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    Summary
    EudraCT Number:2019-001138-32
    Sponsor's Protocol Code Number:208887
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Temporarily Halted
    Date on which this record was first entered in the EudraCT database:2019-07-26
    Trial results View 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 ConcernedSpain - AEMPS
    A.2EudraCT number2019-001138-32
    A.3Full title of the trial
    A Phase I/II, Randomized, Open-label Platform Study Utilizing a Master Protocol to Study belantamab mafodotin (GSK2857916) as monotherapy and in Combination with Anti-Cancer Treatments in Participants with Relapsed/Refractory Multiple Myeloma (RRMM) – DREAMM 5
    Estudio de plataforma de fase I/II, aleatorizado, abierto que utiliza el protocolo maestro para el estudio de belantamab mafodotin (GSK2857916) en monoterapia y en combinación con tratamientos contra el cáncer en participantes con mieloma múltiple en recaída/refractario (MMRR) – DREAMM 5.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Platform Study of GSK2857916 as monotherapy and in combination with anti-cancer treatments in participants with RRMM
    Estudio de plataforma GSK2857916 en monoterapia y en combinación con tratamientos contra el cáncer en participantes con MMRR
    A.4.1Sponsor's protocol code number208887
    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 SponsorGlaxoSmithKline, S.A.
    B.1.3.4CountrySpain
    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 supportGlaxoSmithKline, Research and Development Ltd
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline
    B.5.2Functional name of contact pointCentro de Información
    B.5.3 Address:
    B.5.3.1Street AddressC/Severo Ochoa, 2 (P.T.M.)
    B.5.3.2Town/ cityTres Cantos (Madrid)
    B.5.3.3Post code208760
    B.5.3.4CountrySpain
    B.5.4Telephone number+34 902202700
    B.5.5Fax number+34 918070479
    B.5.6E-mailes-ci@gsk.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/3/17/1925
    D.3 Description of the IMP
    D.3.1Product nameGSK2857916
    D.3.2Product code GSK2857916
    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 INNbelantamab mafodotin
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeGSK2857916
    D.3.9.3Other descriptive nameGSK2857916
    D.3.9.4EV Substance CodeSUB130430
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    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 No
    D.3.11.3.2Gene therapy medical product No
    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 No
    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 No
    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 typeGSK2857916 is a Humanized afucosylated, maleimidocaproyl monomethyl auristatin phenylalanine (mcMMAF) conjugated IgG1 antibody.
    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 No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameGSK3174998
    D.3.2Product code GSK3174998
    D.3.4Pharmaceutical form Powder for solution for injection/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 INNGSK3174998
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeGSK3174998
    D.3.9.3Other descriptive nameGSK3174998
    D.3.9.4EV Substance CodeSUB178364
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number8 to 24
    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 No
    D.3.11.3.2Gene therapy medical product No
    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 No
    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 No
    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 No
    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 nameGSK3359609
    D.3.2Product code GSK3359609
    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 INNGSK3359609
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeGSK3359609
    D.3.9.3Other descriptive nameGSK3359609
    D.3.9.4EV Substance CodeSUB181939
    D.3.10 Strength
    D.3.10.1Concentration unit mg/l milligram(s)/litre
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number8 to 80
    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 No
    D.3.11.3.2Gene therapy medical product No
    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 No
    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 No
    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 typehumanized, engineered IgG4 monoclonal antibody
    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/Refractory Multiple Myeloma
    mieloma múltiple en recaída/refractario
    E.1.1.1Medical condition in easily understood language
    Relapsed/Refractory Multiple Myeloma
    mieloma múltiple en recaída/refractario
    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.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To determine the safety and tolerability of GSK’916 (belantamab mafodotin) in combination with other anti-cancer treatments (in each sub-study), and to establish the recommended Phase 2 dose for each combination treatment to explore in the CE Phase

    Part 2 –To assess the clinical activity of GSK’916 (belantamab mafodotin) at the RP2D in combination with anti-cancer treatments compared to GSK’916 (belantamab mafodotin) monotherapy in participants with RRMM
    Determinar la seguridad y tolerabilidad de GSK’916 (belantamab mafodotin) en combinación con otros tratamientos frente al cáncer (en cada subestudio) y establecer la dosis recomendada para la fase 2 del tratamiento en combinación de cada subestudio para analizar en la fase de EC

