite C ma hanno ricevuto un trattam. antivirale e che da 6 mesi presentano un RNA virale non rilevabile


    ....
    E.5 End points
    E.5.1Primary end point(s)
    Overall Response Rate (ORR):
    Percentage of subjects who achieved partial response (PR) or better according to IMWG Uniform Response Criteria for Multiple Myeloma (Kumar, 2016) as assessed by an independent response committee (IRC)
    Tasso di risposta complessivo (ORR, Overall Response Rate):
    Percentuale di soggetti che hanno ottenuto almeno una risposta parziale (PR) in base ai criteri di risposta uniformi IMWG per il mieloma multiplo (Kumar, 2016) valutata dal comitato di risposta indipendente (IRC, independent response committee).
    E.5.1.1Timepoint(s) of evaluation of this end point
    When all bb2121 treated subjects have completed a minimum of 10 months of post bb2121 infusion follow up. An updated analysis will be performed following a minimum of 24 months of post bb2121 infusion follow up and additional ad hoc analyses will be performed as appropriate.
    Quando tutti i soggetti trattati con bb2121 avranno completato almeno 10 mesi di follow-up dopo l'infusione di bb2121. Un'analisi aggiornata sarà effettuata dopo almeno 24 mesi di follow-up dopo l'infusione di bb2121 e ulteriori analisi ad hoc saranno effettuate secondo necessità.
    E.5.2Secondary end point(s)
    For updates, please refers to the specific updates Protocol section. *Key Secondary
    - Complete Response (CR) Rate: Percentage of subjects who achieved CR or sCR according to IMWG Uniform Response Criteria for Multiple Myeloma (Kumar, 2016) as assessed by an IRC
    *Other Secondary
    - Time to Response: Time from first bb2121 infusion to first documentation of response
    - Duration of Response (DOR): Time from first response to disease progression or death from any cause, whichever occurs first
    - Progression-free Survival (PFS): Time from first bb2121 infusion to first documentation of progressive disease (PD), or death due to any cause, whichever occurs first
    - Time to Progression (TTP): Time from first bb2121 infusion to first documentation of PD
    - Overall Survival (OS): Time from first bb2121 infusion to time of death due to any cause
    - Safety: Type, frequency, and severity of adverse events (AEs), adverse events of special interest (AESI), serious adverse events (SAEs), cytokine release syndrome, neurotoxicity, infection and laboratory abnormalities
    - PK: Maximum transgene level (Cmax), time to peak transgene level (Tmax), area under the curve of the transgene level (AUC), including maximum expansion and duration of persistence of bb2121 CD3+ cells - Immunogenicity: Evaluate the development of an anti-CAR antibody response
    - Minimal Residual Disease (MRD): Evaluate subjects for MRD status using next generation sequencing (NGS)
    - Health Related Quality of Life (HRQoL): Subject-reported outcomes as measured by EORTC-QLQC30, EQ-5D-5L and EORTC-QLQ-MY20.
    Per aggiornamenti fare riferimento all'appostia sezione del Protocollo aggiornato. *Secondario chiave
    - Tasso di risposta completa (CR):
    Percentuale di soggetti che hanno ottenuto una CR o una sCR in base ai criteri di risposta uniformi IMWG per il mieloma multiplo (Kumar, 2016) valutata da una IRC.

    *Altri secondari
    - Tempo alla risposta: Tempo trascorso tra la prima infusione di bb2121 e la prima documentazione di risposta.
    - Durata della risposta (DOR, Duration of Response): Tempo trascorso tra la prima risposta e la progressione della malattia o il decesso per qualunque causa, a seconda di quale dei due si verifichi per primo.
    - Sopravvivenza libera da progressione (PFS, Progression-free Survival): Tempo trascorso tra la prima infusione di bb2121 e la prima documentazione di malattia progressiva (PD, progressive disease) o decesso per qualunque causa, a seconda di quale dei due si verifichi per primo.
    - Tempo alla progressione (TTP, Time to Progression): Tempo trascorso tra la prima infusione di bb2121 e la prima documentazione di PD.
    - Sopravvivenza globale (OS, Overall Survival): Tempo trascorso tra la prima infusione di bb2121 e il momento del decesso per qualunque causa.
    - Sicurezza: Tipo, frequenza e gravit¿ degli eventi avversi (EA), eventi avversi di particolare interesse (AESI, adverse events of special interest), eventi avversi seri (SAE, serious adverse event), sindrome da rilascio di citochine, neurotossicit¿, infezione e valori di laboratorio anomali.
    - PK: Concentrazione massima di transgene (Cmax), tempo alla concentrazione di picco del transgene (Tmax), area sotto la curva della concentrazione del transgene (AUC), compresa espansione massima e durata della persistenza delle cellule bb2121 CD3+
    - Immunogenicità: Valutare lo sviluppo di una risposta anticorpale anti-CAR
    - Malattia residua minima (MRD): Valutare i soggetti per lo stato della MRD utilizzando il sequenziamento di nuova generazione (NGS)
    - Qualit¿ della vita correlata allo stato di salute (HRQoL, Health Related Quality of Life): Esiti riferiti dal soggetto misurati attraverso i questionari EORTC-QLQC30, EQ-5D-5L e EORTC-QLQ-MY20.
    E.5.2.1Timepoint(s) of evaluation of this end point
    When all bb2121 treated subjects have completed a minimum of 6 months of post bb2121 infusion follow up. An updated analysis will be performed following a minimum of 24 months of post bb2121 infusion follow up and additional ad hoc analyses will be performed as appropriate.
    Quando tutti i soggetti trattati con bb2121 avranno completato almeno 6 mesi di follow-up dopo l'infusione di bb2121. Un'analisi aggiornata sar¿ effettuata dopo almeno 24 mesi di follow-up dopo l'infusione di bb2121 e ulteriori analisi ad hoc saranno effettuate secondo necessit¿.
    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 Yes
    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 Yes
    E.6.12Pharmacoeconomic Yes
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    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 No
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA9
    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
    Spain
    E.8.7Trial has a data monitoring committee Yes
    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
    The End of Trial is defined as either the date of the last visit of the last subject to complete the post-treatment follow-up, or the date of receipt of the last data point from the last subject that is required for primary, secondary and/or exploratory analysis, as pre-specified in the protocol, whichever is the later date.
    Il termine della sperimentazione ¿ definito come la data dell¿ultima visita dell¿ultimo soggetto che completa il follow-up post-trattamento, oppure la data di ricevimento dell¿ultimo punto dati dell¿ultimo soggetto, richiesto per l¿analisi primaria, secondaria e/o esplorativa, come predefinito nel protocollo, a seconda di quale sia la data che si verifica pi¿ tardi.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months0
    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: 82
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 58
    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 state12
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 57
    F.4.2.2In the whole clinical trial 140
    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)
    Further details are provided in the protocol.
    Dettagli aggiuntivi sono forniti nel protocollo.
    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 Decision2018-05-16
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-03-21
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2023-12-12
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