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    Summary
    EudraCT Number:2020-004742-11
    Sponsor's Protocol Code Number:64007957MMY3001
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-08-23
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2020-004742-11
    A.3Full title of the trial
    A Phase 3 Randomized Study Comparing Teclistamab in Combination with Daratumumab SC (Tec-Dara) versus Daratumumab SC, Pomalidomide, and Dexamethasone (DPd) or Daratumumab SC, Bortezomib, and Dexamethasone (DVd) in Participants with Relapsed or Refractory Multiple Myeloma
    Estudio aleatorizado fase III que compara teclistamab en combinación con daratumumab s.c. (Tec-Dara) frente a daratumumab s.c., pomalidomida y dexametasona (DPd) o daratumumab s.c., bortezomib y dexametasona (DVd) en pacientes con mieloma múltiple refractario o en recaída.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A randomized phase 3 study of Teclistamab in combination with daratumumab verses an Investigators choice of Daratumumab, Pomalidomide, Dexamethasone or Daratumumab, Velcade, Dexamethasone in Relapsed or Refractory Multiple Myeloma
    Estudio aleatorizado fase III con teclistamab en combinación con daratumumab frente a una eleccion de los investigadores de daratumumab, pomalidomida y dexametasona o daratumumab, velcade y dexametasona en mieloma múltiple refractario o en recaída.
    A.3.2Name or abbreviated title of the trial where available
    MajesTEC-3
    MajesTEC-3
    A.4.1Sponsor's protocol code number64007957MMY3001
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorJanssen-Cilag International NV
    B.1.3.4CountryBelgium
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportJanssen Research & Development, LLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International NV
    B.5.2Functional name of contact pointClinical Registry Group
    B.5.3 Address:
    B.5.3.1Street AddressArchimedesweg 29
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 CM
    B.5.3.4CountryNetherlands
    B.5.4Telephone number+31 71 524 21 06
    B.5.5Fax number+31 71 524 21 10
    B.5.6E-mailClinicalTrialsEU@its.jnj.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2331
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code JNJ-64007957
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameJNJ-64007957-AAA
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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 Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeHuman IgG4 bispecific antibody against BCMA and CD3
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2331
    D.3 Description of the IMP
    D.3.1Product nameTeclistamab
    D.3.2Product code JNJ-64007957
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTeclistamab
    D.3.9.2Current sponsor codeJNJ-64007957
    D.3.9.3Other descriptive nameJNJ-64007957-AAA
    D.3.9.4EV Substance CodeSUB185866
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number90
    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 Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeHuman IgG4 bispecific antibody against BCMA and CD3
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Darzalex
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International N.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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/3/13/1153
    D.3 Description of the IMP
    D.3.1Product nameDaratumumab co-formulated with recombinant human hyaluronidase (rHuPH20)
    D.3.2Product code JNJ-54767414
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDARATUMUMAB
    D.3.9.1CAS number 945721-28-8
    D.3.9.2Current sponsor codeJNJ-54767414
    D.3.9.3Other descriptive nameHUMAX-CD38
    D.3.9.4EV Substance CodeSUB175772
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number120
    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 Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Imnovid
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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/3/09/672
    D.3 Description of the IMP
    D.3.1Product nameImnovid
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNImnovid
    D.3.9.1CAS number 19171-19-8
    D.3.9.3Other descriptive namePOMALIDOMIDE
    D.3.9.4EV Substance CodeSUB33379
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number1 to 4
    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) No
    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: 5
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Neofordex
    D.2.1.1.2Name of the Marketing Authorisation holderLaboratoires CTRS
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameDexamethasone
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravascular use (Noncurrent)
    Oral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDEXAMETHASONE
    D.3.9.2Current sponsor codedexamethasone
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number2 to 4
    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) No
    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: 6
    D.1.2 and D.1.3IMP RoleComparator
    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 Yes
    D.2.1.1.1Trade name Velcade
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International NV
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameVelcade
    D.3.4Pharmaceutical form Powder for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBORTEZOMIB
    D.3.9.1CAS number 179324-69-7
    D.3.9.3Other descriptive nameVELCADE
    D.3.9.4EV Substance CodeSUB20020
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number1.0 to 3.5
    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) No
    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.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
    Multiple Myeloma
    Mieloma Múltiple
    E.1.1.1Medical condition in easily understood language
    Multiple Myeloma
    Mieloma Múltiple
    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 No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the efficacy of Tec-Dara with DPd/DVd
    Comparar la eficacia de Tec-Dara con DPd/DVd.