    Parte 2-Evaluar la actividad clínica de GSK’916 (belantamab mafodotin) a la DRP2 en combinación con tratamientos antitumorales comparado con GSK’916 (belantamab mafodotin) en monoterapia en cada subestudio en participantes con MMR.
    E.2.2Secondary objectives of the trial
    Key Secondary
    To evaluate the clinical measures of efficacy of GSK’916 (belantamab mafodotin) and combination treatments in participants with RRMM
    Secondary
    - To describe the exposure of GSK’916 when administered in combination with each combination treatment within each sub-study in participants with RRMM
    - To describe the exposure of the partner anti-cancer treatment when administered in combination with GSK’916 (belantamab mafodotin)
    - To assess anti-drug antibodies (ADAs) against GSK’916 (belantamab mafodotin) and against combination treatments (biologics) that are administered by IV infusion within each sub-study
    - To further determine the safety and tolerability of GSK’916 (belantamab mafodotin) in combination with other anti-cancer treatments (in each sub-study),

    Refer protocol for Part 2-Cohort Expansion secondary points.
    - Evaluar las medidas clínicas de eficacia de GSK’916 (belantamab mafodotin) y los tratamientos en combinación en cada subestudio en los participantes con MMRR
    - Describir la exposición de GSK’916 (belantamab mafodotin) cuando se administra en combinación con cada terapia combinada en cada subestudio en participantes con MMRR
    - Describir la exposición de los tratamientos antitumorales cuando se administran en combinación con GSK’916 (belantamab mafodotin) en cada subestudio
    - Evaluar los anticuerpos antifármaco (AAF) frente a GSK’916 y frente a las terapias de combinación (fármacos biológicos) que se administran en infusión i.v. en cada subestudio
    - Determinar aún más la seguridad y tolerabilidad de GSK’916 (belantamab mafodotin) en combinación con otras terapias frente al cáncer (en cada subestudio)

    Consulte el Protocolo para los Objetivos secundarios de la Parte 2.-Extensión de la cohorte.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    SUB-STUDY 1 – GSK’916 (BELANTAMAB MAFODOTIN) AND GSK’998 (AOX40) (GSK3174998)

    SUB-STUDY 2 – GSK’916 (BELANTAMAB MAFODOTIN) AND GSK’609 (AICOS) (GSK3359609)
    SUB-ESTUDIO 1 – GSK’916 (BELANTAMAB MAFODOTIN) AND GSK’998 (AOX40) (GSK3174998)

    SUB-ESTUDIO 2 – GSK’916 (BELANTAMAB MAFODOTIN) AND GSK’609 (AICOS) (GSK3359609)
    E.3Principal inclusion criteria
    Participants are eligible to be included in the study only if all of the criteria in Section 5.1 and Section 5.2 apply. In addition, participants must fulfil additional inclusion/exclusion criteria for at least 1 partner combination sub-study. Criteria for each individual substudy can be found in the respective sub-study protocol sections, starting in Section 11.

    Age
    1. Participant must be 18 years of age inclusiveor older, at the time of signing the informed consent.

    Type of Participant and Disease Characteristics
    2. Participants who have histologically or cytologically confirmed diagnosis of MM,as defined by the International Myeloma Working Group(IMWG, [Rajkumar, 2014]).

    3. Participants who have been treated with at least 3 prior lines of prior anti-myeloma treatments including an IMID (eg. lenalidomide), a proteasome inhibitor (eg. bortezomib) and an anti-CD38 monoclonal antibody. Lines of therapy are defined by consensus panel of the International Myeloma Workshop [Rajkumar, 2011a].

