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    Summary
    EudraCT Number:2021-002531-27
    Sponsor's Protocol Code Number:EMN30/64007957MMY3003
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2022-02-03
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2021-002531-27
    A.3Full title of the trial
    Phase 3 Study of Teclistamab in Combination with Lenalidomide versus Lenalidomide Alone in Participants with Newly Diagnosed Multiple Myeloma as Maintenance Therapy Following Autologous Stem Cell Transplantation
    Studio di fase 3 di Teclistamab in combinazione con lenalidomide versus lenalidomide da sola in partecipanti con mieloma multiplo di nuova diagnosi come terapia di mantenimento dopo trapianto di cellule staminali autologhe
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 3 Study of Teclistamab in Combination with Lenalidomide versus Lenalidomide Alone in Participants with Newly Diagnosed Multiple Myeloma as Maintenance Therapy Following Autologous Stem Cell Transplantation
    Studio di fase 3 di Teclistamab in combinazione con lenalidomide versus lenalidomide da sola in partecipanti con mieloma multiplo di nuova diagnosi come terapia di mantenimento dopo trapianto di cellule staminali autologhe
    A.3.2Name or abbreviated title of the trial where available
    MajesTEC-4
    MajesTEC-4
    A.4.1Sponsor's protocol code numberEMN30/64007957MMY3003
    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 SponsorSTICHTING EUROPEAN MYELOMA NETWORK
    B.1.3.4CountryNetherlands
    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 organisationEuropean Myeloma Network - EMN
    B.5.2Functional name of contact pointSarah Lonergan
    B.5.3 Address:
    B.5.3.1Street AddressErasmus MC, dr. Molewaterplein 40
    B.5.3.2Town/ cityRotterdam
    B.5.3.3Post code3015 GD
    B.5.3.4CountryNetherlands
    B.5.4Telephone number0031107033740
    B.5.5Fax number0031107033740
    B.5.6E-mailsecretariaat.psonneveld@erasmusmc.nl
    D. IMP Identification
    D.IMP: 1
    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.2.5The 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 10mg
    D.3.2Product code [NA]
    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.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 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 90mg/ml
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for injection/infusion
    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.3.9.1CAS number 2119595-80-9
    D.3.9.2Current sponsor codeJNJ-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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 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 typeBiTE (bispecific T-cell engager)
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 10mg/ml
    D.3.2Product code [JNJ-64007957]
    D.3.4Pharmaceutical form Solution for infusion
    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.3.9.1CAS number 2119595-80-9
    D.3.9.2Current sponsor codeJNJ-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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 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 typeBiTE (bispecific T-cell engager)
    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.2.5The 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 2.5mg
    D.3.2Product code [NA]
    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.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typenot less then
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.2.5The 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 5mg
    D.3.2Product code [NA]
    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.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.2.5The 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 15mg
    D.3.2Product code [NA]
    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.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB25389
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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
    Newly Diagnosed Multiple Myeloma
    Mieloma multiplo di nuova diagnosi
    E.1.1.1Medical condition in easily understood language
    Multiple Myeloma
    Mieloma Multiplo
    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 teclistamab in combination with lenalidomide (Tec-Len; Arm A) with that of lenalidomide (Len; Arm B) as assessed by PFS.
    Per confrontare l'efficacia di teclistamab in combinazione con lenalidomide (Tec-Len; Arm A) con quella di lenalidomide (Len; Arm B) valutata mediante PFS.
    E.2.2Secondary objectives of the trial
    To further compare the efficacy of Tec Len maintenance compared with Len.
    To assess the safety profile of Tec Len, characterize the PK of Tec Len, assess the immunogenicity of Tec Len, evaluate the impact of treatment with Tec Len on PROs compared with Len.
    EXPLORATORY OBJECTIVES:
    To evaluate the efficacy of Tec-Len in high-risk subgroups, explore pharmacodynamic biomarkers of antimyeloma and immune activity for Tec-Len, explore relationships between pharmacodynamic markers and clinical activity of Tec Len compared with Len, explore predictive biomarkers of response and resistance for Tec Len.
    To evaluate MRD negative conversion and CR or better conversion.
    To explore the relationships between PK, pharmacodynamic, AE profile, and clinical activity of Tec-Len.
    To explore time to symptomatic progression in both treatment arms.
    To explore the impact of treatment with Tec-Len on MRU compared with Len.
    Per confrontare ulteriormente l'efficacia del mantenimento di Tec Len rispetto a Len.
