Relapsed/Refractory Multiple Myeloma MedDRA version: 21.0 Level: LLT Classification code 10028228 Term: Multiple myeloma System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Conditions
Sponsors
F. Hoffman-La Roche Ltd.
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: • Age >= 18 years • Documented diagnosis of multiple myeloma (MM) based on standard International Myeloma Working Group (IMWG) criteria • Evidence of progressive disease based on investigators determination of response by IMWG criteria on or after their last dosing regimen • Prior B cell maturation antigen (BCMA) antibody-drug conjugate (ADC) or chimeric antigen receptor T (CAR-T) Cohort: participants who have received a BCMA-targeted CAR-T or ADC therapy and are triple-class relapsed or refractory • Prior BCMA Bispecific Cohort: participants who have received a BCMAtargeting T-cell-dependent bispecific (TDB) antibody and are triple-class relapsed or refractory • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 • Life expectancy is at least 12 weeks • Agreement to protocol-specified assessments, including bone marrow biopsy and aspirate samples as detailed in the protocol • Resolution of adverse events from prior anti-cancer therapy to Grade == 0.5 g/dL (>= 5 g/L) – Urine M-protein >= 200 mg/24 hours – Serum-free light chain (sFLC) assay: involved sFLCs >= 10 mg/dL (>=100 mg/L) and an abnormal sFLC ratio ( 1.65) – If central laboratory assessments are not available, relevant local laboratory measurements must exceed the minimum required level by at least 25% • Adequate laboratory values • For female participants of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception during the treatment period and for at least 5 months after the final dose of cevostamab and for 3 months after the last dose of tocilizumab was administered • For male participants: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom, and agree to refrain from donating sperm during the treatment period and for at least 2 months after the final dose of tocilizumab (if applicable) to avoid exposing the embryo Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 80 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 60
Exclusion criteria
Exclusion criteria: • Inability to comply with protocol-mandated hospitalization • Pregnancy or breastfeeding, or intention of becoming pregnant during the study or within 5 months after the final dose of cevostamab or within 3 months after the last dose of tocilizumab • Prior treatment with cevostamab or another agent with the same target • Prior BCMA ADC or CAR-T Cohort: prior treatment with any T cell dependent bispecific antibody (TDB) antibody including non BCMA targeting TDB • Prior BCMA Bispecific Cohort: treatment with TDB antibody within 12 weeks prior to enrollment in the study • Prior use of any monoclonal antibody (mAb), radioimmunoconjugate, or ADC as anti-cancer therapy within 4 weeks before first study treatment, except for the use of non-myeloma therapy • Prior treatment with systemic immunotherapeutic agents • Prior treatment with CAR-T cell therapy within 12 weeks before first cevostamab infusion • Known treatment-related, immune-mediated adverse events associated with prior checkpoint inhibitors as follows: – Prior PD-L1/PD-1 or CTLA-4 inhibitor: Grade >= 3 adverse events with the exception of Grade 3 endocrinopathy managed with replacement therapy – Grade 1-2 adverse events that did not resolve to baseline after treatment discontinuation • Treatment with radiotherapy, any chemotherapeutic agent, or treatment with any other anti-cancer agent within 4 weeks or 5 halflives of the drug, whichever is shorter, prior to first study treatment • Autologous stem cell transplantation (SCT) within 100 days prior to first study treatment • Prior allogeneic SCT • Circulating plasma cell count exceeding 500/ microliter (µL) or 5% of the peripheral blood white cells • Prior solid organ transplantation • History of autoimmune disease • History of confirmed progressive multifocal leukoencephalopathy • History of severe allergic or anaphylactic reactions to mAb therapy • Known history of amyloidosis • Lesions in proximity of vital organs that may develop sudden decompensation/deterioration in the setting of a tumor flare • History of other malignancy within 2 years prior to screening, except those with negligible risk of metastasis or death, such as ductal carcinoma in situ not requiring chemotherapy, appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, lowgrade, localized prostate cancer not requiring treatment or appropriately treated Stage I uterine cancer • Current or past history of central nervous system (CNS) disease, such as stroke, epilepsy, CNS vasculitis, neurodegenerative disease, or CNS involvement by MM • Significant cardiovascular disease that may limit a potential participant's ability