    4. Participants with a history of autologous stem cell transplant are eligible for study participation provided the following eligibility criteria are met:
    a. transplant was >100 days prior to screening
    b. no active infection(s)

    5. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

    6. Measurable disease defined as at least 1 of the following:
    • Serum M-protein ≥0.5 g/dL (≥5 g/L)
    • Urine M-protein ≥200 mg/24 hours
    • Serum free light chain (FLC) assay: Involved FLC level ≥10 mg/dL (≥100 mg/L) and an abnormal serum FLC ratio (<0.26 or >1.65)

    7. Have organ system functions as defined by the laboratory assessments in Table 13:

    8. All prior treatment-related toxicities (defined by National Cancer Institute- Common Toxicity Criteria for Adverse Events [NCI -CTCAE], version 5.0, 2017) must be Grade ≤1 at the time of screening except for alopecia (any grade), neuropathy (Grade ≤2), or endocrinopathy managed with replacement therapy (any grade).

    Sex
    9. Male or female
    Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies (see Appendix 7 for further details).

    a. Male Participants:
    Contraceptive use by men should be consistent with local regulations regarding the methods of contraception for those participating in the clinical studies.
    Male participants are eligible to participate if they agree to the following during the intervention period and for at least 140 days after the last dose of study intervention to allow for clearance of any altered sperm:
    Refrain from donating sperm
    PLUS either:
    • Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent
    OR
    • Must agree to use contraception/barrier as detailed below
    • Agree to use a male condom and female partner to use an additional highly effective contraceptive method with a failure rate of <1% per year when having sexual intercourse with a woman of childbearing potential who is not currently pregnant

    b. Female Participants:
    a. Contraceptive use by women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
    A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
    • Is not a woman of childbearing potential (WOCBP)
    OR
    • Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), preferably with low user dependency, as described in Appendix 7 during the intervention period and for at least 120 days after the last dose of study intervention and agrees not to donate eggs (ova, oocytes) for the purpose of reproduction during this period. The investigator should evaluate the effectiveness of the contraceptive method in relationship to the first dose of study intervention.
    • A WOCBP must have a negative highly sensitive pregnancy test ([urine or serum] as required by local regulations) within 72 hours before the first dose of study intervention.
    • The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy

    Informed Consent
    10. Capable of giving signed written informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
    Los participantes son elegibles para su inclusión en el estudio solo si cumplen todos los criterios. Asimismo, los sujetos deben cumplir los criterios de inclusión/exclusión adicionales para al menos un subestudio de combinación asociado. Los criterios para cada subestudio se disponen en las secciones respectivas del protocolo del subestudio.
    1. El participante debe tener 18 años de edad inclusive o más en el momento de la firma del consentimiento informado.
    2. Participantes con un diagnóstico de MM con confirmación histológica o citológica, conforme a la definición del International Myeloma Working Group.
    3. Participantes que han recibido al menos 3 líneas previas de tratamiento antimieloma incluyendo un IMiD (p. ej., lenalidomida), un inhibidor de la proteasoma (p. ej., bortezomib) y un anticuerpo monoclonal antiCD38. El panel de consenso del International Myeloma Workshop (IMWG) define las líneas de tratamiento.
    4. Los sujetos con antecedentes de trasplante autólogo de progenitores hematopoyéticos son elegibles para participar en el estudio siempre y cuando se cumplan los siguientes criterios de elegibilidad:
    a. el trasplante se efectuó >100 días antes de selección
    b. no presenta infecciones activas
    5. Estado funcional del Eastern Cooperative Oncology Group de 0 a 2.
    6. Enfermedad medible se define como al menos 1 de los siguientes criterios:
    - Proteína M en suero ≥0,5 g/dl (≥5 g/l)
    - Proteína M en orina ≥200 mg/24 horas
    - Análisis de la cadena ligera libre (CLL) en suero: implica un nivel de CLL ≥10 mg/dl (100 mg/l) y cociente anómalo de CLL en suero (<0,26 o >1,65)
    7. Presenta funciones de sistemas de órganos conforme a lo definido por las evaluaciones analíticas en Tabla 13.
    8. Todas las toxicidades relacionadas con el tratamiento previas (definidas por los criterios de toxicidad comunes para acontecimientos adversos del Instituto Nacional de Cáncer de EEUU [NCI-CTCAE], versión 5.0, 2017) deben ser de grado ≤1 en el momento de la selección salvo por alopecia (cualquier grado), neuropatía (grado ≤2) o endocrinopatía controlada con terapia de reemplazo (cualquier grado).
    9. Hombre o mujer
    El uso de anticonceptivos por parte de hombres o mujeres debe ser coherente con la normativa local sobre métodos anticonceptivos para participantes en estudios clínicos (véase el Apéndice 7 del protocolo para más información).
    a. Participantes masculinos:
    El uso de anticonceptivos por los varones debe ser coherente con la normativa local sobre métodos anticonceptivos para participantes en los estudios clínicos.
    Los sujetos varones son elegibles para participar si aceptan lo siguiente durante el periodo de tratamiento y, al menos, a lo largo de los 140 días posteriores a la última dosis del tratamiento del estudio para permitir el aclaramiento de cualquier esperma alterado:
    Abstenerse de donar esperma.
    MÁS:
    -Practicar la abstinencia del contacto heterosexual como su estilo de vida preferido y habitual (abstinencia a largo plazo y de manera persistente) y aceptar mantener la abstinencia.
    O
    -Debe aceptar utilizar un método anticonceptivo/de barrera según lo indicado a continuación.
    -Acepta usar un preservativo masculino y la pareja femenina debe utilizar un método anticonceptivo de gran eficacia adicional con una tasa de fracaso <1% al año durante una relación sexual con una mujer en edad fértil que no está embarazada en ese momento.
    b. Participantes femeninas:
    a. El uso de anticonceptivos por las mujeres debe ser coherente con la normativa local sobre métodos anticonceptivos para participantes en los estudios clínicos.
    Una paciente femenina es elegible para participar si no está embarazada o en periodo de lactancia y se cumple, al menos, una de las siguientes condiciones:
    - No es una mujer en edad fértil (MEF).
    O
    - Es una MEF y utiliza un método anticonceptivo altamente eficaz (con una tasa de fracaso de <1% al año), preferiblemente con una baja dependencia del usuario, conforme a lo descrito en el Apéndice 7 durante el periodo terapéutico y, al menos, en los 120 días posteriores a la última dosis del tratamiento del estudio y acepta no donar óvulos con fines de reproducción durante este periodo. El investigador debe evaluar la eficacia del método anticonceptivo en relación con la primera dosis de la terapia del estudio.
    - Una MEF debe presentar una prueba sérica de embarazo de elevada sensibilidad con resultado negativo ([en suero u orina] según lo requerido por la normativa local) en las 72 horas antes de la primera dosis del tratamiento del estudio.
    - El investigador es responsable de revisar el historial médico, antecedentes menstruales y actividad sexual reciente para reducir el riesgo de inclusión de una mujer con un embarazo no detectado precozmente.
    10. Con capacidad para otorgar el consentimiento informado por escrito firmado, que incluye el cumplimiento con los requisitos y las restricciones dispuestas en el formulario de consentimiento informado y en este protocolo.
    E.4Principal exclusion criteria
    Participants are excluded from the study if any of the following criteria apply:

    Medical Conditions
    1. Symptomatic amyloidosis, active ‘polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes’ (POEMS) syndrome, active plasma cell leukemia at the time of screening.

    2. Any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions (including lab abnormalities) that could interfere with participant’s safety, obtaining informed consent, or compliance with study procedures.

    3. Current corneal epithelial disease except mild punctate keratopathy

    4. Current unstable liver or biliary disease per investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis. Note: Stable chronic liver disease (including Gilbert’s syndrome or asymptomatic gallstones) or hepatobiliary involvement of malignancy is acceptable if participant otherwise meets entry criteria.

    5. Malignancies other than disease under study are excluded, except for any other malignancy from which the participant has been disease-free for more than 2 years and, in the opinion of the principal investigators and GSK Medical Monitor, will not affect the evaluation of the effects of this clinical trial treatment on the currently targeted malignancy (MM).
    • Participants with curatively treated non-melanoma skin cancer are not excluded.