    Per valutare il profilo di sicurezza di Tec Len, caratterizzare la PK di Tec Len, valutare l'immunogenicità di Tec Len, valutare l'impatto del trattamento con Tec Len sui PROs rispetto a Len.
    OBIETTIVI ESPLORATIVI:
    Per valutare l'efficacia di Tec-Len in sottogruppi ad alto rischio, esplorare i biomarcatori farmacodinamici dell'antimieloma e dell'attività immunitaria per Tec-Len, esplorare le relazioni tra i marcatori farmacodinamici e l'attività clinica di Tec Len rispetto a Len, esplorare i biomarcatori predittivi di risposta e resistenza per tecnico len.
    Per valutare la conversione negativa MRD e la conversione CR o migliore.
    Esplorare le relazioni tra PK, farmacodinamica, profilo AE e attività clinica di Tec-Len.
    Esplorare il tempo per la progressione sintomatica in entrambi i bracci di trattamento.
    Per esplorare l'impatto del trattamento con Tec-Len su MRU rispetto a Len.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1 =18 years of age
    2 Must have a new diagnosis of MM according to IMWG criteria and have received 4 to 6 cycles of 3 or 4 drug-induction therapy that includes a proteasome inhibitor and/or an IMiD with or without anti-CD38 monoclonal antibody and a single or tandem ASCT. Post ASCT consolidation is permitted for up to 2 cycles as long as the total number of induction plus consolidation cycles does not exceed 6 and all treatment has completed prior to screening.
    3 Must have received only one line of therapy and achieved at least a partial response (=PR) as per IMWG 2016 response criteria. Participants with plasmacytomas at the time of diagnosis must meet IMWG 2016 response criteria for =PR based on repeat imaging during screening utilizing the same modality.
    4 Must not be intolerant to the starting dose of lenalidomide.
    5 Must have received high-dose chemotherapy and ASCT within 12 months of the start of induction therapy and be within 6 months of the last ASCT at the time of first treatment dose. a) For participants who have not received consolidation therapy, the participant must be within 120 days post-transplant at the time of first treatment dose. b)For participants treated with consolidation therapy, the participant must be within 90 days of the last dose of consolidation therapy at the time of first treatment dose
    6 Must not have received any maintenance therapy.
    7 Have an ECOG performance status score of 0, 1, or 2 at screening and immediately prior to the start of administration of study treatment.
    8 Have clinical laboratory values meeting the following criteria during the Screening Phase. In addition, these laboratory values must be re-evaluated within 72 hours prior to the first dose and the participant must also meet all criteria. If one or more criteria are not met within 72 hours prior to dosing, one repeat of laboratory testing is permitted. If >1 repeat laboratory test is necessary, the sponsor must be consulted prior to dosing.
    9 A woman of childbearing potential must have a negative highly sensitive serum pregnancy test within 10-14 days prior to the start of study treatment and again either a serum or urine pregnancy test within 24 hours of the start of study treatment and must agree to further serum or urine pregnancy tests during the study.
    10 A woman must be: a) Not of childbearing potential, or b) Of childbearing potential and 1) Practicing true abstinence; or 2) Practicing 2 reliable methods of contraception simultaneously including one highly effective method of contraception and one other effective method of contraception starting 4 weeks prior to dosing, throughout the study including during dose interruptions and for a minimum of 4 weeks after the last dose of lenalidomide or for a minimum of 90 days after the last dose of teclistamab, whichever occurs later. For participants who are of childbearing potential, see Section 6.11.3 for details regarding concomitant use of estrogen containing products and lenalidomide.
    11 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 a minimum of 4 weeks after the last dose of lenalidomide or for a minimum of 90 days after the last dose of teclistamab, whichever occurs later.
    The inclusion criteria from n.12 to n.15 are included in the study Protocol.
    1 = 18 anni di età
    2 Avere una nuova diagnosi di MM secondo i criteri IMWG e aver ricevuto da 4 a 6 cicli di 3 o 4 terapie di induzione del farmaco che includono un inibitore del proteasoma e/o un IMiD con o senza anticorpo monoclonale anti-CD38 e un singolo o tandem ASCT. Il consolidamento post ASCT è consentito per un massimo di 2 cicli purché il numero totale di cicli di induzione più consolidamento non superi 6 e tutto il trattamento sia stato completato prima dello screening.