    E.2.2Secondary objectives of the trial
    - To further compare the efficacy of Tec-Dara with DPd/DVd
    - To assess the safety profile of Tec-Dara
    - To characterize the PK of teclistamab
    - To assess the immunogenicity of teclistamab and daratumumab
    - To compare the patient-reported outcomes (PROs) of Tec-Dara with DPd/DVd
    - To evaluate the efficacy of teclistamab in-high-risk molecular subgroups
    -Comparar en mayor medida la eficacia de Tec-Dara con DPd / DVd
    - Evaluar el perfil de seguridad de Tec-Dara
    - Caracterizar la PK de teclistamab
    - Evaluar la inmunogenicidad de teclistamab y daratumumab
    - Comparar los Cuestionarios de caldiad de vida (PRO) de Tec-Dara con DPd / DVd
    - Evaluar la eficacia de teclistamab en subgrupos moleculares de alto riesgo
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. ≥18 years of age.
    2. Criterion modified as per amendment 1.
    2.1 Documented multiple myeloma as defined by the criteria below:
    a. Multiple myeloma diagnosis according to the IMWG diagnostic criteria
    b. Measurable disease at screening as defined by any of the following:
    1) Serum M-protein level ≥0.5 g/dL (central laboratory); or
    2) Urine M-protein level ≥200 mg/24 hours (central laboratory); or
    3) Serum immunoglobulin free light chain ≥10 mg/dL (central laboratory) and abnormal serum immunoglobulin kappa lambda free light chain ratio.
    3. Criterion modified as per amendment 1.
    3.1 Received 1 to 3 prior line(s) of antimyeloma therapy (Appendix 6) including a PI and lenalidomide.
    a. Participants who have received only 1 line of prior line of antimyeloma therapy must be lenalidomide refractory (ie, have demonstrated progressive disease by IMWG criteria during treatment or within 60 days of completion of lenalidomide-containing regimen). Progression on or within 60 days of the last dose of lenalidomide given as maintenance will meet this criterion.
    4. Documented evidence of progressive disease based on investigator’s determination of response by IMWG criteria on or after their last regimen.
    5. Have an ECOG performance status score of 0, 1, or 2 at screening and immediately prior to the start of administration of study treatment (Appendix 7).
    6. Progression on or within 60 days of the last dose of lenalidomide given as maintenance
    will meet this criterion.
    6.1 Have clinical laboratory values meeting the criteria as defined in the protocol during the screening phase and also at start of administration of study treatment.
    7. A woman of childbearing potential must have a negative highly-sensitive serum pregnancy test at screening and again within 24 hours of the start of study treatment and must agree to further serum or urine pregnancy tests during the study
    8. Criterion modified as per amendment 1.
    8.1. A woman must be:
    a. Not of childbearing potential, or
    b. Of childbearing potential and
    1) Practicing true abstinence; or
    2) Have a sole partner who is vasectomized; or
    3) Practicing ≥1 highly-effective, user-independent method of contraception. For participants who are of childbearing potential and treated with DPd in Arm B, see Section 6.12.3 for details regarding concomitant use of estrogen-containing products and pomalidomide.
