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    Summary
    EudraCT Number:2022-001442-38
    Sponsor's Protocol Code Number:64407564MMY3008
    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:2022-08-03
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2022-001442-38
    A.3Full title of the trial
    A Phase 3 Study Comparing Talquetamab to Belantamab Mafodotin in Participants With Relapsed/Refractory Multiple Myeloma who have Received at least 4 Prior Therapies Including an Immunomodulatory Drug, a Proteasome Inhibitor, and an Anti-CD38 Antibody
    Estudio aleatorizado en fase III que compara Talquetamab con el Belantamab Mafodotina en pacientes con mieloma múltiple recidivante/refractario que han recibido al menos 4 terapias previas, incluyendo un inmunomodulador, un inhibidor del proteasoma y un anticuerpo monoclonal anti-CD38.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Clinical Study Comparing Talquetamab to Belantamab Mafodotin in Participants With Relapsed/Refractory Multiple Myeloma who have Received at least 4 Prior Therapies Including an Immunomodulatory Drug, a Proteasome Inhibitor, and an Anti-CD38 Antibody
    Estudio aleatorizado en fase III que compara Talquetamab con el Belantamab Mafodotina en pacientes con mieloma múltiple recidivante/refractario que han recibido al menos 4 terapias previas, incluyendo un inmunomodulador, un inhibidor del proteasoma y un anticuerpo monoclonal anti-CD38.
    A.3.2Name or abbreviated title of the trial where available
    MonumenTAL-5
    A.4.1Sponsor's protocol code number64407564MMY3008
    A.5.4Other Identifiers
    Name:IND numberNumber:133811
    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 S.A.
    B.5.2Functional name of contact pointGlobal Clinical Operations Spain
    B.5.3 Address:
    B.5.3.1Street AddressPaseo de las Doce Estrellas, 5-7
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28042
    B.5.3.4CountrySpain
    B.5.4Telephone number+3134917228625
    B.5.6E-mailipolo@its.jnj.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/21/2486
    D.3 Description of the IMP
    D.3.1Product nameTalquetamab
    D.3.2Product code JNJ-64407564
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTalquetamab
    D.3.9.1CAS number 2226212-40-2
    D.3.9.2Current sponsor codeJNJ-64407564
    D.3.9.3Other descriptive nameTalquetamab
    D.3.9.4EV Substance CodeSUB204100
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeHumanized GPRC5D x CD3 Bispecific Antibody
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/21/2486
    D.3 Description of the IMP
    D.3.1Product nameTalquetamab
    D.3.2Product code JNJ-64407564
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTalquetamab
    D.3.9.1CAS number 2226212-40-2
    D.3.9.2Current sponsor codeJNJ-64407564
    D.3.9.3Other descriptive nameTalquetamab
    D.3.9.4EV Substance CodeSUB204100
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeHumanized GPRC5D x CD3 Bispecific Antibody
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Blenrep
    D.2.1.1.2Name of the Marketing Authorisation holderGlaxoSmithKline (Ireland) 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 Yes
    D.2.5.1Orphan drug designation numberEU/3/17/1925
    D.3 Description of the IMP
    D.3.1Product nameBelantamab mafodotin
    D.3.4Pharmaceutical form Powder for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNbelantamab mafodotin
    D.3.9.1CAS number 2050232-20-5
    D.3.9.2Current sponsor codeGSK2857916
    D.3.9.3Other descriptive nameBelantamab mafodotin
    D.3.9.4EV Substance CodeSUB195504
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product 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 typean afucosylated humanised monoclonal IgG1k antibody specific for B cell maturation antigen (BCMA) that is conjugated with maleimidocaproyl monomethyl auristatin F (mcMMAF).