to adequately respond to a cytokine release syndrome (CRS) event • Symptomatic active pulmonary disease or requiring supplemental oxygen • Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection at study enrollment, or any major episode of infection requiring treatment with IV (intravenous) antimicrobials where the last dose of IV antimicrobial was given within 14 days prior to first study treatment • Active symptomatic coronavirus disease 2019 (COVID-19) infection at study enrollment or requiring treatment with IV antiviral where last dose of IV antiviral treatment was given within 14 days prior to first study treatment. Patients with active COVID-19 infection must have clinical recovery and two negative antigen tests at least 24 hours apart prior to first study treatment • Positive and quantifiabl
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: • To evaluate the efficacy of cevostamab based on investigator assessed Objective response rate (ORR) • To evaluate the safety and tolerability of cevostamab ;Secondary Objective: • To evaluate the efficacy of cevostamab based on IRC assessed ORR, DOR, CR or better, rate of VGPR or better, OS, PFS, time to first response, time to best response, proportion of participants experiencing a clinically meaningful improvement and time to deterioration assessed by EORTC QLQ-C30 and EORTC QLQ-MY20 • To characterize the PK of cevostamab in participants with MM • To evaluate the immune response to cevostamab, potential relationships between cevostamab exposure and pharmacodynamic biomarkers • To make a preliminary assessment of the efficacy of tocilizumab in ameliorating the symptoms of CRS following treatment with cevostamab • To identify biomarkers that may be: o Able to provide evidence of cevostamab activity and to increase the knowledge and understanding of disease biology o Predictive of response to cevostamab o Associated with progression to a more severe disease state, acquired resistance to cevostamab and susceptibility to developing AEs;Primary end point(s): 1. ORR, defined as the proportion of participants with an objective response [stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR)], based on investigator-assessed response, according to IMWG criteria 2. Incidence and severity of adverse events, with severity determined according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0 and American Society for Transplantation and Cellular Therapy (ASTCT) for CRS and of immune effector cell associated neurotoxicity syndrome (ICANS) grading;Timepoint(s) of evaluation of this end point: 1-2. Up to approximately 2 years | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): 1. ORR, defined as the proportion of participants with an objective response based on independent review committee (IRC)-assessed response 2. Duration of response (DOR), defined as the time from the first occurrence of an objective response until the date of disease progression or death from any cause (whichever occurs first), as determined separately by the IRC and the investigator 3. Rate of CR or better, defined as the proportion of participants who achieve a response of sCR or CR, as assessed separately by IRC and the investigator 4. Rate of VGPR or better, defined as the proportion of participants who achieve a response of VGPR or better, as assessed separately by IRC and the investigator 5. Overall survival (OS), defined as the time from initiation of study treatment to death from any cause 6. Progression-free survival (PFS), defined as the time from initiation of study treatment to the first occurrence of disease progression, relapse, or death from any cause (whichever occurs first), as assessed separately by IRC and the investigator 7. Time to first response (for participants who achieve an objective response), defined as time from initiation of study treatment to first achieving an objective response (separate analyses by IRC and investigator) 8. Time to best response (for participants who achieve an objective response), defined as time from initiation of study treatment to achieving the deepest response (separate analyses by IRC and investigator) 9. Proportion of participants experiencing a clinically meaningful improvement in the fatigue domain of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core-30 Questionnaire (QLQC-30) and EORTC QLQ-MY20 10. Time to deterioration in the fatigue domain of the EORTC QLQ-C30 and/or disease symptoms domain of the EORTC QLQ-MY20 11. Serum concentration of cevostamab at specified timepoints 12. Pharmacokinetics (PK) parameters of cevostamab, as data allow 13. | — |
Countries
Australia, Belgium, Brazil, Canada, France, Germany, Greece, Hungary, Israel, Italy, Netherlands, Spain, United Kingdom, United States
Contacts
Public ContactTrial Information Support Line TISL
F.Hoffman-La Roche Ltd.
Outcome results
None listed