    9. Criterion modified as per amendment 1.
    9.1 A woman must agree not to donate eggs (ova, oocytes) or freeze for future use, for the purposes of assisted reproduction during the study and for 90 days after receiving the last dose of study treatment
    10. Criterion modified as per amendment 1.
    10.1 A man must wear a condom (with or without spermicidal foam/gel/film/cream/suppository) when engaging in any activity that allows for passage of ejaculate to another person during the study and for a minimum of 90 days after receiving the last dose of study treatment. If a female partner is of childbearing potential, she must also be practicing a highly effective
    method of contraception.
    11. Criterion modified as per amendment 1.
    11.1 A male participant must agree not to donate sperm for the purpose of reproduction during the study and for a minimum of 90 days after receiving the last dose of study treatment.
    12. Must be willing and able to adhere to the lifestyle restrictions specified in this protocol (Section 5.3)
    13. Must sign an ICF (or their legally acceptable representative must sign) indicating that the participant understands the purpose of, and procedures required for, the study and is willing to participate in the study.
    1. ≥ 18 años de edad.
    2. Criterio modificado en virtud de la enmienda 1.
    2.1 Documentar la enfermedad de Mieloma múltiple según lo definido por los siguientes criterios:
    a. Diagnóstico de mieloma múltiple según los criterios de diagnóstico del Grupo de Trabajo del Mieloma (IMWG).
    b. Enfermedad medible en la selección según lo definido por cualquiera de los siguientes:
    1) Nivel de proteína M en suero ≥ 0,5 g / dL (laboratorio central); o
    2) Nivel de proteína M en orina ≥200 mg / 24 horas (laboratorio central); o
    3) Cadenas ligeras libres de inmunoglobulina sérica ≥10 mg / dL (laboratorio central) y proporción anormal de cadenas ligeras libres de inmunoglobulina kappa lambda sérica.
    3. Criterio modificado en virtud de la enmienda 1.
    3.1 Recibió de 1 a 3 líneas anteriores de terapia antimieloma (Apéndice 6) que incluyen un IP y lenalidomida.
    a. Los participantes que hayan recibido solo 1 linea de tratamiento previa de terapia antimieloma deben ser refractarios a lenalidomida (es decir, haber demostrado enfermedad progresiva según los criterios del IMWG durante el tratamiento o dentro de los 60 días posteriores a la finalización del régimen que contiene lenalidomida). La progresión en los 60 días posteriores a la última dosis de lenalidomida administrada como mantenimiento cumplirá este criterio.
    4. Evidencia documentada de la progresión de la enfermedad basada en la determinación de respuesta del investigador según los criterios del IMWG en o después de su último régimen.
    5. Tener una puntuación del estado funcional ECOG de 0, 1 o 2 en la selección e inmediatamente antes del inicio de la administración del tratamiento del estudio (Apéndice 7).
    6. Progresión en o dentro de los 60 días posteriores a la última dosis de lenalidomida administrada como mantenimiento cumplirá con este criterio.
    6.1 Tener valores de laboratorio clínico que cumplan los criterios definidos en el protocolo durante la fase de selección y también al inicio de la administración del tratamiento del estudio.
    7. Una mujer en edad fértil debe tener una prueba de embarazo en suero altamente sensible negativa en el momento de la selección y nuevamente dentro de las 24 horas posteriores al inicio del tratamiento del estudio y debe aceptar que se realicen más pruebas de embarazo en suero u orina durante el estudio.
    8. Criterio modificado en virtud de la enmienda 1.
    8.1. Una mujer debe cumplir:
    a. No estar en edad fértil, o
    b. ser potencialmente fértil y
    1) Practicar la verdadera abstinencia; o
    2) Tener una pareja única que esté vasectomizada; o
    3) Utilizar ≥1 método anticonceptivo altamente eficaz e independiente del usuario. Para las participantes en edad fértil y tratadas con DPd en el Grupo B, consulte la Sección 6.12.3 para obtener detalles sobre el uso concomitante de productos que contienen estrógenos y pomalidomida.
    9. Criterio modificado en virtud de la enmienda 1.
    9.1 La mujer debe aceptar no donar óvulos (óvulos, ovocitos) o congelarlos para uso futuro, con fines de reproducción asistida durante el estudio y durante los 90 días posteriores a la recepción de la última dosis del tratamiento del estudio.