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Blenrep
    D.2.1.1.2Name of the Marketing Authorisation holderGlaxoSmithKline (UK) 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 Yes
    D.2.5.1Orphan drug designation numberEU/3/17/1925
    D.3 Description of the IMP
    D.3.1Product nameBelantamab mafodotin
    D.3.4Pharmaceutical form Powder for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNbelantamab mafodotin
    D.3.9.1CAS number 2050232-20-5
    D.3.9.2Current sponsor codeGSK2857916
    D.3.9.3Other descriptive nameBelantamab mafodotin
    D.3.9.4EV Substance CodeSUB195504
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product 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 typean afucosylated humanised monoclonal IgG1k antibody specific for B cell maturation antigen (BCMA) that is conjugated with maleimidocaproyl monomethyl auristatin F (mcMMAF).
    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
    Bone marrow cancer
    Cáncer de médula ósea
    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
    The primary objective is to compare the efficacy of talquetamab versus belantamab mafodotin in terms of ORR or PFS.
    El objetivo principal es comparar la eficacia de Talquetamab frente a Belantamab Mafodotin en términos de tasa de respuesta global (TRG) o superiviencia libre de progresión (SLP).
    E.2.2Secondary objectives of the trial
    The secondary objectives are:
    ●To further compare the efficacy of talquetamab versus belantamab mafodotin.
    ●To assess the safety and tolerability of talquetamab and belantamab mafodotin.
    ●To characterize the PK of talquetamab.
    ●To assess the immunogenicity of talquetamab.
    ●To assess participant’s reported symptoms and general well-being with talquetamab and belantamab mafodotin.
    Los objetivos secundarios son:
    ●Comparar mejor la eficacia de Talquetamab frente a Belantamab Mafodotin.
    ●Evaluar la seguridad y la tolerabilidad de Talquetamab y Belantamab Mafodotin.
    ●Caracterizar la farmacocinética (FC) de Talquetamab.
    ●Evaluar la inmunogenicidad de Talquetamab.
    ●Evaluar los síntomas reportados por los pacientes y el bienestar general con Talquetamab y Belantamab Mafodotin.
    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
    1. Be ≥18 years of age at the time of informed consent.

    Disease Characteristics
    2. Documented multiple myeloma as defined by the criteria below:
    a. Multiple myeloma according to IMWG diagnostic criteria.
    b. Measurable disease at screening, as assessed by central laboratory, defined by any of the following:
    1) Serum M-protein level ≥1.0 g/dL; or
    2) Urine M-protein level ≥200 mg/24 hours; or
    3) Light chain multiple myeloma without measurable M-protein in the serum or the urine: sFLC ≥10 mg/dL (central laboratory) and abnormal serum immunoglobulin kappa lambda FLC ratio.

    Prior Therapy Restrictions or Requirements
    3. Received at least 4 prior antimyeloma therapies including an anti-CD38 mAb (alone or in combination) and is refractory per IMWG criteria to at least one PI, and one IMiD.
    4. Documented evidence of progressive disease based on investigator’s determination of response by IMWG criteria on or after their last regimen.

    Performance Status
    5. Have an ECOG performance status of 0 to 2 at screening.

    Clinical Laboratory Values
    6. Have clinical laboratory values meeting the criteria during the Screening Phase.
    7. Human immunodeficiency virus-positive participants are eligible if they meet all of the following:
    ● No detectable viral load (ie, <50 copies/mL) at screening
    ● CD4+ count >300 cells/mm^3 at screening
    ● No acquired immunodeficiency syndrome (AIDS)-defining opportunistic infection within 6 months of screening
    ● Receiving HAART. Any changes in HAART due to resistance/progression should occur at least 3 months prior to screening. A change in HAART due to toxicity is allowed up to 4 weeks prior to screening. Note: HAART that could interfere with study treatment is excluded (consult the sponsor for a review of medications prior to enrollment).

    Sex and Contraceptive/Barrier Requirements
    8. A female participant of childbearing potential must have a negative serum pregnancy testat screening, and must agree to further serum or urine pregnancy tests during the study and within 6 months after receiving the last dose of study treatment.
    9. A female participant must agree not to be pregnant, breastfeeding, or planning to become pregnant while enrolled in this study or for 6 months after the last dose of study treatment.
