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Study of Tabalumab (LY2127399) in Japanese Participants With Relapsed or Refactory Multiple Myeloma

A Phase 1 Study of Tabalumab (LY2127399) in Combination With Bortezomib and Dexamethasone in Japanese Patients With Relapsed or Refractory Multiple Myeloma

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01556438
Enrollment
16
Registered
2012-03-16
Start date
2012-07-31
Completion date
2015-08-31
Last updated
2019-03-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Multiple Myeloma

Brief summary

The purpose of this study is to evaluate the safety and effect on the body of Tabalumab (LY2127399) in combination with bortezomib and dexamethasone in Japanese participants with relapsed or refractory multiple myeloma (MM).

Detailed description

The study has 3 cohorts. Cohort 2 and cohort 2-SC will be conducted in parallel with some data presented combined. Cohort 1 - Participants will receive 100 mg Tabalumab (LY2127399) intravenously (IV), 1.3 milligram per square meter (mg/m\^2) bortezomib IV, and 20 mg dexamethasone orally. Cohort 2 - Participants will receive 300 mg Tabalumab (LY2127399) IV, 1.3 mg/m\^2 bortezomib IV, and 20 mg dexamethasone orally. Cohort 2-SC - Participants will receive 300 mg Tabalumab (LY2127399) IV, 1.3 mg/m\^2 bortezomib subcutaneously (SC), and 20 mg dexamethasone orally. Cohort 2-SC was added per protocol amendment in February 2013.

Interventions

BIOLOGICALTabalumab

Administered IV

DRUGBortezomib IV

Administered IV

DRUGBortezomib SC

Administered SC

DRUGDexamethasone

Administered orally

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Have relapsed or refractory MM treated with at least 1 prior regimen. Prior therapy with bortezomib is allowed if there was previously at least a minimal response (MR). * Have measurable disease as defined by one or more of the following: * serum M-protein concentration ≥ 1 g/dL (10 g/L) * urine monoclonal light chain concentration ≥ 200 mg/24 hours as determined by urine protein electrophoresis * involved serum free light chain (SFLC) concentration ≥ 10 mg/dL (100 mg/L) and an abnormal SFLC ratio * Have adequate organ function including: * Absolute neutrophil count (ANC) ≥ 1000/microliter * Platelet (PLT) count ≥ 75,000/microliter * Hemoglobin (Hgb) ≥ 8.0 g/dL * Total bilirubin ≤ 1.5 x upper limit of normal (ULN) (if total is elevated check direct and, if normal, participant is eligible) * Aspartate transaminase (AST) and alanine aminotransferase (ALT) are ≤ 3 x ULN * Serum creatinine ≤ 3.0 mg/dL. * Have an Eastern Cooperative Oncology Group performance status (ECOG PS) score of ≤ 2. * Have discontinued all previous therapies for cancer, including chemotherapy, surgery, and radiotherapy for at least 2 weeks (6 weeks for mitomycin-C or nitrosoureas) before study enrollment and recovered from the acute effects of therapy. * Males and females with reproductive potential: Must agree to use medically approved contraceptive precautions during the study and for 4 months following the last dose of study drug. * Females with childbearing potential: Must have had a negative urine or serum pregnancy test \<7 days before the first dose of study drug. * Have an estimated life expectancy of ≥16 weeks, in the opinion of the investigator.

Exclusion criteria

* Have received treatment within 30 days of the initial dose of study drug with an experimental agent for non-cancer indications that has not received regulatory approval for any indication. * Have one or more serious preexisting medical conditions that, in the opinion of the investigator, would preclude participation in this study. * Have an uncontrolled infection. * Females who are pregnant or breastfeeding. * Have known positive test results for human immunodeficiency virus (HIV), hepatitis B\*, or hepatitis C antibodies (HCAb). \* Have evidence of or test positive for hepatitis B. A positive test for hepatitis B is defined as: 1. positive for hepatitis B surface antigen (HBsAg+). OR 2. positive for anti-hepatitis B core antibody and positive for hepatitis B deoxyribonucleic acid (HBV DNA). OR 3. positive for anti-hepatitis B surface antibody (HBsAb+) and positive for hepatitis B deoxyribonucleic acid (HBV DNA). * Have ≥ Grade 2 peripheral neuropathy or any grade with pain as assessed using the Common Terminology Criteria for Adverse Events, version 4.03 (CTCAE v 4.03). * Have previously received an allogenic hematopoietic stem cell transplant. * Have previously received treatment with an experimental agent that targets B-cell activating factor (BAFF). * Have a corrected QT (QTc) interval \>470 msec on their baseline electrocardiogram (ECG). * Have interstitial pneumonitis (interstitial pneumonia) or pulmonary fibrosis manifested as opacity on chest X-ray or computed tomography (CT) scan. * Have had another active malignancy within the past 5 years.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With One or More Drug Related Adverse Events (AEs) or Any Serious AEsBaseline through 8 monthsA summary of other non-serious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.