    3 Deve aver ricevuto una sola linea di terapia e ottenuto almeno una risposta parziale (=PR) secondo i criteri di risposta IMWG 2016. I partecipanti con plasmacitomi al momento della diagnosi devono soddisfare i criteri di risposta IMWG 2016 per =PR basati sulla ripetizione dell'imaging durante lo screening utilizzando la stessa modalità.
    4 Non deve essere intollerante alla dose iniziale di lenalidomide.
    5 Deve aver ricevuto chemioterapia ad alte dosi e ASCT entro 12 mesi dall'inizio della terapia di induzione ed essere entro 6 mesi dall'ultimo ASCT al momento della prima dose di trattamento. a) Per i partecipanti che non hanno ricevuto la terapia di consolidamento, il partecipante deve trovarsi entro 120 giorni dopo il trapianto al momento della prima dose di trattamento. b) Per i partecipanti trattati con terapia di consolidamento, il partecipante deve trovarsi entro 90 giorni dall'ultima dose di terapia di consolidamento al momento della prima dose di trattamento
    6 Non deve aver ricevuto alcuna terapia di mantenimento.
    7 Avere un punteggio di performance status ECOG di 0, 1 o 2 allo screening e immediatamente prima dell'inizio della somministrazione del trattamento in studio.
    8 Avere valori clinici di laboratorio che soddisfino i seguenti criteri durante la fase di screening. Inoltre, questi valori di laboratorio devono essere rivalutati entro 72 ore prima della prima dose e anche il partecipante deve soddisfare tutti i criteri. Se uno o più criteri non vengono soddisfatti entro 72 ore prima della somministrazione, è consentita una ripetizione dei test di laboratorio. Se è necessaria >1 ripetizione del test di laboratorio, lo sponsor deve essere consultato prima della somministrazione.
    9 Una donna in età fertile deve avere un test di gravidanza su siero altamente sensibile negativo entro 10-14 giorni prima dell'inizio del trattamento in studio e nuovamente un test di gravidanza su siero o urina entro 24 ore dall'inizio del trattamento in studio e deve accettare di proseguire test di gravidanza su siero o urina durante lo studio.
    10 Una donna deve essere: a) non in età fertile, oppure b) in età fertile e 1) praticando la vera astinenza; o 2) Praticare 2 metodi contraccettivi affidabili contemporaneamente, compreso un metodo contraccettivo altamente efficace e un altro metodo contraccettivo efficace a partire da 4 settimane prima della somministrazione, durante lo studio anche durante le interruzioni della dose e per un minimo di 4 settimane dopo l'ultima dose di lenalidomide o per un minimo di 90 giorni dopo l'ultima dose di teclistamab, a seconda dell'evento che si verifica dopo. Per i partecipanti in età fertile, vedere la Sezione 6.11.3 per i dettagli sull'uso concomitante di prodotti contenenti estrogeni e lenalidomide.
    11 Una donna deve accettare di non donare ovuli (ovuli, ovociti) o congelare per usi futuri, ai fini della riproduzione assistita durante lo studio e per un minimo di 4 settimane dopo l'ultima dose di lenalidomide o per un minimo di 90 giorni dopo l'ultima dose di teclistamab, a seconda di quale si verifica dopo.
    I criteri di inclusione dal n.12 al n.15 sono indicati nel Protocollo di studio.
    E.4Principal exclusion criteria
    1 Received any prior BCMA-directed therapy.
    2 Any previous therapy with an immune cell redirecting agent or gene modified adoptive cell therapy.
    3 Discontinued treatment due to any AE related to lenalidomide as determined by the investigator.
    4 History of allogeneic stem cell transplantation or prior organ transplant requiring immunosuppressive therapy.
    5 Progressed on multiple myeloma therapy as per IMWG 2016 response criteria at any time prior to screening.
    6 Radiotherapy within 14 days or focal radiation within 7 days of first treatment dose.
    7 Received a cumulative dose of corticosteroids equivalent to =140 mg of prednisone within the 14 days prior to first treatment dose.
    8 Received a live, attenuated vaccine within 4 weeks before first treatment dose. Non-live vaccines authorized for emergency use are allowed.
    9 Myelodysplastic syndrome or active malignancies. 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 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: 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.
    10 Plasma cell leukemia, Waldenström’s macroglobulinemia, POEMS syndrome or primary light chain amyloidosis.
    11 Central nervous system involvement or exhibits clinical signs of meningeal involvement of multiple myeloma. If either is suspected, brain MRI and lumbar cytology are required.
    12 Stroke or seizure within 6 months of first treatment dose.
    13 Contraindications or life-threatening allergies, hypersensitivity, or intolerance to any study treatment or its excipients .