    10. A female participant must be either of the following:
    a. Not of childbearing potential, or
    b. Of childbearing potential and
    1) Practicing true abstinence; or
    2) Have a sole partner who is bilaterally vasectomized; or
    3) Practicing at least 1 highly effective method of contraception (failure rate of <1% per year when used consistently and correctly) and
    agrees to remain on a highly effective method while receiving study treatment and until 6 months after the last dose of study treatment. The investigator must evaluate the potential for contraceptive method failure (eg, noncompliance, recently initiated) in relationship to the first dose of study intervention.
    11. A female participant using oral contraceptives must use an additional barrier contraceptive method.
    12. A female participant 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 period of 6 months after receiving the last dose of study treatment. Female participants should consider preservation of eggs prior to study treatment as anticancer treatments may impair fertility.
    13. A male participant must agree not to plan to father a child while enrolled in this study or within 6 months after the last dose of study treatment.
    14. A male participant must wear a condom (with or without spermicide) when engaging in any activity that allows for passage of ejaculate to another person during the study and for 6 months after receiving the last dose of study treatment.
    If partner is a female of childbearing potential, the male participant must use condom(with or without spermicide) and the partner must also be practicing a highly effective method of contraception.
    15. A male participant must agree not to donate sperm for the purposes of reproduction during the study and for 6 months after receiving the last dose of study treatment.

    Informed Consent
    16. Must sign an ICF (or their legally acceptable representative must sign) indicating that the participant understands the purpose of, and procedures required for, the study and is willing to participate in the study.
    17. Be willing and able to adhere to the lifestyle restrictions specified in this protocol.

    Refer the protocol for full inclusion criteria
    Cada participante potencial debe satisfacer todos los siguientes criterios para ser incluido en el estudio:
    Edad
    1.≥18años en el momento de firmar el consentimiento informado
    Características de la patología
    2.Mieloma múltiple documentado según se define en los siguientes criterios:
    a Mieloma Múltiple según los criterios de diagnóstico del International IMWG
    b Enfermedad medible en el momento del cribado,tal como se define en cualquiera de los siguientes términos:
    1)Nivel de proteínaM en suero≥1.0g/dL o
    2)nivel de proteínaM en orina≥200mg/24hrs o
    3)Pacientes con mieloma múltiple de cadenas ligeras,sin enfermedad medible ni en suero ni orina,sFLC ≥10mg/dL en laboratorio central y un ratio de inmunoglobulinas kappa lambda FLC anormal
    Restricciones o requerimientos previos
    3.Haber recibido al menos 4 tratamientos antimieloma previos incluyendo uno de anticuerpo monoclonal anti-CD38 (solo o en combinación) y que sea refractario para los criterios IMWG para al menos un IP y un IMiD
    4.Documentada la progresión a la enfermedad en base a la determinación del investigador siguiendo los criterior IMWG durante o después de su último tratamiento
    Estado funcional
    5.Puntuación del estado general ECOG de 0 a 2 en cribado.
