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The European Union Clinical Trials Register   allows you to search for protocol and results information on:
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    The EU Clinical Trials Register currently displays   43856   clinical trials with a EudraCT protocol, of which   7284   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
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    Summary
    EudraCT Number:2021-001242-35
    Sponsor's Protocol Code Number:68284528MMY3004
    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:2021-12-09
    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 number2021-001242-35
    A.3Full title of the trial
    A Phase 3 Randomized Study Comparing Bortezomib, Lenalidomide and Dexamethasone (VRd) followed by Ciltacabtagene Autoleucel, a Chimeric Antigen Receptor T cell (CAR-T) Therapy Directed Against BCMA versus Bortezomib, Lenalidomide, and Dexamethasone (VRd) followed by Lenalidomide and Dexamethasone (Rd) Therapy in Participants with Newly Diagnosed Multiple Myeloma for Whom Hematopoietic Stem Cell Transplant is Not Planned as Initial Therapy
    Estudio aleatorizado en fase III que compara bortezomib, lenalidomida y dexametasona (VRd) seguidos de ciltacabtagene autoleucel, una terapia de linfocitos T con receptor de antígeno quimérico (T-CAR) dirigida contra BCMA frente a bortezomib, lenalidomida y dexametasona (VRd) seguidos de una terapia con lenalidomida y dexametasona (Rd) en pacientes con diagnóstico reciente de mieloma múltiple para los que no está previsto un trasplante de células madre hematopoyéticas como tratamiento inicial
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Randomized Study Comparing Bortezomib, Lenalidomide and Dexamethasone (VRd) followed by Ciltacabtagene Autoleucel versus Bortezomib, Lenalidomide, and Dexamethasone (VRd) followed by Lenalidomide and Dexamethasone (Rd) Therapy in Participants with Newly Diagnosed Multiple Myeloma for Whom Stem Cell Transplant is Not Planned as Initial Therapy
    Un estudio aleatorizado que compara bortezomib, lenalidomida y dexametasona (VRd) seguido de ciltacabtagene autoleucel frente a bortezomib, lenalidomida y dexametasona (VRd) seguido de lenalidomida y dexametasona en pacients con mieloma múltiple recién diagnosticado por trasplante como terapia inicial
    A.3.2Name or abbreviated title of the trial where available
    CARTITUDE-5
    CARTITUDE-5
    A.4.1Sponsor's protocol code number68284528MMY3004
    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 code2333CM
    B.5.3.4CountryNetherlands
    B.5.4Telephone number+31 71 524 21 66
    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 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 nameBortezomib
    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.3.9.4EV Substance CodeSUB20020
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number3.5
    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.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 Yes
    D.2.1.1.1Trade name Revlimid
    D.2.1.1.2Name of the Marketing Authorisation holderBristol Myers Squibb Pharma EEIG
    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 nameLenalidomide
    D.3.4Pharmaceutical form Capsule, hard
    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 INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg/g milligram(s)/gram
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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: 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 Dexamethasone
    D.2.1.1.2Name of the Marketing Authorisation holdermibe GmbH Arzneimittel Munchener Str. 15
    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 Tablet
    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 INNDEXAMETHASONE
    D.3.9.3Other descriptive nameDexamethson
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    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: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCiltacabtagene Autoleucel
    D.3.2Product code JNJ-68284528
    D.3.4Pharmaceutical form Dispersion 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 INNN/A
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeJNJ-68284528
    D.3.9.3Other descriptive nameJNJ-68284528
    D.3.9.4EV Substance CodeSUB197280
    D.3.10 Strength
    D.3.10.1Concentration unit kg kilogram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number0.5 to 1.0
    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) Yes
    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 numberThe EMA/CAT considers that product JNJ-68284528, falls within the definition of gene therapy medicinal product. Product ref.: H0005095
    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 Yes
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    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.IMP: 5
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Revlimid
    D.2.1.1.2Name of the Marketing Authorisation holderBristol Myers Squibb Pharma EEIG
    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 nameLenalidomide
    D.3.4Pharmaceutical form Capsule, hard
    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 INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg/g milligram(s)/gram
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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 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 Revlimid