    14 Participant is pregnant or breast-feeding or planning to become pregnant while enrolled in this study or within 90 days after the last dose of study drug.
    15 Participant plans to father a child while enrolled in this study or within 90 days after the last dose of study drug.
    16 Presence of the following conditions: a)New York Heart Association stage III or IV congestive heart failure b)Myocardial infarction, or coronary artery bypass graft =6 months prior to first treatment dose c) History of clinically significant ventricular arrhythmia or unexplained syncope, not believed to be vasovagal in nature or due to dehydration d) Uncontrolled cardiac arrhythmia or clinically significant electrocardiogram (ECG) abnormalities.
    The exclusion criteria from n.17 to n.22 are included in the study Protocol.
    1 Ha ricevuto una qualsiasi precedente terapia diretta da BCMA.
    2 Qualsiasi precedente terapia con un agente di reindirizzamento delle cellule immunitarie o una terapia cellulare adottiva modificata dal gene.
    3 Interruzione del trattamento a causa di eventi avversi correlati alla lenalidomide come determinato dallo sperimentatore.
    4 Storia di trapianto allogenico di cellule staminali o precedente trapianto d'organo che richiede una terapia immunosoppressiva.
    5 Progressi nella terapia del mieloma multiplo secondo i criteri di risposta IMWG 2016 in qualsiasi momento prima dello screening.
    6 Radioterapia entro 14 giorni o radiazione focale entro 7 giorni dalla prima dose di trattamento.
    7 Ha ricevuto una dose cumulativa di corticosteroidi equivalente a =140 mg di prednisone nei 14 giorni precedenti la prima dose di trattamento.
    8 Ha ricevuto un vaccino vivo attenuato entro 4 settimane prima della prima dose di trattamento. Sono ammessi vaccini non vivi autorizzati per l'uso di emergenza.
    9 Sindrome mielodisplastica o tumori maligni attivi. Le uniche eccezioni consentite sono: a) cancro della vescica non invasivo muscolare trattato negli ultimi 24 mesi che è considerato completamente guarito b) cancro della pelle trattato negli ultimi 24 mesi che è considerato completamente guarito c) cancro della cervice non invasivo trattato negli ultimi 24 mesi mesi che è considerato completamente guarito d) Carcinoma prostatico localizzato: 1) Con un punteggio di Gleason di =6, trattato negli ultimi 24 mesi o non trattato e sotto sorveglianza 2) Con un punteggio di Gleason di 3+4 che è stato trattato >6 mesi prima dello screening completo dello studio e considerato a rischio molto basso di recidiva o 3) Storia di cancro alla prostata localizzato e terapia di deprivazione androgenica e considerato a rischio molto basso di recidiva. e) Carcinoma mammario: carcinoma lobulare in situ o carcinoma duttale in situ adeguatamente trattato, o storia di carcinoma mammario localizzato e trattamento con agenti antiormonali e considerato a rischio molto basso di recidiva f) Altro tumore maligno che è considerato curato con un rischio minimo di recidiva .
    10 Leucemia plasmacellulare, macroglobulinemia di Waldenström, sindrome POEMS o amiloidosi primaria delle catene leggere.
    11 Coinvolgimento del sistema nervoso centrale o mostra segni clinici di coinvolgimento meningeo del mieloma multiplo. Se si sospetta uno dei due, sono necessarie la risonanza magnetica cerebrale e la citologia lombare.
    12 Ictus o convulsioni entro 6 mesi dalla prima dose di trattamento.
    13 Controindicazioni o allergie pericolose per la vita, ipersensibilità o intolleranza a qualsiasi trattamento in studio o ai suoi eccipienti .
    14 La partecipante è incinta o sta allattando o sta pianificando una gravidanza mentre è arruolata in questo studio o entro 90 giorni dall'ultima dose del farmaco in studio.
    15 Il partecipante prevede di concepire un figlio mentre è arruolato in questo studio o entro 90 giorni dall'ultima dose del farmaco in studio.
    16 Presenza delle seguenti condizioni: a) insufficienza cardiaca congestizia in stadio III o IV secondo la New York Heart Association b) infarto miocardico o innesto di bypass coronarico = 6 mesi prima della prima dose di trattamento c) storia di aritmia ventricolare clinicamente significativa o sincope inspiegabile, non ritenuto di natura vasovagale o dovuto a disidratazione d) aritmia cardiaca non controllata o anomalie dell'elettrocardiogramma (ECG) clinicamente significative.