    10. Criterio modificado en virtud de la enmienda 1.
    10.1 El hombre debe usar un preservativo (con o sin espuma / gel / película / crema / supositorio espermicida) cuando participe en cualquier actividad que permita el paso de la eyaculación a otra persona durante el estudio y por un mínimo de 90 días después de recibir la última dosis del tratamiento del estudio. Si una pareja femenina está en edad fértil, también debe estar practicando con un método anticonceptivo altamente eficaz.
    11. Criterio modificado en virtud de la enmienda 1.
    11.1 El participante masculino debe aceptar no donar esperma con fines de reproducción durante el estudio y durante un mínimo de 90 días después de recibir la última dosis del tratamiento del estudio.
    12. Debe estar dispuesto y ser capaz de cumplir con las restricciones de estilo de vida especificadas en este protocolo (Sección 5.3).
    13. Debe firmar un ICF (o su representante legalmente aceptable debe firmar) indicando que el participante comprende el propósito y los procedimientos requeridos para el estudio y está dispuesto a participar en el estudio.
    E.4Principal exclusion criteria
    1. Criterion modified as per amendment 1.
    1.1 Contraindications or life-threatening allergies, hypersensitivity, or intolerance to any study drug or its excipients (refer to the teclistamab Investigator’s Brochure and appropriate package inserts), Additional exclusion criteria pertaining to specific study drugs include:
    a. A participant is not eligible to receive DPd as control therapy if any of the following are present:
    1) Contraindications or life-threatening allergies, hypersensitivity, or intolerance to pomalidomide (intolerance defined as prior therapy discontinued due to any AE related to pomalidomide)
    2) Disease that is considered refractory to pomalidomide per IMWG (progression during treatment or within 60 days of completing treatment with pomalidomide).
    b. A participant is not eligible to receive DVd as control therapy if any of the following are present:
    1) Contraindications or life-threatening allergies, hypersensitivity, or intolerance to bortezomib (intolerance defined as prior therapy discontinued due to any AE related to bortezomib)
    2) Grade 1 peripheral neuropathy with pain or Grade ≥2 peripheral neuropathy as defined by NCI-CTCAE Version 5.0
    3) Disease that is considered refractory to bortezomib per IMWG (progression during treatment or within 60 days of completing treatment with bortezomib).
    4) Received a strong CYP3A4 inducer (see Section 6.12.3.3) within 5 half-lives prior to randomization.
    c. A participant is not eligible for this study if they are refractory to both pomalidomide and bortezomib.
    2. Received any prior BCMA-directed therapy.
    3. Has disease that is considered refractory to an anti-CD38 monoclonal antibody per IMWG (progression during treatment or within 60 days of completing therapy with an anti-CD38 monoclonal antibody).
    4. Received the following prior antimyeloma therapy, in the specified time frame prior to randomization:
    a. Targeted therapy, epigenetic therapy, or treatment with an investigational drug or an invasive investigational medical device within 21 days or ≥5 half-lives, whichever is less
    b. Investigational vaccine within 4 weeks
    c. Monoclonal antibody therapy within 21 days
    d. Cytotoxic therapy within 21 days
    e. PI therapy within 14 days
    f. IMiD agent therapy within 14 days
    g. Radiotherapy within 14 days or focal radiation within 7 days
    h. Gene-modified adoptive cell therapy (eg, chimeric antigen receptor modified T cells, NK cells) within 3 months.
    5. Stem cell transplant:
    a. An allogeneic stem cell transplant within 6 months before randomization. Participants who received an allogeneic transplant must be off all immunosuppressive medications for ≥42 days without signs of graft-versus-host disease before randomization.
    b. An autologous stem cell transplant within 12 weeks before randomization.
    6. Received a cumulative dose of corticosteroids equivalent to ≥140 mg of prednisone within 14 days before randomization.