    6. Evidence of cardiovascular risk including any of the following:
    a. QTcF interval ≥480 msecs (the QT interval values must be corrected for heart rate by Fridericia’s formula [QTcF])
    b. Evidence of current clinically significant untreated arrhythmias, including clinically significant ECG abnormalities such as 2nd degree (Mobiz Type II) or 3rd degree atrioventricular (AV) block.
    c. History of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty, stenting or bypass grafting, all within three months of Screening.
    d.Class III or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system
    e. Uncontrolled hypertension
    f. Recent (within the past 6 months) history of symptomatic pericarditis.

    7. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to GSK’916 (belantamab mafodotin) or any of the components of the study treatment. History of severe hypersensitivity to other mAbs.

    8. Active infection requiring antibiotic, antiviral, or antifungal treatment.

    9. Known HIV infection.

    10. Recent history (within the past 6 months) of acute diverticulitis, inflammatory bowel disease, intra-abdominal abscess, or gastrointestinal obstruction.

    11. Presence of hepatitis B surface antigen (HBsAg), or hepatitis B core antibody (HBcAb) at screening or within 3 months prior to first dose of study treatment

    12. Positive hepatitis C antibody test result or positive hepatitis C RNA test result at screening or within 3 months prior to first dose of study treatment.
    Note: Participants with positive Hepatitis C antibody due to prior resolved disease can be enrolled, only if a confirmatory negative Hepatitis C RNA test is obtained. Hepatitis RNA testing is optional and participants with negative Hepatitis C antibody test are not required to also undergo Hepatitis C RNA testing

    Prior/Concomitant Therapy

    13. Patients who have received prior therapy with GSK’916 (belantamab mafodotin).

    14. Other monoclonal antibodies within 30 days orsystemic anti-myeloma therapy within <14 days of first dose of study drug.

    15. Prior radiotherapy within 2 weeks of start of study therapy. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-central nervous system (CNS) disease.

    16. Plasmapheresis within 7 days prior to the first dose of study drug

    17. Prior allogeneic transplant is prohibited

    18. Patients who have received prior CAR-T therapy with lymphodepletion with chemotherapy within 3 months of screening.

    19. Any major surgery (other than bone-stabilizing surgery) within 30 days of screening.

    20. Prior treatment with a monoclonal antibody within 30 days of receiving the first dose of study drugs, or treatment with an investigational agent or approved systemic anti-myeloma therapy (including systemic steroids) within 14 days or 5 half-lives of receiving the first dose of study drugs, whichever is shorter.