    D.2.1.1.2Name of the Marketing Authorisation holderBristol Myers Squibb Pharma EEIG
    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 nameLenalidomide
    D.3.4Pharmaceutical form Capsule, hard
    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 INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg/g milligram(s)/gram
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    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: 7
    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 Revlimid
    D.2.1.1.2Name of the Marketing Authorisation holderBristol Myers Squibb Pharma EEIG
    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 nameLenalidomide
    D.3.4Pharmaceutical form Capsule, hard
    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 INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg/g milligram(s)/gram
    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 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: 8
    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 Revlimid
    D.2.1.1.2Name of the Marketing Authorisation holderBristol Myers Squibb Pharma EEIG
    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 nameLenalidomide
    D.3.4Pharmaceutical form Capsule, hard
    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 INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg/g milligram(s)/gram
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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: 9
    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 Revlimid
    D.2.1.1.2Name of the Marketing Authorisation holderBristol Myers Squibb Pharma EEIG
    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 nameLenalidomide
    D.3.4Pharmaceutical form Capsule, hard
    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 INNLENALIDOMIDE
    D.3.9.1CAS number 191732-72-6
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg/g milligram(s)/gram
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2.5
    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.IMP: 10
    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 Dexamethasone
    D.2.1.1.2Name of the Marketing Authorisation holderAspen Pharma Trading Limited
    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 Tablet
    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 INNDEXAMETHASONE
    D.3.9.3Other descriptive nameDexamethson
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    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
    Newly diagnosed multiple myeloma
    Mieloma múltiple recién diagnosticado
    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 compare the efficacy of bortezomib, lenalidomide, and dexamethasone (VRd) induction followed by a single administration of cilta-cel versus VRd induction followed by lenalidomide and dexamethasone (Rd) maintenance in terms of progression-free survival (PFS)
    Comparar la eficacia de la inducción de VRd seguida de una única administración de cilta-cel frente a la inducción de VRd seguida de mantenimiento con Rd en términos de supervivencia sin progresión (SSP)
    E.2.2Secondary objectives of the trial
    1. To characterize minimal residual disease (MRD) negativity
    2. To further compare the efficacy of VRd induction followed by a single administration of cilta-cel versus VRd induction followed by Rd maintenance
    3. To characterize the safety of cilta-cel VRd induction followed by a single administration of cilta-cel versus VRd induction followed by Rd maintenance
    4. To characterize the pharmacokinetics and pharmacodynamics of cilta-cel
    5. To assess the immunogenicity of cilta-cel
    6. To determine whether replication competent lentivirus is present in participants that receive cilta-cel
    7. To evaluate the patient-reported outcomes (PRO) associated with VRd induction followed by single administration of cilta-cel versus VRd induction followed by Rd maintenance
    1. Caracterizar la negatividad de la enfermedad mínima residual (ERM)
    2. Comparar aún más la eficacia de la inducción de VRd seguida de una sola administración de cilta-cel frente a la inducción de VRd seguida de mantenimiento de Rd
    3. Caracterizar la seguridad de la inducción de cilta-cel VRd seguida de una sola administración de cilta-cel frente a la inducción de VRd seguida de mantenimiento de Rd
    4. Caracterizar la farmacocinética y farmacodinámica de cilta-cel
    5. Evaluar la inmunogenicidad de cilta-cel
    6. Determinar si el lentivirus competente en replicación está presente en los pacientes que reciben cilta-cel
    7. Evaluar los resultados informados por el paciente (PRO) asociados con la inducción de VRd seguida de la administración única de cilta-cel frente a la inducción de VRd seguida de mantenimiento de Rd.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Each potential participant must satisfy all of the following criteria to be enrolled in the study:
    Age, Type of Participant, and Disease Characteristic
    1. ≥18 years of age
    2. Documented diagnosis of MM according to IMWG diagnostic criteria
    3. Measurable disease at Screening as defined by any of the following:
    • Serum monoclonal paraprotein (M-protein) level ≥1.0 g/dL or urine M-protein level ≥200 mg/24 hours; or
    • Light chain MM in whom only measurable disease is by serum free light chain (FLC) levels: Serum Ig free light chain ≥10 mg/dL and abnormal serum Ig kappa/lambda FLC ratio.