    Valores de laboratorio clínico
    6.Tener valores de lab. clínico que cumplan los criterios durante la fase de cribado
    7.Pacientes positivos en virus de inmunodeficiencia humana son elegibles si cumplen con todo lo siguiente:
    ●Carga viral no detectable(ej<50 copias/mL)en cribado
    ●Recuento de células CD4+>300Células/mm^3 en cribado
    ●No haber adquirido el SIDA definido como infección oportunista en los 6meses de cribado
    ●Recibir tratamiento antiretroviral de alta eficacia HAART.Cualquier cambio en el HAART debido a resistencia/pregresión debe de ocurrir al menos 3meses antes del cribado.Un cambio en HAART debido a toxicidad está permitido hasta 4semanas antes del cribado.Nota: HAART que pueda interferir con el tratamiento del estudio será excluido(consultar con el promotor para hacer una revisión de la medicación antes del reclutamiento)
    Sexo y anticoncepción/requerimientos
    8.Una paciente en edad fértil debe dar negativo en test de embarazo en sangre en el cribado y debe estar de acuerdo con la realización de otros test de embarazo en sangre u orina durante el estudio y durante 6meses después de recibir la última dosis del tratamiento de estudio
    9.Una paciente debe estar de acuerdo en no quedar embarazada,no ser madre lactante o no planificar quedarse embarazada durante el ensayo o en los 6 meses después de recibir la última dosis del tratamiento de estudio
    10.Una paciente debe también cumplir:
    a.sin capacidad reproductiva o
    b.no quedar embarazada y
    1)abstenerse de tener relaciones sexuales o
    2)tener una sola pareja con vasectomía bilateral o
    3)utilizar al menos un método altamente efectivo de anticoncepción(ratio de fallo<1% al año usado correctamente)y comprometerse a seguir con un método altamente efectivo mientras esté recibiendo el tratamiento de estudio y hasta 6meses desde la última dosis del tratamiento de estudio.El investigador debe evaluar el fallo potencial del método anticonceptivo(ej.Incumplimiento, recientemente iniciado)en relación con la primera dosis del estudio.
    11.Una paciente que use un anticonceptivo oral debe de usar un método barrera anticonceptivo adicional
    12.Una paciente debe estar de acuerdo en no donar óvulos(óvulos, ovocitos) o congelar para un futuro uso con el propósito de reproducción asistida durante el estudio y en los 6 meses después de recibir la última dosis del tratamiento de estudio Las pacientes deben considerar conservar óvulos antes del tratamiento estudio ya que los tratamientos anticancerígenos pueden afectar a la fertilidad
    13.Un paciente debe estar de acuerdo en no planear ser padre durante el reclutamiento o durante los 6 meses después de recibir la última dosis del tratamiento de estudio
    14.Un paciente debe usar preservativo(con o sin espermicida)cuando vaya a realizar cualquier actividad que le permita el paso de eyaculado a otra persona durante el estudio y en los 6meses después de recibir la última dosis del tratamiento de estudio.Si la pareja es una mujer con capacidad reproductiva,el hombre deberá usar preservativo y la pareja deberá usar un método anticonceptivo efectivo
    15.Un paciente debe estar de acuerdo en no donar esperma con el propósito de reproducción asistida durante el estudio y en los 6meses después de recibir la última dosis del tratamiento de estudio
    Consentimiento informado
    16.Debe firmarse una hoja de información al paciente(o el representante legal aceptado debe firmar)indicando que el participante entiende el propósito y los procedimientos requeridos para el estudio y está dispuesto participar en él
    17.Estar dispuesto y ser capaz de adherirse a las restricciones en el estilo de vida especificadas en este protocolo
    Consulte el protocolo para revisar todos los criterios de inclusión
    E.4Principal exclusion criteria
    Any potential participant who meets any of the following criteria will be excluded from participating in the study:

    Medical Conditions
    1. Contraindications or life-threatening known allergies, hypersensitivity, or intolerance to any study drug or its excipients.
    2. Stroke or seizure within 6 months prior to signing ICF.
    3. Presence of the following cardiac 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 randomization.
    c. History of clinically significant ventricular arrhythmia or unexplained syncope, not believed to be vasovagal in nature or due to dehydration.
    d. History of severe non-ischemic cardiomyopathy.
    4. Any of the following:
    a. Hepatitis B infection (hepatitis B surface antigen or HBV-DNA positive): In the event the infection status is unclear, quantitative viral levels are necessary to determine the infection status.
    b. Active hepatitis C infection as measured by positive HCV-RNA testing.
    Participants with a history of HCV antibody positivity must undergo HCV-RNA testing. If a participant with history of chronic hepatitis C infection
    (defined as both HCV antibody and HCV-RNA positive) completed antiviral therapy and has undetectable HCV-RNA for at least 12 weeks following the completion of therapy, the participant is eligible for the study.