Secondary

MeasureTime frameDescription
Pharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 1, Day 1: 6 + or - hours after bortezomib (BTZ); Cycle 7, Day 1: immediately post BTZ dose and 2 hours after tabalumab
Pharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 1, Day 1: 6 + or - hours after bortezomib (BTZ); Cycle 7, Day 1: immediately post BTZ dose and 2 hours after tabalumab
Number of Participants With Tumor Response (Tumor Response Rate)Baseline to disease progression (up to 421 days)Stringent Complete Response- Complete response in addition to normal free light chain ration and no clonal cells in bone marrow. Complete Response- no monoclonal protein (mp) in blood, no serum or urine mp, less than 5% plasma cells in bone marrow. Very Good Partial Response-more than 90% decrease in mp and urine protein. Partial Response- over 50% decrease in serum mp. Stable Disease- less than 25 percent decrease of monoclonal protein. Progressive Disease- 25% increase compared to lowest value of serum mp, urine mp, no measurable mp.
Pharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 1, Day 1: 6 + or - hours after bortezomib (BTZ); Cycle 7, Day 1: immediately post BTZ dose and 2 hours after tabalumab
Time to Progression (TTP)Baseline to date of Progressive Disease (up to 455 days)TTP is defined as the time from the date of study enrollment to the date of objectively determined progressive disease. TTP will be censored at the date of the last objective progression free disease assessment.
Pharmacodynamics (PD): Change From Baseline in Absolute B-cell CountBaseline through study completion (up to 455 days)
Pharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsBaseline, Cycle 1 and Cycle 7: prior to first tabalumab dose.CD19+ peripheral B-cells counts are based on the percentage of total leukocyte population and absolute cell counts.
Duration of Response (DoR)Time from Response until measured Progressive Disease (up to 455 days)DoR is defined as the time from the date when the measurement criteria are met for CR, CRu, or PR (whichever status is recorded first) until the date of first observation of measured progressive disease. For responding participants who die without progressive disease (including death from study disease),DoR will be censored at the date of death. For responding participants not known to have died as of the data cut-off date and who do not have progressive disease, DoR will be censored at the last objective progression-free assessment date prior to the data cut-off date.

Countries

Japan

Participant flow

Participants by arm

ArmCount
100 mg Tabalumab+BTZ IV+Dex
Cohort 1. 100 mg tabalumab (LY2127399) intravenously (IV) on day 1 of each cycle. Bortezomib (BTZ), 1.3 milligram per square meter (mg/m\^2), IV on days 1, 4, 8, 11 of Cycle 1-8, then on days 1, 8, 15, 22 from Cycle 9 onward. Oral dexamethasone (Dex), 20 mg/day, on day of and day after BTZ.
4
300 mg Tabalumab+BTZ +Dex
Cohort 2. 300 mg tabalumab (LY2127399) IV on day 1 of each cycle. BTZ, 1.3 mg/m\^2, IV on days 1, 4, 8, 11 of Cycle 1-8, then on days 1, 8, 15, 22 from Cycle 9 onward. Oral dex, 20 mg/day, on day of and day after BTZ subcutaneously or intravenously (SC, IV respectively).
12
Total16

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event42
Overall StudyDeath01
Overall StudyProgressive Disease06
Overall StudySponsor Decision02

Baseline characteristics

Characteristic100 mg Tabalumab+BTZ IV+DexTotal300 mg Tabalumab+BTZ +Dex
Age, Continuous70.7 years71.1 years71.3 years
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants16 Participants12 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
4 Participants16 Participants12 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants
Region of Enrollment
Japan
4 Participants16 Participants12 Participants
Sex: Female, Male
Female
2 Participants10 Participants8 Participants
Sex: Female, Male
Male
2 Participants6 Participants4 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
4 / 412 / 12
serious
Total, serious adverse events
2 / 48 / 12

Outcome results

Primary

Number of Participants With One or More Drug Related Adverse Events (AEs) or Any Serious AEs

A summary of other non-serious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.