    For 'Other Exclusions' please refer to the protocol.
    1. Amiloidosis sintomática, síndrome de polineuropatía, organomegalia, endocrinopatía, proteína de mieloma y cambios cutáneos (POEMS) activo, leucemia de células plasmáticas activa en el momento de la selección.
    2. Cualquier trastorno psiquiátrico, médico preexistente grave e/o inestable u otras afecciones (incluyendo anomalías de laboratorio) que puedan interferir con la seguridad del paciente, obtención del consentimiento informado o cumplimiento con los procedimientos del estudio.
    3. Enfermedad epitelial corneal actual salvo queratopatía punteada leve.
    4. Enfermedad biliar o hepática inestable actual según la evaluación del investigador definida por la presencia de ascitis, encefalopatía, coagulopatía, hipoalbuminemia, varices esofágicas o gástricas, ictericia persistente o cirrosis. Nota: Se acepta la presencia de hepatopatía crónica estable (incluyendo síndrome de Gilbert o cálculos biliares asintomáticos) o afectación hepatobiliar de la neoplasia maligna si el sujeto cumple los criterios de inclusión.
    5. Se excluyen las neoplasias malignas distintas de la enfermedad del estudio, salvo cualquier otra neoplasia no presentada por el participante durante más de 2 años y que, en opinión de los investigadores principales y el monitor médico de GSK, no afectará la evaluación de los efectos de este tratamiento del ensayo clínico sobre la neoplasia maligna objetivo actual (MM).
    - No se excluyen los participantes con cáncer de piel no melanoma tratados de manera curativa.
    6. Evidencias de riesgo cardiovascular incluyendo cualquiera de los siguientes:
    a. Intervalo QTcF ≥480 ms (los valores del intervalo QT se deben corregir para la frecuencia cardiaca conforme a la fórmula de Fridericia [QTcF]).
    b. Indicios de arritmias actualmente no tratadas y clínicamente significativas, incluyendo anomalías del ECG clínicamente significativas como bloqueo auriculoventricular (AV) de 2º (tipo II de Mobiz) o 3er grado.
    c. Antecedentes de infarto de miocardio, síndromes coronarios agudos (incluyendo angina inestable), angioplastia coronaria, implante de Stent o injerto de derivación, todos en los tres meses de la selección.
    d. Insuficiencia cardiaca de clase III o IV según se define en el sistema de clasificación funcional de la New York Heart Association.
    e. Hipertensión no controlada.
    f. Antecedentes recientes (en los últimos 6 meses) de pericarditis sintomática.
    7. Reacción de hipersensibilidad inmediata o retardada conocida o idiosincrasia a fármacos químicamente relacionados con GSK’916 (belantamab mafodotin), o cualquiera de los componentes del tratamiento del estudio. Antecedentes de hipersensibilidad grave a otros AcM.
    8. Infección activa que requiere tratamiento antibiótico, antiviral o antifúngico.
    9. Infección por VIH conocida.
    10. Antecedentes recientes (en los últimos 6 meses) de diverticulitis aguda, enfermedad intestinal inflamatoria, abscesos intraabdominales u obstrucción gastrointestinal.
    11. Presencia del antígeno de superficie de hepatitis B (HBsAg) o anticuerpo nuclear de hepatitis B (HBcAb) en la selección o en los 3 meses previos a la primera dosis del tratamiento del estudio.
    12. Resultado positivo en la prueba de anticuerpos de hepatitis C o resultado positivo en la prueba de ARN de hepatitis C en la selección o en los 3 meses previos a la primera dosis del tratamiento del estudio.
    Nota: Se pueden incluir participantes con un resultado positivo para anticuerpos de hepatitis C debido a una enfermedad resuelta previa solo si se obtiene una prueba confirmatoria negativa sobre ARN de hepatitis C. La prueba de ARN de hepatitis es opcional y los participantes con un resultado negativo en la prueba de anticuerpos de hepatitis C no necesitan someterse al análisis del ARN de hepatitis C.
    13. Pacientes que han recibido una terapia previa con GSK’916 (belantamab mafodotin).
    14. Otros anticuerpos monoclonales en 30 días o tratamiento antimieloma sistémico en < 14 días desde la primera dosis del fármaco del estudio.
    15. Radioterapia previa en un plazo de 2 semanas del inicio del tratamiento del estudio. Los participantes se deben haber recuperado de todas las toxicidades relacionadas con la radiación, no requerir corticoesteroides y no haber tenido neumonitis por radiación. Se permite un periodo de reposo de 1 semana para la radiación paliativa (≤2 semanas de radioterapia) en caso de enfermedad no en el sistema nervioso central (SNC).
    16. Plasmaféresis en los 7 días antes de la primera dosis del fármaco del estudio.
    17. Se prohíbe un trasplante alogénico previo.
    18. Pacientes que han recibido tratamiento T CAR previo con depleción linfocitaria con quimioterapia en los 3 meses de la selección.
    19. Cualquier cirugía mayor (distinta de cirugía estabilizadora de huesos) en los 30 días de la selección.

    Consulte el Protocolo para una lista completa de los criterios de exclusión.
    E.5 End points
    E.5.1Primary end point(s)
    Dose Exploration
    - Percentage (number) of participants with dose limiting toxicities (DLTs)
    - Percent of subjects with AEs, changes in clinical signs and laboratory parameters

    Part 2 – Cohort Expansion
    Overall Response Rate (ORR), according to the International Myeloma Working Group (IMWG) Response Criteria [Kumar, 2016].
    Exploración de la dosis
    - Porcentaje (número) de participantes con toxicidades limitantes de la dosis (TLD)
    - Porcentaje de sujetos con acontecimientos adverso (AA)