    4. Not considered for high-dose chemotherapy with autologous stem cell transplant (ASCT) due to:
    • Ineligible due to advanced age; or
    • Ineligible due to presence of comorbid condition(s) likely to have a negative impact on tolerability of high-dose chemotherapy with ASCT; or
    • Deferral of high-dose chemotherapy with ASCT as initial treatment.
    5. Eastern Cooperative Oncology Group Performance Status grade of 0 or 1
    Contraceptive/Barrier Requirements
    6. A woman of childbearing potential (WOCBP) must have 2 negative highly sensitive serum (β-human chorionic gonadotropin) tests prior to starting VRd. The first test must be within 10 to 14 days prior to the start of VRd. The second pregnancy test will be done within 24 hours prior to the start of VRd. The investigator must verify that the results of these tests are negative prior to starting VRd.
    7. When a woman is of childbearing potential, the participant must commit either to abstaining continuously from heterosexual intercourse or agree to practice 2 methods of reliable birth control simultaneously, ie, one highly effective method of contraception (failure rate of <1% per year when used consistently and correctly; see examples below) and one other effective method (ie, male latex or synthetic condom, diaphragm, or cervical cap). The participant must agree to remain on both methods of birth control from the time of signing the informed consent until at least 1 year after receiving cilta-cel infusion or for at least 4 weeks following the last dose of lenalidomide or for 3 months after receiving the last dose of bortezomib (whichever is later). Reliable contraception is indicated even where there has been a history of infertility, unless it is due to hysterectomy. Women of childbearing potential should be referred to a qualified provider of contraceptive methods, if needed. Examples of highly effective contraceptives include:
    • User-independent methods: 1) implantable progestogen-only hormone contraception associated with inhibition of ovulation; 2) intrauterine device; intrauterine hormone releasing system; 3) vasectomized partner.
    • User-dependent method: progestogen-only hormone contraception associated with inhibition of ovulation (oral or injectable). Estrogen-containing hormonal contraception is contraindicated due to increased risk of thromboembolic events with lenalidomide.
    • Women of childbearing potential must follow the contraception criteria outlined in the global REVLIMID® pregnancy prevention program or equivalent local Risk
    Evaluation and Mitigation Strategy, whichever is more stringent, as applicable in their region.
    8. A man must commit either to abstaining continuously from heterosexual intercourse or a man
    • Who is sexually active with a WOCBP or a pregnant woman must agree to use a barrier method of contraception (eg, latex or synthetic condom with spermicidal foam/gel/film/cream/suppository), from the time of signing the informed consent form (ICF) until at least 1 year after receiving cilta-cel infusion or for at least 4 weeks after the last dose of lenalidomide or for at least 3 months after the last dose of bortezomib (whichever is later), even if they have undergone a successful vasectomy.
    • Should agree to practice contraception according to and for the time frame specified in the global REVLIMID® pregnancy prevention program or equivalent local REVLIMID® pregnancy prevention program, whichever is more stringent.
    9. Women and men must agree not to donate eggs (ova, oocytes) or sperm, respectively, during the study and for at least 1 year after receiving a cilta-cel infusion or for at least 4 weeks after the last dose of lenalidomide or for at least 3 months after the last dose of bortezomib (whichever is later).
    Informed Consent
    10. Participant must sign an ICF indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study. Consent is to be obtained prior to the initiation of any study-related tests or procedures that are not part of standard-of-care for the participant’s disease.
    11. Willing and able to adhere to the prohibitions and lifestyle restrictions.

    For additional information see section 5.1 of the protocol.