Time frame: Baseline through 8 months

Population: All participants who received at least 1 dose of study drug.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
100 mg Tabalumab+BTZ IV+DexNumber of Participants With One or More Drug Related Adverse Events (AEs) or Any Serious AEs4 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With One or More Drug Related Adverse Events (AEs) or Any Serious AEs12 Participants
Secondary

Duration of Response (DoR)

DoR is defined as the time from the date when the measurement criteria are met for CR, CRu, or PR (whichever status is recorded first) until the date of first observation of measured progressive disease. For responding participants who die without progressive disease (including death from study disease),DoR will be censored at the date of death. For responding participants not known to have died as of the data cut-off date and who do not have progressive disease, DoR will be censored at the last objective progression-free assessment date prior to the data cut-off date.

Time frame: Time from Response until measured Progressive Disease (up to 455 days)

Population: All participants who received at least 1 dose of study drug, 4 participants were censored from Cohort 1 and 5 participants from Cohort 2. 300 mg tabalumab group administered BTZ IV or SC data were combined per protocol, BTZ was a supplemental therapy for participants.

ArmMeasureValue (NUMBER)
100 mg Tabalumab+BTZ IV+DexDuration of Response (DoR)NA months
300 mg Tabalumab+BTZ +DexDuration of Response (DoR)NA months
Secondary

Number of Participants With Tumor Response (Tumor Response Rate)

Stringent Complete Response- Complete response in addition to normal free light chain ration and no clonal cells in bone marrow. Complete Response- no monoclonal protein (mp) in blood, no serum or urine mp, less than 5% plasma cells in bone marrow. Very Good Partial Response-more than 90% decrease in mp and urine protein. Partial Response- over 50% decrease in serum mp. Stable Disease- less than 25 percent decrease of monoclonal protein. Progressive Disease- 25% increase compared to lowest value of serum mp, urine mp, no measurable mp.

Time frame: Baseline to disease progression (up to 421 days)

Population: All participants who received at least 1 dose of study drug.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Complete Response (CR)0 Participants
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Partial Response(PR)2 Participants
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Stringent Complete Response (sCR)0 Participants
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Stable Disease(SD)0 Participants
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Very Good Partial Response (VGPR)2 Participants
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Progressive Disease0 Participants
100 mg Tabalumab+BTZ IV+DexNumber of Participants With Tumor Response (Tumor Response Rate)Numbers of Responders4 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Progressive Disease3 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Numbers of Responders5 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Stringent Complete Response (sCR)0 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Complete Response (CR)0 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Very Good Partial Response (VGPR)1 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Partial Response(PR)4 Participants
300 mg Tabalumab+BTZ +DexNumber of Participants With Tumor Response (Tumor Response Rate)Stable Disease(SD)2 Participants
Secondary

Pharmacodynamics (PD): Change From Baseline in Absolute B-cell Count

Time frame: Baseline through study completion (up to 455 days)

Population: Zero participants analyzed as no post baseline data collected.

Secondary

Pharmacodynamics (PD): Change From Baseline in B-cell Subset Fractions

CD19+ peripheral B-cells counts are based on the percentage of total leukocyte population and absolute cell counts.

Time frame: Baseline, Cycle 1 and Cycle 7: prior to first tabalumab dose.

Population: All participants who received at least 1 dose of study drug and had evaluable PD. 300 mg tabalumab IV and SC dose were analyzed together.

ArmMeasureGroupValue (MEAN)Dispersion
100 mg Tabalumab+BTZ IV+DexPharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsBaseline9.3 percentage of b-cell changeStandard Deviation 8.1
100 mg Tabalumab+BTZ IV+DexPharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsCycle 1, Day 11.1 percentage of b-cell changeStandard Deviation 1.6
100 mg Tabalumab+BTZ IV+DexPharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsCycle 7, Day 1NA percentage of b-cell change
300 mg Tabalumab+BTZ +DexPharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsBaseline12.5 percentage of b-cell changeStandard Deviation 10.7
300 mg Tabalumab+BTZ +DexPharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsCycle 1, Day 10.3 percentage of b-cell changeStandard Deviation 6.7
300 mg Tabalumab+BTZ +DexPharmacodynamics (PD): Change From Baseline in B-cell Subset FractionsCycle 7, Day 1-14.4 percentage of b-cell changeStandard Deviation 7.5
Secondary

Pharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)

Time frame: Cycle 1, Day 1: 6 + or - hours after bortezomib (BTZ); Cycle 7, Day 1: immediately post BTZ dose and 2 hours after tabalumab

Population: All participants who received at least 1 dose of any study drug and had evaluable PK data. Participants in the 300 mg tabalumab group may have received IV and SC BTZ and may be counted in the IV and SC group for analysis.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
100 mg Tabalumab+BTZ IV+DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 1 Day 113300 ng*hr/mLGeometric Coefficient of Variation 21
100 mg Tabalumab+BTZ IV+DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 7 Day 1NA ng*hr/mL
300 mg Tabalumab+BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 1 Day 164200 ng*hr/mLGeometric Coefficient of Variation 35
300 mg Tabalumab+BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 7 Day 184100 ng*hr/mL
300 mg Tabalumab+ SC BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 7 Day 1131000 ng*hr/mL
300 mg Tabalumab+ SC BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Tabalumab (LY2127399)Cycle 1 Day 150900 ng*hr/mLGeometric Coefficient of Variation 60
Secondary

Pharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)

Time frame: Cycle 1, Day 1: 6 + or - hours after bortezomib (BTZ); Cycle 7, Day 1: immediately post BTZ dose and 2 hours after tabalumab

Population: All participants who received at least 1 dose of any study drug and had evaluable PK data.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
100 mg Tabalumab+BTZ IV+DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 1 Day 18100 hours times nanograms per milliliterGeometric Coefficient of Variation 15
100 mg Tabalumab+BTZ IV+DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 7 Day 19400 hours times nanograms per milliliter
300 mg Tabalumab+BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 1 Day 134600 hours times nanograms per milliliterGeometric Coefficient of Variation 23
300 mg Tabalumab+BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 7 Day 127300 hours times nanograms per milliliter
300 mg Tabalumab+ SC BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 1 Day 126900 hours times nanograms per milliliterGeometric Coefficient of Variation 48
300 mg Tabalumab+ SC BTZ +DexPharmacokinetics (PK): Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Plasma Concentration (AUC0-tlast) of Tabalumab (LY2127399)Cycle 7 Day 122900 hours times nanograms per milliliterGeometric Coefficient of Variation 71
Secondary

Pharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)

Time frame: Cycle 1, Day 1: 6 + or - hours after bortezomib (BTZ); Cycle 7, Day 1: immediately post BTZ dose and 2 hours after tabalumab

Population: All participants who received at least 1 dose of any study drug and had evaluable PK data.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
100 mg Tabalumab+BTZ IV+DexPharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 1 Day 138.5 microgram per milliliter (μg/mL)Geometric Coefficient of Variation 12
100 mg Tabalumab+BTZ IV+DexPharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 7 Day 170.5 microgram per milliliter (μg/mL)
300 mg Tabalumab+BTZ +DexPharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 1 Day 1154 microgram per milliliter (μg/mL)Geometric Coefficient of Variation 21
300 mg Tabalumab+BTZ +DexPharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 7 Day 1179 microgram per milliliter (μg/mL)
300 mg Tabalumab+ SC BTZ +DexPharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 1 Day 1139 microgram per milliliter (μg/mL)Geometric Coefficient of Variation 14
300 mg Tabalumab+ SC BTZ +DexPharmacokinetics (PK): Maximum Plasma Concentration (Cmax) for Tabalumab (LY2127399)Cycle 7 Day 1220 microgram per milliliter (μg/mL)Geometric Coefficient of Variation 25
Secondary

Time to Progression (TTP)

TTP is defined as the time from the date of study enrollment to the date of objectively determined progressive disease. TTP will be censored at the date of the last objective progression free disease assessment.

Time frame: Baseline to date of Progressive Disease (up to 455 days)

Population: All participants who received at least 1 dose of study drug and didn't have AEs . 300 mg tabalumab group administered BTZ IV or SC data were combined per protocol, BTZ was a supplemental therapy for participants. Participants that were censored prior to PD and not included in analysis:100 mg tabalumab n=4, 300 mg tabalumab n=8.

ArmMeasureValue (MEDIAN)
100 mg Tabalumab+BTZ IV+DexTime to Progression (TTP)NA months
300 mg Tabalumab+BTZ +DexTime to Progression (TTP)NA months

Source: ClinicalTrials.gov · Data processed: Mar 1, 2026