    I criteri di esclusione dal n.17 al n.22 sono contenuti nel Protocollo di studio.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint is PFS, defined as the time from the date of randomization to the date of first confirmed disease progression, as defined in the IMWG criteria, or death due to any cause, whichever occurs first.
    L'endpoint primario è la PFS, definita come il tempo dalla data di randomizzazione alla data della prima progressione confermata della malattia, come definito nei criteri IMWG, o la morte per qualsiasi causa, a seconda di quale si verifica per prima.
    E.5.1.1Timepoint(s) of evaluation of this end point
    From the date of randomization to the date of first confirmed disease progression or death due to any cause, whichever occurs first.
    Dalla data di randomizzazione alla data della prima progressione della malattia confermata o morte per qualsiasi causa, a seconda di quella che si verifica per prima.
    E.5.2Secondary end point(s)
    CR or better (sCR+CR) is defined as participants who achieve a CR or better response per IMWG criteria.
    MRD negative CR is defined as participants who achieve CR or better and are MRD negative before initiation of subsequent therapy.
    Sustained MRD negativity is defined as the proportion of participants who achieve MRD-negative CR, confirmed minimum 1 year apart and without any examination showing MRD-positive status in between.
    OS will be measured from the date of randomization to the date of the participant’s death. If the participant is alive or the vital status is unknown, then the participant’s data will be censored at the date the participant was last known to be alive.
    PFS2 is defined as the time interval between the date of randomization and date of event, which is defined as PD as assessed by investigator on the first subsequent line of antimyeloma therapy, or death from any cause, whichever occurs first. Those who are alive and for whom a second
    disease progression has not been observed will be censored at the last date of follow-up.
    Incidence and severity of AEs
    The PK of teclistamab will be assessed.
    Presence and activity of ADAs to teclistamab
    Time to worsening in overall HRQoL, symptoms, and functioning
    Change from baseline in overall HRQoL, symptoms, and functioning
    PFS, depth of response, etc will be determined in participants with high-risk molecular features as defined by IMWG criteria
    As part of the PROs, treatment effect will be assessed by change from baseline in overall HRQoL symptoms and functioning at each time point summarized by treatment arm. Time to worsening of symptoms will be measured as the interval from the date of randomization to the start date of worsening. Death due to disease progression will be considered as worsening.
    Participants who have not met the definition of worsening will be censored as of the last assessment date.
    The analysis methods for binary endpoints (eg, CR/sCR, and MRD negativity) will be conducted using stratified Cochran Mantel Haenszel test. The Mantel Haenszel odds ratio will be provided along with its 2-sided 95% CI and will be provided as the measure of treatment
    effect. For time-to-event endpoints (eg, PFS2, OS, and time of worsening symptoms), similar statistical methods will be applied as for PFS.
    EXPLORATORY ENDOPOINTS:
    To evaluate the efficacy of Tec-Len in high-risk subgroups
    To explore pharmacodynamic biomarkers of antimyeloma and immune activity for Tec-Len
    To explore relationships between pharmacodynamic markers and clinical activity of Tec-Len compared with Len
    To explore predictive biomarkers of response and resistance for Tec-Len, including prognostic and disease markers, at baseline, during treatment, and in relation to efficacy parameters
    To evaluate rate of conversion to CR and MRD negative CR
    To explore the relationships between PK, pharmacodynamic, AE profile, and clinical activity of Tec-Len
    To explore time to symptomatic progression in both treatment arms
    To explore the impact of treatment with Tec-Len on MRU compared with Len
    CR o migliore (sCR+CR) è definito come partecipanti che ottengono una risposta CR o migliore secondo i criteri IMWG.
    CR negativa per MRD è definita come i partecipanti che ottengono CR o meglio e sono negativi per MRD prima dell'inizio della terapia successiva.
    La negatività MRD sostenuta è definita come la proporzione di partecipanti che ottengono CR negativa per MRD, confermata almeno a 1 anno di distanza e senza alcun esame che mostri lo stato MRD-positivo nel mezzo.
    L'OS sarà misurata dalla data di randomizzazione alla data della morte del partecipante. Se il partecipante è vivo o lo stato vitale è sconosciuto, i dati del partecipante verranno censurati alla data in cui il partecipante è stato conosciuto per l'ultima volta per essere vivo.