    1. ≥18 años de edad
    2. Diagnóstico documentado de MM según criterios de diagnóstico de IMWG
    3. Enfermedad medible en la selección según lo definido por cualquiera de los siguientes:
    •Nivel de paraproteína monoclonal (proteína M) en suero ≥1.0 g / dL o nivel de proteína M en orina ≥200 mg / 24 horas; o MM de cadena ligera (CL)L en el que la enfermedad solo se puede medir mediante niveles de cadenas ligeras libres (CLL) en suero: CLL de Ig en suero ≥10 mg / dL y relación Ig kappa / lambda CLL en suero anormal.
    4. No se considera para quimioterapia de dosis alta con trasplante autólogo de células madre (TACM) debido a: • No elegible debido a edad avanzada; o afecciones comórbidas que probablemente tengan impacto negativo en tolerabilidad de quimioterapia de dosis alta con TACM; o aplazamiento de quimioterapia de dosis alta con TACM como tto inicial.
    5. Calificación del estado de desempeño del Eastern Cooperative Oncology Group de 0 o 1
    Requisitos de anticonceptivos/barreras
    6. Mujer en edad fértil (WOCBP) debe tener 2 pruebas de suero altamente sensible negativas (gonadotropina coriónica humana β) antes de comenzar con VRd. La 1ª prueba debe realizarse dentro de los 10 a 14 días anteriores al inicio de VRd. 2ª prueba embarazo dentro de las 24 h. anteriores al inicio de VRd. El inv. debe verificar que los resultados sean negativos antes de comenzar con VRd.
    7. Mujer en edad fértil, comprometerse a abstenerse de relaciones heterosexuales o aceptar practicar 2 métodos de control de la natalidad confiables simultáneamente, es decir, un método anticonceptivo altamente efectivo (tasa de falla de <1% por año cuando se usa de manera consistente y correcta) y otro método efectivo (es decir, condón de látex masculino o sintético, diafragma o capuchón cervical). La pac. debe aceptar permanecer en ambos métodos de control de la natalidad desde la firma del ICF el hasta al menos 1 año después de recibir infusión de cilta-cel o durante al menos 4 semanas después de última dosis de lenalidomida o durante 3 meses después de recibir la última dosis de bortezomib (la que sea posterior). La anticoncepción confiable está indicada incluso cuando ha habido antecedentes de infertilidad, a menos que se deba a una histerectomía. Las mujeres en edad fértil deben ser derivadas a un proveedor calificado de métodos anticonceptivos, si es necesario. Ej. anticonceptivos altamente efectivos: • Métodos independientes del usuario: 1) anticoncepción hormonal implantable de progestágeno solo asociada con la inhibición de la ovulación; 2) dispositivo intrauterino; sistema de liberación de hormonas intrauterinas; 3) pareja vasectomizada.
    • Método dependiente del usuario: anticoncepción hormonal con progestágeno solo asociada con la inhibición de la ovulación (oral o inyectable). La anticoncepción hormonal que contiene estrógenos está contraindicada debido al mayor riesgo de eventos tromboembólicos con lenalidomida.
    • Mujeres en edad fértil deben seguir los criterios de anticoncepción descritos en el programa global de prevención de embarazos REVLIMID® o riesgo local equivalente.
    Estrategia de evaluación y mitigación, la que sea más estricta, según corresponda en su región.
    8. Un hombre debe comprometerse a abstenerse de las relaciones heterosexuales o con un hombre
    • Quien es sexualmente activo con un WOCBP o una mujer embarazada debe aceptar usar un método anticonceptivo de barrera (p. ej. condón de látex o sintético con espuma / gel / película / crema / supositorio espermicida), desde el momento de firmar el formulario de consentimiento informado (ICF) hasta al menos 1 año después de recibir la perfusión de cilta-cel o durante al menos 4 semanas después de la última dosis de lenalidomida o durante al menos 3 meses después de la última dosis de bortezomib (lo que sea posterior), incluso si se han sometido a una vasectomía exitosa.