    7. Received a live, attenuated vaccine within 4 weeks before randomization.
    8. Myelodysplastic syndrome or active malignancies (ie, progressing or requiring treatment change in the last 24 months) other than relapsed/refractory multiple myeloma. The only allowed exceptions are:
    a. Non-muscle invasive bladder cancer treated within the last 24 months that is considered completely cured
    b. Skin cancer (non-melanoma or melanoma) treated within the last 24 months that is considered completely cured
    c. Noninvasive cervical cancer treated within the last 24 months that is considered completely cured
    d. Localized prostate cancer (N0M0):
    1) With a Gleason score of ≤6, treated within the last 24 months, or untreated and under surveillance
    2) With a Gleason score of 3+4 that has been treated >6 months prior to full study screening and considered to have a very low risk of recurrence, or
    3) History of localized prostate cancer and receiving androgen deprivation therapy and considered to have a very low risk of recurrence.
    e. Breast cancer: adequately treated lobular carcinoma in situ or ductal carcinoma in situ, or history of localized breast cancer and receiving antihormonal agents and considered to have a very low risk of recurrence
    f. Other malignancy that is considered cured with minimal risk of recurrence.
    9. Plasma cell leukemia at the time of screening, Waldenström’s macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes), or primary amyloid light chain amyloidosis.


    For a full list of exclusion criteria, please refer to section 5.2 of the study protocol
    1.Criterio modif. en virtud de la enmienda1.
    1.1Contraindicación o alergias potencialmente mortales, hipersensibilidad o intolerancia a cualquiera de los fármacos del estudio o sus excipientes (ver manual del investigador de Tecli. y los prospectos). Otros criterios de excl. debidos a fármacos concretos del estudio:a.Se considerará que el ppte. no es apto para recibir DPd como tto comparador si se da cualquiera de estas situaciones:
    1)Contraindicación o alergias potencialmente mortales, hipersensibilidad o intolerancia a la pomalidomida (la intolerancia se define como el abandono de una línea de tto. anterior por un AA de este fármaco)2) Enf. resistente a la pomalidomida según los crit. del IMWG (progresión durante el tto. o en un plazo de 60días tras finalizar el tto. con pomalidomida) b.Se considerará que el ppte. no es apto para recibir DVd como tto. comparador si se da cualquiera de estas situaciones:
    1)Contraindicación o alergias potencialmente mortales, hipersensibilidad o intolerancia al bortezomib (la intolerancia se define como el abandono de una línea de tto. anterior por un AA de este fármaco).2) Neuropatía periférica con dolor de G1 o neuropatía periférica de G≥2 según la v.5.0 de la terminología común de AA (NCI-CTCAE)3) Enf. resistente al bortezomib. según los criterios del IMWG (progresión durante el tto. o en un plazo de 60días tras finalizar el tto. con bortezomib)
    4)Recepción de un inductor potente de CYP3A4 (ver apartado6.12.3.3) en las 5semividas previas a la aleatorización.
    c.Se considerará que el ppte. no es apto para participar en este estudio si es resistente a pomalidomida y a bortezomib.
    2.Recepción de cualquier tto dirigido anterior contra BCMA. 3. Enf. considerara resistente a un anticuerpo monoclonal anti-CD38 según los criterios del IMWG (progresión durante el tto. o en un plazo de 60días tras finalizar el tto. con anticuerpos monoclonales anti-CD38).4. Recepción de los siguientes tto. para el mieloma en los plazos previos a la aleatorización especificados:
    a.Tto.dirigido, epigenético o con un fármaco en investigación o con un producto sanitario invasivo en estudio en los 21días anteriores o en≥5semividas, lo que sea más reciente; b. Vacuna en invest. en las 4semanas anteriores; c.Tto. con anticuerpos monoclonales en los 21días anteriores;d.Tto. citotóxico en los 21días anteriores.;e. Tto. con IP en los 14días anteriores; f.Tto. con inmunomodul. en los 14días anteriores.