    5. Major surgery or had significant traumatic injury within 2 weeks prior to the start of administration of study treatment, or will not have fully recovered from surgery, or has major surgery planned during the time the participant is expected to be treated in the study or within 2 weeks after administration of the last dose of study treatment.
    6. Current corneal epithelial disease except mild punctate keratopathy.
    7. Concurrent medical or psychiatric condition or disease that is likely to interfere with study procedures or results, or that in the opinion of the investigator would constitute a hazard for participating in this study, such as:
    a. Uncontrolled diabetes
    b. Acute diffuse infiltrative pulmonary disease.
    c. Evidence of active systemic viral, fungal, or bacterial infection, requiring systemic antimicrobial therapy.
    d. Active autoimmune disease requiring systemic immunosuppressive therapy within 6 months before start of study treatment. EXCEPTION: Participants with vitiligo, controlled type I diabetes, and prior autoimmune thyroiditis that is currently euthyroid based on clinical symptoms and laboratory testing are eligible regardless of when these conditions were diagnosed.
    e. Disabling psychiatric conditions (eg, alcohol or drug abuse), severe dementia, or altered mental status.
    f. Any other issue that would impair the ability of the participant to receive or tolerate the planned treatment at the investigational site, to understand informed consent or any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg, compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments.
    g. History of noncompliance with recommended medical treatments.

    Disease Characteristics
    8. Known active CNS involvement or exhibits clinical signs of meningeal involvement of multiple myeloma. If either is suspected, negative whole brain MRI and lumbar cytology are required.
    9. Plasma cell leukemia (>2.0×10^9/L) at the time of screening, Waldenström's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes), or primary amyloid light chain amyloidosis.
    10. Myelodysplastic syndrome or active malignancies (ie, progressing or requiring treatment change in the last 24 months) other than relapsed/refractory multiple myeloma. The only allowed exceptions are:
    a. Non-muscle invasive bladder cancer treated within the last 24 months that is considered completely cured.
    b. Skin cancer (non-melanoma or melanoma) treated within the last 24 months that is considered completely cured.
    c. Noninvasive cervical cancer treated within the last 24 months that is considered completely cured.
    d. Localized prostate cancer (N0M0):
    1) With a Gleason score of ≤6, treated within the last 24 months, or untreated and under surveillance.
    2) With a Gleason score of 3+4 that has been treated >6 months prior to full study screening and considered to have a very low-risk of recurrence, or
    e. History of localized prostate cancer and receiving androgen deprivation therapy and considered to have a very low-risk of recurrence.
    f. 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.

    Refer the protocol for full exclusion criteria
    Cualquier participante potencial que cumpla alguno de los siguientes criterios será excluido de participar en el estudio:
    Condiciones médicas
    1.Contraindicaciones o alergias conocidas que pongan en riesgo la vida, hipersensibilidad o intolerancia a cualquier medicamento de estudio o sus excipientes.
    2.Accidente cerebrovascular o convulsiones en los 6meses anteriores al HIP
    3.Presencia de las siguientes condiciones cardiacas
    a.Estadio III o IV de fallo cardíaco congestivo según New York Heart Association
    b.Infarto de miocardio o coronario o bypass en la arteria coronaria≤6meses antes de la aleatorización
    c.Historial clínico relevante de arritmia ventricular o síncope inexplicado, que no sea de naturaleza vasovagal o por deshidratación
    d,Historial de cardiomiopatía no isquémica severa
    4.Alguno de los siguientes:
    a.Infección HepatitisB(antígeno de superficie hepat.B o VHB-DNA+):en el caso de que el estado de la infección no sea claro,son necesarios niveles virales cuantitativos para determinar el estado de la infección.