    • Deben estar de acuerdo en practicar la anticoncepción de acuerdo con y durante el período de tiempo especificado en el programa global de prevención del embarazo REVLIMID® o el programa local equivalente de prevención del embarazo REVLIMID®, el que sea más estricto.
    9. Mujeres y hombres deben aceptar no donar óvulos (óvulos, ovocitos) o esperma, durante el estudio y al menos 1 año después de recibir infusión de cilta-cel o durante al menos 4 semanas después de la última dosis de lenalidomida o durante al menos 3 meses después de la última dosis de bortezomib (lo que ocurra más tarde).
    ICF
    10. El Pac. debe firmar un ICF indicando que comprende el propósito y los procedimientos requeridos para el estudio y que está dispuesto a participar en el estudio. El ICF debe obtenerse antes del inicio de cualquier prueba o procedimiento relacionado con el estudio que no sea parte del estándar de atención para la enfermedad del pac.
    11. Dispuesto y capaz de adherirse a las prohibiciones y restricciones de estilo de vida.
    Para obtener información adicional, consulte la sección 5.1 del protocolo.
    E.4Principal exclusion criteria
    Any potential participant who meets any of the following criteria will be excluded from participating in the study:
    Medical Condition
    1. Frailty index of ≥ 2 according to Myeloma Geriatric Assessment score
    2. Active malignancies (ie, progressing or requiring treatment change in the last 24 months) other than the disease being treated under study. The only allowed exceptions are:
    • non-muscle invasive bladder cancer treated within the last 24 months that is considered completely cured.
    • skin cancer (non-melanoma or melanoma) treated within the last 24 months that is considered completely cured.
    • non-invasive cervical cancer treated within the last 24 months that is considered completely cured.
    • localized prostate cancer (N0M0):
    - with a Gleason score of ≤6, treated within the last 24 months or untreated and under surveillance,
    - with a Gleason score of 3+4 that has been treated more than 6 months prior to full study screening and considered to have a very low risk of recurrence, or
    - history of localized prostate cancer and receiving androgen deprivation therapy and considered to have a very low risk of recurrence.
    • 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.
    • malignancy that is considered cured with minimal risk of recurrence.
    3. Peripheral neuropathy or neuropathic pain Grade 2 or higher, as defined by the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 5.
    4. The following cardiac conditions:
    • New York Heart Association Stage III or IV congestive heart failure
    • Myocardial infarction or coronary artery bypass graft ≤6 months prior to enrollment
    • History of clinically significant ventricular arrhythmia or unexplained syncope, not believed to be vasovagal in nature or due to dehydration
    • History of severe non-ischemic cardiomyopathy
    • Impaired cardiac function (left ventricular ejection fraction <45%) as assessed by echocardiogram or multiple-gated acquisition (MUGA) scan (performed ≤8 weeks of apheresis)
    5. Known active, or prior history of central nervous system (CNS) involvement or exhibits clinical signs of meningeal involvement of MM.
    6. Stroke or seizure within 6 months of signing ICF.
    7. Plasma cell leukemia at the time of screening (>2.0 x 10^9/L plasma cells by standard differential), Waldenström’s macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes), or primary amyloid light-chain amyloidosis.
    8. Seropositive for human immunodeficiency virus (HIV).
    9. Vaccinated with live, attenuated vaccine within 4 weeks prior to first dose of VRd.
    10. Hepatitis B infection. In the event the infection status is unclear, quantitative levels are necessary to determine the infection status
    11. Hepatitis C infection defined as (anti-hepatitis C virus [HCV] antibody positive or detectable HCV-RNA) or known to have a history of hepatitis C.
    12. Participant must not require continuous supplemental oxygen.
    13. Contraindications, known life-threatening allergies, hypersensitivity, or intolerance to any of the study treatments (if known) or any of their excipients, including boron, mannitol and dimethyl sulfoxide.