    g.Radioterapia en los 14días anteriores o radiación focalizara en los 7días anteriores;h. Tto. celular adoptivo con modificación genética (p.ej.,linfocitosT modificados con receptores del antígeno quimérico, cels NK) en los 3meses anteriores.5. Trasplante de cels. progenitoras hematopoyéticas:
    a.Alotrasplante de cels. progenitoras hematopoyéticas en los 6meses anteriores a la aleatorización. Los ppte. que hayan recibido un alotrasplante deben haber dejado de recibir medicación inmunodepresora≥42días antes de la aleatorización y no haber presentado signos de enf. huésped contra injerto en este periodo.b. Autotrasplante cels. progenitoras hematopoyéticas en las 12semanas previas a la aleatorización.
    6.Recepción de 1dosis acumulada de corticoesteroides equivalente a ≥140mg de prednisona en los 14días previos a la aleatorización.
    7.Recepción de 1vacuna atenuada en las 4semanas previas a la aleatorización.
    8.Síndrome mielodisplásico o neoplasias malignas activas (i.e, que progresan o requieren un cambio de tto.en los últimos 24meses) que no sean MMrecidivante/refractario. Las únicas excepciones permitidas son:
    a.Cáncer de vejiga no músculo invasivo tratado en los últimos 24meses que se considera completamente curado.
    b.Cáncer de piel (no melanoma o melanoma) tratado en los últimos 24meses que se considera completamente curado.
    c.Cáncer de cuello uterino no invasivo tratado en los últimos 24meses que se considera completamente curado.
    d.Cáncer de próstata localizado(N0M0): 1)Con una puntuación de Gleason≤6, tratados en los últimos 24meses o sin tto.y bajo vigilancia
    2)Con una puntuación de Gleason de3+4que ha sido tratada> 6meses antes de la selección completa del estudio y se considera que tiene un riesgo muy bajo de recurrencia, o 3)Antecedentes de cáncer de próstata localizado y que reciben terapia de privación de andrógenos y se considera que tienen un riesgo bajo de recurrencia.
    e.Cáncer de mama: carcinoma lobulillar insitu adecuadamente tratado o carcinoma ductal insitu, o antecedentes de cáncer de mama localizado, que reciban agentes antihormonales y tengan bajo riesgo de recurrencia.
    f.Otra neoplasia que se considera curada con un riesgo min. de recurrencia.
    9.Leucemia de céls. plasmáticas en el momento de la selección, macroglobulinemia de Waldenström, síndrome POEMS (polineuropatía, organomegalia, endocrinopatía, proteínaM y cambios cutáneos)o amiloidosis primaria de cadena ligera amiloide.
    Para conocer la lista completa de los criterios de excl., consulte la sección 5.2 del protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    PFS
    SLP
    E.5.1.1Timepoint(s) of evaluation of this end point
    At dosing days
    En los días de dosificación
    E.5.2Secondary end point(s)
    - Overall response (PR or better)
    - VGPR or better
    - CR or better
    - MRD negativity
    - PFS-2
    - OS
    - Time to next treatment
    Respuesta general (RP o mejor)
    - RPMB o mejor
    - RC o mejor
    - ERM negativa
    - SLP-2
    - SGO
    - Tiempo para el próximo tratamiento
    E.5.2.1Timepoint(s) of evaluation of this end point
    At dosing days
    En los días de dosificación
    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 No
    E.6.12Pharmacoeconomic No
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    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) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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 concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA61
    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
    Brazil
    Canada
    China
    Japan
    Korea, Republic of
    Russian Federation
    Taiwan
    Ukraine
    United States
    Argentina
    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
    Final OS analysis
    Análisis SGO Final
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    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 years5
    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: 504
    F.1.3Elderly (>=65 years) No
    F.1.3.1Number of subjects for this age range: 56
    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 state52
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 560
    F.4.2.2In the whole clinical trial 560
    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)
    None
    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 Decision2021-11-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-08-27
    P. End of Trial
    P.End of Trial StatusOngoing
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