E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Adult participants with relapsed and refractory multiple myeloma after failure of 3 or more different prior lines of therapy, including failing an immunomodulatory drug (IMiD), a proteasome inhibitor (PI) and an anti-CD38 (cluster of differentiation 38) monoclonal antibody (mAb), and who have measurable disease at enrollment and documented evidence of progressive disease per IMWG criteria on the last prior therapy. Participants must be refractory to the last line of therapy. |
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E.1.1.1 | Medical condition in easily understood language |
relapsed and refractory Multiple Myeloma |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10028228 |
E.1.2 | Term | Multiple myeloma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Evaluate the efficacy of durcabtagene autoleucel with respect to disease response per independent review committee (IRC) in participants infused with durcabtagene autoleucel
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E.2.2 | Secondary objectives of the trial |
• Evaluate the efficacy of durcabtagene autoleucel with respect to MRD negativity in bone marrow measured by next generation sequencing (NGS) • Assess additional efficacy outcomes including complete response rate (CRR), time to response (TTR), duration of response (DOR), progression-free survival (PFS) per IRC and local investigator assessment • Assess time to next treatment (TTNT) and overall survival (OS) • Evaluate rate of minimal residual disease (MRD) negativity in bone marrow measured by next-generation sequencing (NGS) • Assess durability of MRD negativity • Assess patient reported outcomes (PRO) • Assess the durcabtagene autoleucel manufacturing success rate • Assess manufacturing turnaround time • Assess safety of durcabtagene autoleucel • Assess the cellular kinetics of durcabtagene autoleucel in peripheral blood and bone marrow by qPCR • Assess immunogenicity (humoral and cellular) to durcabtagene autoleucel
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. ≥18 years of age at the time of informed consent form (ICF) XML File Identifier: XCoD+oo9kWY4cmTprypP05dS2nE= Page 11/30 signature. 2. Adult participants with relapsed and refractory multiple myeloma who have received at least 3 prior lines of therapy including an IMiD (e.g., lenalidomide or pomalidomide), a proteasome inhibitor (e.g., bortezomib, carfilzomib), and an approved anti-CD38 antibody (e.g., daratumumab, isatuximab), and have documented evidence of disease progression (IMWG criteria). 3. Must be refractory to the last treatment regimen (defined as progressive disease on or within 60 days measured from last dose of last regimen). 4. Measurable disease at enrollment as defined by the protocol. 5. Eastern Cooperative Oncology Group (ECOG) performance status that is either 0 or 1 at screening. 6. Must have a leukapheresis material of non-mobilized cells accepted for manufacturing.
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E.4 | Principal exclusion criteria |
1. Prior administration of a genetically modified cellular product including prior BCMA CAR-T therapy. Participants who have received prior BCMA-directed bi-specific antibodies or anti-BCMA antibody drug conjugate. 2. Prior autologous stem cell transplantation (SCT) within 3 months or allogeneic stem cell transplantation within 6 months prior to signing informed consent. 3. Plasma cell (PC) leukemia and other plasmacytoid disorders, other than MM. 4. POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes). 5. Active central nervous system (CNS) involvement by malignancy. 6. Participants with active neurological autoimmune or inflammatory disorders.
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E.5 End points |
E.5.1 | Primary end point(s) |
Best overall response (BOR) per IRC defined as the best disease response recorded from Durcabtagene autoleucel administration until progressive disease (PD), death or starting new anticancer therapy whichever comes first, with possible values of either stringent complete response (sCR), complete response (CR), very good partial response (VGPR), partial response (PR), minimal response (MR), stable disease (SD), progressive disease (PD) or unknown (UNK), according to the International Myeloma Working Group (IMWG) criteria. The summary measure for the primary endpoint is overall response rate (ORR), defined as the proportion of participants with a BOR of PR or better, assessed in the efficacy analysis set (EAS).
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Efficacy interim analysis (6 months after the first 60 pts), Primary analysis (6 months after 90 pts) Final analysis (all patients). |
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E.5.2 | Secondary end point(s) |
• Proportion of participants who achieved MRD negative status at any time point within 3 months of achieving at least CR until time of PD, death or starting new anticancer therapy, whichever comes first • CRR defined as the proportion of participants with BOR of sCR or CR • TTR defined as time from durcabtagene autoleucel administration to the date of first documented response (PR or better) • DOR defined as time from first documented response (PR or better) until relapse or death due to any cause • PFS defined as time from durcabtagene autoleucel administration until progression or death due to any cause • TTNT defined as time from durcabtagene autoleucel administration until start of new anti-myeloma therapy or death due to any cause • OS defined as time from durcabtagene autoleucel administration until death due to any cause • Duration from the start of undetectable MRD to the time of reappearance of detectable MRD • Summary scores of PRO measured by EQ-5D-5L, EORTC-QLQ-C30 and EORTC-QLQ-MY20 • Proportion of enrolled participants for whom a durcabtagene autoleucel product was manufactured that met all release specifications • Time from pick up of cryopreserved material at the clinic or hospital until return to the clinic or hospital. • Type, frequency, and severity of adverse events, serious adverse events, adverse events of special interest (AESIs) and laboratory abnormalities • Transgene of durcabtagene autoleucel concentrations over time in peripheral blood and bone marrow determined by quantitative PCR Cellular kinetics parameters: Cmax (maximum serum concentration), Tmax (time to reach Cmax), AUCs and other cellular kinetic parameters • Summary of pre-existing and treatment-induced immunogenicity (cellular and humoral) of durcabtagene autoleucel Correlate levels of pre-existing and treatment-induced immunogenicity with cellular kinetic parameters, safety and efficacy |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Efficacy interim analysis (6 months after the first 75 pts), Primary analysis (6 months after 100 pts) and Final CSR (24 months after all 100 pts) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 14 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Singapore |
Australia |
Brazil |
Canada |
Israel |
Japan |
Saudi Arabia |
United Kingdom |
United States |
France |
Germany |
Greece |
Italy |
Spain |
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E.8.7 | Trial 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
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The end of study is when all participants have completed Month 24 evaluation or progressed or died earlier or were withdrawn prematurely and analysis of primary and secondary end points of the study are performed. Participants who have completed their Month 24 visit before the end of the study will be followed every 1 year until the end of the study. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 8 |