    La PFS2 è definita come l'intervallo di tempo tra la data di randomizzazione e la data dell'evento, che è definita come PD valutata dallo sperimentatore sulla prima linea successiva di terapia antimieloma, o morte per qualsiasi causa, a seconda di quale si verifica per prima. Coloro che sono vivi e per chi un secondo
    la progressione della malattia non è stata osservata sarà censurata all'ultima data di follow-up.
    Incidenza e gravità degli eventi avversi
    Verrà valutata la PK di teclistamab.
    Presenza e attività di ADA a teclistamab
    Tempo per il peggioramento della HRQoL, dei sintomi e del funzionamento complessivi
    Modifica rispetto al basale dell'HRQoL, dei sintomi e del funzionamento complessivi
    La PFS, la profondità della risposta, ecc. saranno determinati nei partecipanti con caratteristiche molecolari ad alto rischio come definito dai criteri IMWG
    Nell'ambito dei PRO, l'effetto del trattamento sarà valutato in base alla variazione rispetto al basale dei sintomi complessivi della HRQoL e del funzionamento in ogni momento riassunto per braccio di trattamento. Il tempo al peggioramento dei sintomi sarà misurato come l'intervallo dalla data di randomizzazione alla data di inizio del peggioramento. La morte per progressione della malattia sarà considerata in peggioramento.
    I partecipanti che non soddisfano la definizione di peggioramento saranno censurati a partire dall'ultima data di valutazione.
    I metodi di analisi per gli endpoint binari (ad es. CR/sCR e negatività MRD) saranno condotti utilizzando il test stratificato di Cochran Mantel Haenszel. L'odds ratio di Mantel Haenszel sarà fornito insieme al suo IC al 95% a 2 code e sarà fornito come misura del trattamento
    effetto. Per gli endpoint di tempo all'evento (p. es., PFS2, OS e tempo di peggioramento dei sintomi), verranno applicati metodi statistici simili a quelli della PFS.
    ENDOPOINT ESPLORATIVI:
    Per valutare l'efficacia di Tec-Len nei sottogruppi ad alto rischio
    Per esplorare i biomarcatori farmacodinamici dell'antimieloma e dell'attività immunitaria per Tec-Len
    Per esplorare le relazioni tra marcatori farmacodinamici e attività clinica di Tec-Len rispetto a Len
    Per esplorare i biomarcatori predittivi di risposta e resistenza per Tec-Len, inclusi i marcatori prognostici e di malattia, al basale, durante il trattamento e in relazione ai parametri di efficacia
    Per valutare il tasso di conversione in CR e CR negativo MRD
    Esplorare le relazioni tra PK, farmacodinamica, profilo AE e attività clinica di Tec-Len
    Esplorare il tempo per la progressione sintomatica in entrambi i bracci di trattamento
    Per esplorare l'impatto del trattamento con Tec-Len su MRU rispetto a Len.
    E.5.2.1Timepoint(s) of evaluation of this end point
    During the entire duration of the study
    Per tutta la durata dello studio
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic Yes
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenenicity evaluations, Exploratory Biomarker evaluations
    Valutazioni di immunogenicità, Valutazioni esplorative di biomarcatori
    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 Yes
    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 concerned19
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA62
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Austria
    Belgium
    Canada
    Czechia
    Denmark
    Germany
    Greece
    Italy
    Korea, Republic of
    Netherlands
    Norway
    Serbia
    Switzerland
    Turkey
    United Kingdom
    United States
    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 defined by the final OS analysis, which will occur when approximately 380 deaths have been observed, or 8 years after the last participant randomized, whichever is earlier.
    La fine dello studio è definita dall'analisi finale dell'OS, che si verificherà quando saranno stati osservati circa 380 decessi, o 8 anni dopo l'ultimo partecipante randomizzato, a seconda di quale sia il precedente.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years10
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years10
    E.8.9.2In all countries concerned by the trial months1
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 404
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 626
    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 Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Impartial witness(es), caregiver, or participant's legally acceptable representative must consent and sign indicating that the participant understands the purpose of, and procedures required for, the study and is willing to participate in the study.
    Il/i testimone/i imparziale/i, il caregiver o il rappresentante legalmente accettabile del partecipante deve acconsentire e firmare indicando che il partecipante comprende lo scopo e le procedure richieste per lo studio ed è disposto a partecipare al
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state170
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 575
    F.4.2.2In the whole clinical trial 1030
    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. EMN is a non-commercial sponsor.
    Nessuno. EMN è uno sponsor non commerciale.
    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 Decision2022-05-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-03-17
    P. End of Trial
    P.End of Trial StatusOngoing
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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