    b.Infección activa de HepaitisC medida por prueba VHC-RNA+
    Pacientes con historial de anticuerpos VHC+ deben someterse a una prueba VHC-RNA. Si un paciente tiene historial de infección por hepat.C crónica(anticuerpos VHC y VHC- RNA+)con terapia antiviral completa y tiene un VHC-RNA indetectable en al menos 12semanas después de haber completado el tto., el paciente puede ser elegido
    5.Cirugía mayor o heridas significativas traumáticas en las 2semanas antes a comenzar con la administración del tto. de estudio,o no estar totalmente recuperado de una cirugía o tener planeada una cirugía mayor durante el periodo en el que el paciente se espera esté tratado por el estudio o en las 2semanas tras la administración de la última dosis del tto. de estudio
    6.Actual enfermedad epitelial corneal excepto queratopatía punteada
    7.Condición médica o psicológica o enfermedad que pueda interferir con los procedimientos o resultados del estudio o que,en la opinión del investigador,pueda constituir un riesgo en la participación en el estudio:
    a.diabetes incontrolada
    b.enfermedad pulmonar infiltrativa difusa
    c.evidencia de infección sistémica activa viral, fúngica o bacteriana que requiera tto. sistémico antimicrobiano
    d.enfermedad autoinmune activa que requiera una terapia inmunosupresora sistémica en los 6meses antes de empezar el tto. de estudio. EXCEPCIÓN: participantes con vitíligo, diabetes tipo1 controlada y tiroiditis autoinmune previa tiroiditis autoinmune que es actualmente eutiroidea basada en los síntomas clínicos y datos de laboratorio independientedmente de cuando fue diagnosticado
    e.condiciones psiquiátricas incapacitantes(ej.abuso de drogas o alcohol), demencia severa o estado mental alterado
    f.cualquier otro problema que pueda perjudicar la habilidad del paciente de recibir o tolerar el tratamiento planeado en el centro investigador, entender el consentimiento informado o cualquier condición por la que, en opinión del investigador,la participación no sería lo mejor para el paciente (ej,comprometer su bienestar) o que pudiera prevenir,limitar o confundir las evaluaciones específicas del protocolo
    g.historial de incumplimiento de tratamientos médicos recomendados
    Características de la enfermedad
    8.Afectación conocida del SNC activo o muestra signos clínicos de compromiso meníngeo. Si se sospecha cualquiera de los dos, se requieren una resonancia magnética(RMN)de todo el cerebro negativa y una citología lumbar múltiple
    9.Leucemia de células plasmáticas(>2.0×10^9/L)en el momento del cribado.Macroglobulinemia de Waldenström,síndrome de POEMS(polineuropatía, organomegalia, endocrinopatía,proteínaM y cambios en la piel) o amiloidosis primaria de cadena ligera amieloide
    10.Síndrome mielodisplásico o neoplasias activas(ej.progresión o requerimiento de cambio de tto. en los últimos 24meses)a parte de mieloma múltiple refractario o en recidiva. Las únicas excepciones permitidas son:
    a.cáncer invasivo de vejiga no muscular tratado en los últimos 24meses que se considera curado
    b.cáncer de piel(no melanoma o melanoma) tratado en los últimos 24meses que se considera curado
    c.cáncer cervical no invasivo tratado en los últimos 24meses que se considera curado
    d.cáncer de próstata localizado(N0M0)
    1)con puntuación de ≤6en la escala Gleason, tratado en los últimos 24meses o no tratado pero en seguimiento
    2)con puntación de Gleason 3+4 que haya sido tratado >6meses antes de completar el estudio de cribado y que se considera tiene un riesgo muy bajo de recurrencia o
    e.historial de cáncer de próstata localizado y recibiendo terapia de supresión de andrógenos y considerado con riesgo muy bajo de recurrencia
    f.Cáncer de mama:carcinoma lobular in situ adecuadamente tratado o carcinoma ductal in situ, o historial de cáncer de mama localizado y recibiendo agentes antihormonales y considerado con riesgo muy bajo de recurrencia
    Consulte el protocolo para revisar todos los criterios de exclusión
    E.5 End points
    E.5.1Primary end point(s)
    1. Overall response: defined as confirmed best overall response of PR or better according to IMWG criteria.
    2. PFS: defined as the duration from the date of randomization to either progressive disease or death, whichever comes first.