    Parte 2- Extensión de la cohorte
    Tasa de respuestas global (TRG), conforme a los criterios de respuesta del International Myeloma Working Group (IMWG)
    E.5.1.1Timepoint(s) of evaluation of this end point
    From when the first participant initiated treatment until the last participant has received 3 cycles of study drug(s).
    Desde que el primer participante inicia el tratamiento hasta que el último recibió 3 ciclos de medicamento(s) del estudio.
    E.5.2Secondary end point(s)
    Dose Exploration
    -Clinical activity measured as Overall Response Rate (ORR) according to the International Myeloma Working Group (IMWG) Response Criteria [Kumar, 2016].
    -GSK’916 observed concentration
    -Anti-cancer combination treatment’s observed concentration
    -Incidence and titers of ADAs against GSK’916 (belantamab mafodotin) and combination treatments, when measured.
    • AEs of special interest for GSK’916 (belantamab mafodotin)
    • AEs of special interest for combination treatments
    • Ocular findings on ophthalmic exam

    Part 2 – Cohort Expansion
    Assess the Clinical Benefit Rate (CBR) [Kumar, 2016]
    - PFS
    - DoR
    - TTR
    - OS
    - Number (%) of adverse events (AEs), Serious Adverse Events (SAEs), AEs leading to discontinuation or dose reduction/delay, changes in clinical signs, ECGs, and laboratory parameters
    - AEs of special interest for GSK’916 (belantamab mafodotin)
    - AESIs for the individual partner for each sub-study
    - Number (%) of adverse events (AEs), Serious Adverse Events (SAEs), AEs
    - Ocular findings on ophthalmic exam for GSK’916 (belantamab mafodotin)
    -GSK’916 and combination treatment’s plasma concentrations.
    -Incidence and titers of ADAs against GSK’916 and combination treatments, when measured.
    Exploración de la dosis
    - Actividad clínica determinada como tasa de respuestas global (TRG) conforme a los criterios de respuesta del International Myeloma Working Group (IMWG)
    - Concentración observada de GSK’916 (belantamab mafodotin)
    - Concentración observada del tratamiento de combinación frente al cáncer
    - Incidencia y títulos de AAF frente a GSK’916 y tratamientos combinados, cuando se realice su medición
    - AA de especial interés para GSK’916 (belantamab mafodotin)
    - AA de especial interés para las terapias de combinación
    - Hallazgos oculares durante un examen oftálmico

    Extensión de la cohorte
    - Evaluar la tasa de beneficio clínico (TBC)
    - Supervivencia libre de progresión (SLP)
    - Duración de la respuesta (DdR)
    - Tiempo hasta la respuesta (TTR)
    - Supervivencia global (SG)Número (%) de acontecimientos adversos (AA), acontecimientos adversos graves (AAG), AA que conllevan la suspensión o reducción/demora de la dosis, cambios en los signos clínicos, ECG y parámetros de laboratorio
    - AAEI de GSK’916 (belantamab mafodotin)
    - AAEI de cada fármaco asociado para cada subestudio
    - Hallazgos oculares en el examen oftálmico para GSK’916 (belantamab mafodotin)
    - Concentraciones de GSK’916 (aBCMA) y tratamientos combinados
    Incidencia y títulos de AAF frente a GSK’916 (aBCMA) y tratamientos combinados, cuando se realice su medición
    E.5.2.1Timepoint(s) of evaluation of this end point
    From when the first participant initiated treatment until the last participant has received 3 cycles of study drug(s).
    Desde que el primer participante inicia el tratamiento hasta que el último recibió 3 ciclos de medicamento(s) del estudio.
    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 No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    dose ranging
    rango de dosis
    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 Yes
    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 trial3
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA15
    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 No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Canada
    France
    Germany
    Netherlands
    Spain
    Sweden
    United States
    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
    última visita del último paciente
    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 months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years4
    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: 421
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 83
    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 state5
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 184
    F.4.2.2In the whole clinical trial 504
    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 Investigator is responsible for ensuring that consideration has been given to the post-study care of the participant’s medical condition.
    El investigador es responsable de garantizar que se haya tenido en cuenta el tratamiento posterior al estudio de la enfermedad del sujeto.
    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 Decision2019-10-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-09-17
    P. End of Trial
    P.End of Trial StatusTemporarily Halted
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