    14. Serious underlying medical condition, such as:
    • Evidence of active viral or bacterial infection requiring systemic antimicrobial therapy, or uncontrolled systemic fungal infection
    • Active autoimmune disease
    • Overt clinical evidence of dementia or altered mental status
    • Any history of Parkinson’s disease or other neurodegenerative disorder Prior/Concomitant Medications
    15. Prior treatment with CAR-T therapy directed at any target.
    16. Any therapy that is targeted to BCMA.
    17. Any prior therapy for MM or smoldering myeloma other than a short course of corticosteroids (not to exceed 40 mg of dexamethasone, or equivalent per day for a maximum of 4 days, total of 160 mg dexamethasone or equivalent) or maximum 1 cycle of VRd therapy prior to enrollment, in a dosing regimen that is consistent with the protocol regimen for VRd induction.
    18. Received a strong cytochrome P450 (CYP) 3A4 inducer within 5 half-lives prior to VRd induction therapy
    Prior/Concurrent Clinical Study Experience
    19. Received an investigational treatment (including investigational vaccines) or used an invasive investigational medical device within 15 days prior to VRd induction therapy or is currently enrolled in an investigational study.

    For additional information see section 5.2 of the protocol.
    1. Índ. fragilidad ≥ 2 según puntuación de la evaluación geriátrica del mieloma
    2. Neoplasias activas (que progresan o requieren cambio de tto. en los últimos 24 meses) distintas de la enfermedad que se está tratando en estudio. Excepciones permitidas: • Cáncer vejiga no músculo invasivo tratado en últimos 24 meses que se considera completamente curado
    • cáncer de piel (no melanoma o melanoma) tratado en los últimos 24 meses que se considera completamente curado.
    • Cáncer de cuello uterino no invasivo tratado en los últimos 24 meses que se considera completamente curado.
    • cáncer de próstata localizado (N0M0):
    - con una puntuación de Gleason ≤6, tratados en los últimos 24 meses o sin tratamiento y bajo vigilancia,
    - con una puntuación de Gleason de 3 + 4 que ha sido tratada más de 6 meses antes de la selección completa del estudio y se considera que tiene un riesgo muy bajo de recurrencia, o
    - antecedentes cáncer de próstata localizado y que reciben terapia de privación de andrógenos y se considera que tienen un riesgo muy bajo de recurrencia.
    • cáncer de mama: carcinoma lobulillar in situ adecuadamente tratado o carcinoma ductal in situ, o antecedentes de cáncer de mama localizado y en tratamiento con agentes antihormonales y que se considera que tiene un riesgo muy bajo de recurrencia.
    • malignidad que se considera curada con un riesgo mínimo de recurrencia.
    3. Neuropatía periférica o dolor neuropático de Grado 2 o >, según criterios terminológicos comunes para eventos adversos del Instituto Nacional del Cáncer (NCI-CTCAE) Versión 5.
    4. Las siguientes afecciones cardíacas:
    • Insuficiencia cardíaca congestiva en estadio III o IV de la New York Heart Association
    • Infarto de miocardio o injerto de derivación de arteria coronaria ≤ 6 meses antes de la inscripción
    • Historia de arritmia ventricular clínicamente significativa o síncope inexplicable, que no se cree que sea de naturaleza vasovagal o debido a deshidratación
    • Antecedentes de miocardiopatía no isquémica grave
    • Deterioro de la función cardíaca (fracción de eyección del ventrículo izquierdo <45%) según lo evaluado por ecocardiograma o exploración de adquisición múltiple (MUGA) (realizada ≤8 semanas de aféresis)
    5. Historia activa o previa conocida de afectación del sistema nervioso central (SNC) o muestra signos clínicos de afectación meníngea del MM.
    6. Accidente cerebrovascular o convulsión dentro de los 6 meses posteriores a la firma de la ICF.
    7. Leucemia de células plasmáticas en el momento del cribado (> 2,0 x 10 ^ 9 / L células plasmáticas por diferencial estándar), macroglobulinemia de Waldenström, síndrome POEMS (polineuropatía, organomegalia, endocrinopatía, proteína monoclonal y cambios cutáneos) o luz amiloide primaria amiloidosis en cadena.