    Respuesta global: definida como la mejor respuesta global, respuesta parcial o mejor según los criterios IMWG.
    Supervivencia libre de progresión (SLP): definido como duración desde la fecha de aleatorización hasta la progresión de la enfermedad o muerte, lo que sea primero.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Subjects will have disease evaluation performed by the central laboratory every 6 weeks until disease progression. These endpoints will be evaluated at interim analysis and primary analysis.
    Los pacientes tendrán una evaluación de la patología por el laboratorio central cada 6 semanas hasta la progresión de la enfermedad. Estos parámetros serán evaluados en análisis intermedios y en análisis primarios.
    E.5.2Secondary end point(s)
    1. Depth of response characteristic:
    - VGPR or better: defined as confirmed best overall response of VGPR or better according to IMWG criteria.
    - CR or better: defined as confirmed best overall response of CR or better according to IMWG criteria.
    2. OS: defined as the time from randomization to date of death due to any cause.
    3. PFS2: defined as time from randomization to progression on the first subsequent line of therapy or death due to any cause, whichever comes first.
    4. Incidence and severity of AEs, laboratory results, and other safety parameters
    5. Serum concentration of talquetamab.
    6. Incidence and titers of ADAs to talquetamab.
    7. Change from baseline in symptoms, functioning, and general well-being.
    8. Time to sustained worsening in symptoms and general well-being.
    1.Característica de profundidad de respuesta
    -RPMB (tasa de respuesta parcial muy buena) o mejor: definido como la mejor respuesta global confirmada de RPMB o la mejor de acuerdo a los criterios IMWG.
    -RC (respuesta completa) o mejor: definida como la mejor respuesta global confirmado de RC la mejor de acuerdo a los criterios IMWG.
    2. Supervivencia global(SG): definida como el tiempo desde la aleatorización hasta la fecha de la muerte por cualquier causa.
    3.Supervivencia libre de progresión2(SLP): definido como el tiempo desde la aleatorización hasta la progresión en la primera línea subsiguiente de terapia o muerte por cualquier causa, lo que ocurra primero.
    4.Incidencia y severidad de eventos adversos, resultados de laboratorio y otros parámetros de seguridad.
    5.Concentración de Talquetamab en suero
    6.Incidencias y títulos de ADA (adenosina desaminasa) a Talquetamab
    7.Cambios desde el inicio en los síntomas, funcionamiento y bienestar general
    8. Tiempo hasta el empeoramiento sostenido de los síntomas y el bienestar general
    E.5.2.1Timepoint(s) of evaluation of this end point
    These endpoints will be evaluated at interim analysis and primary analysis.
    Estos parámetros serán evaluados en análisis intermedios y análisis primarios.
    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 Yes
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Tolerability, Immunogenicity and Biomarker Evaluations
    Tolerabilidad, inmunogenicidad y evaluación de biomarcadores.
    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) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Belantamab
    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 concerned12
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA45
    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
    Canada
    Israel
    United States
    Poland
    Spain
    Czechia
    Germany
    Greece
    Italy
    Portugal
    United Kingdom
    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 study will end upon completion of the Final OS Analysis.
    El estudio finalizará una vez que se complete el análisis final de la supervivencia global (SG).
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months11
    E.8.9.1In the Member State concerned days26
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months11
    E.8.9.2In all countries concerned by the trial days26
    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: 108
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 108
    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 state48
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 150
    F.4.2.2In the whole clinical trial 216
    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)
    At the end of their participation in the study, the sponsor will ensure that participants who are benefiting from study treatment, as determined by the investigator, will continue to be treated.
    Al final de su participación en el estudio, el espónsor se asegurará de que los participantes que se benefician del tratamiento del estudio, según lo determine el investigador, continúen recibiendo tratamiento.
    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 Decision2022-11-03
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-10-26
    P. End of Trial
    P.End of Trial StatusOngoing
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