    8. Seropositivo para el virus de la inmunodeficiencia humana (VIH).
    9. Vacunado con vacuna viva atenuada en las 4 semanas anteriores a la primera dosis de VRd.
    10. Infección por hepatitis B. En caso de que el estado de la infección no esté claro, se necesitan niveles cuantitativos para determinar el estado de la infección.
    11. Infección por hepatitis C definida como (anticuerpo anti-virus de la hepatitis C [VHC] positivo o ARN-VHC detectable) o que se sabe que tiene antecedentes de hepatitis C.
    12. El participante no debe requerir oxígeno suplementario continuo.
    13. Contraindicaciones, alergias potencialmente mortales conocidas, hipersensibilidad o intolerancia a cualquiera de los tratamientos del estudio (si se conocen) o cualquiera de sus excipientes, incluidos boro, manitol y dimetilsulfóxido.
    14. Condición médica subyacente grave, como: • Evidencia de infección viral o bacteriana activa que requiera terapia antimicrobiana sistémica o infección fúngica sistémica no controlada
    • Enfermedad autoinmune activa
    • Evidencia clínica manifiesta de demencia o estado mental alterado
    • Cualquier historial de la enfermedad de Parkinson u otro trastorno neurodegenerativo Medicamentos previos/concomitantes
    15. Tratamiento previo con terapia CAR-T dirigida a cualquier objetivo.
    16. Cualquier terapia dirigida a BCMA.
    17. Cualquier terapia previa para MM o mieloma latente que no sea un ciclo corto de corticosteroides (que no exceda los 40 mg de dexametasona, o equivalente por día durante un máx. 4 días, total de 160 mg de dexametasona o equivalente) o un máx. 1 ciclo de Terapia con VRd antes de la inscripción, en un régimen de dosificación que sea consistente con el régimen de protocolo para la inducción de VRd.
    18. Recibió inductor potente del citocromo P450 (CYP) 3A4 en los 5 periodos antes de terapia de inducción con VRd experiencia previa/concurrente en estudios clínicos
    19. Recibió un tto. en investigación (incluidas vacunas en investigación) o utilizó un dispositivo médico en investigación invasivo dentro de los 15 días anteriores a la terapia de inducción con VRd o está actualmente inscrito en un estudio de investigación.
    Mas información en sección 5.2 del protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    Progression-free survival (PFS) with progression defined by IMWG criteria, or death, whichever occurred first.
    Supervivencia libre de progresión (SLP) con progresión definida por los criterios del IMWG, o muerte, lo que ocurra primero.
    E.5.1.1Timepoint(s) of evaluation of this end point
    From the date of randomization to the date of first documented progressive disease (PD), as defined in the IMWG criteria, or death due to any cause, whichever occurs first.
    Desde la fecha de la aleatorización hasta la fecha de la primera enfermedad progresiva (EP) documentada, según se define en los criterios del IMWG, o la muerte por cualquier causa, lo que ocurra primero.
    E.5.2Secondary end point(s)
    1. Sustained minimal residual disease (MRD) negative complete response (CR), as determined by next generation sequencing (NGS) with sensitivity of 10^-5 and defined by MRD negative CR plus at least 12 months durability of the MRD negative CR status.
    2. MRD negative CR at 9 months is defined as the participants who achieve MRD negative status at 9±3 months after the randomization date
    3. Overall MRD negative CR
    4. Overall survival (OS)
    5. CR or better
    6. Time to subsequent anti-myeloma therapy
    7. PFS on next-line therapy (PFS2)
    8. Incidence and severity of AEs, laboratory results and other safety parameters
    9. Pharmacokinetic and pharmacodynamic markers including, but not limited to the depletion of soluble BCMA and BCMA expressing cells, systemic inflammatory cytokine concentrations and markers of CAR-T cell expansion (proliferation), and persistence via monitoring CAR-T positive cells and CAR transgene level.
    10. Presence of anti-cilta-cel antibodies
    11. Presence of replication competent lentivirus.
    12. Mean change from baseline in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Multiple Myeloma Symptom and Impact Questionnaire (MySIm-Q), EuroQol Five Dimension Questionnaire (EQ-5D-5L) subscale scores, and the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) items
    13. Time to worsening of symptoms, functioning, and overall well-being
    14. Proportion of participants with a meaningful improvement in the EORTC QLQ-C30 and MySIm-Q subscale scores using the Patient Global Impression of Severity (PGIS) to calculate the meaningful change threshold
    1. Respuesta completa negativa (RC) de enfermedad residual mínima sostenida (ERM), según lo determinado por la secuenciación de próxima generación (NGS) con sensibilidad de 10 ^ -5 y definida por RC negativa para ERM más al menos 12 meses de durabilidad del estado de RC negativa para ERM .
    2. La RC negativa a la ERM a los 9 meses se define como los participantes que alcanzan el estado negativo de la ERM 9 ± 3 meses después de la fecha de aleatorización.
    3. CR global negativo para MRD
    4. Supervivencia general (SG)
    5. CR o mejor
    6. Tiempo hasta la terapia posterior contra el mieloma
    7. SSP en la terapia de próxima línea (SSP2)
    8. Incidencia y gravedad de EA, resultados de laboratorio y otros parámetros de seguridad
    9. Marcadores farmacocinéticos y farmacodinámicos que incluyen, entre otros, el agotamiento de las células solubles que expresan BCMA y BCMA, concentraciones de citocinas inflamatorias sistémicas y marcadores de expansión (proliferación) de células CAR-T y persistencia mediante el control de células CAR-T positivas y transgén CAR nivel.
    10. Presencia de anticuerpos anti-cilta-cel
    11. Presencia de lentivirus competentes en replicación.
    12. Cambio medio desde el inicio en el Cuestionario de Calidad de Vida de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC QLQ-C30), Cuestionario de Síntomas e Impacto del Mieloma Múltiple (MySIm-Q), Cuestionario de Cinco Dimensiones EuroQol (EQ-5D-5L) puntuaciones de subescala y la versión de los resultados informados por el paciente de los elementos de Criterios de terminología común para eventos adversos (PRO-CTCAE)
    13. Tiempo hasta el empeoramiento de los síntomas, el funcionamiento y el bienestar general
    14. Proporción de participantes con una mejora significativa en las puntuaciones de las subescalas EORTC QLQ-C30 y MySIm-Q utilizando la Impresión global de gravedad del paciente (PGIS) para calcular el umbral de cambio significativo
    E.5.2.1Timepoint(s) of evaluation of this end point
    Followed until the end of the study
    Seguimiento hasta el final 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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Biomarker assessments, Immunogenicity assessments, PROs and Cytogenetic assessments
    Evaluaciones de biomarcadores, evaluaciones de inmunogenicidad, PRO y evaluaciones citogenéticas
    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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA80
    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
    Argentina
    Austria
    Belgium
    Brazil
    Canada
    Czechia
    Denmark
    Finland
    Germany
    Greece
    Israel
    Italy
    Japan
    Korea, Republic of
    Netherlands
    Norway
    Poland
    Portugal
    Spain
    Sweden
    Switzerland
    United Kingdom
    United States
    France
    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 study is when approximately 300 OS events have been accumulated in the study or 10 years after the last participant is randomized, whichever happens earlier.
    El final del estudio es cuando se han acumulado aproximadamente 300 eventos de SG en el estudio o 10 años después de que el último participante es aleatorizado, lo que ocurra antes.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years15
    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 years15
    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: 455
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 195
    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 state50
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 400
    F.4.2.2In the whole clinical trial 650
    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)
    All participants who receive cilta-cel will continue to be monitored for long-term safety under a separate study (68284528MMY4002) for up to 15 years after cilta-cel administration.
    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 Decision2021-08-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-07-16
    P. End of Trial
    P.End of Trial StatusOngoing
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