Multiple Myeloma
Conditions
Brief summary
Phase 1 study comprised of open-label, dose escalation, multiple cohorts of P-BCMA-ALLO1 allogeneic T stem cell memory (Tscm) CAR-T cells in subjects with relapsed / refractory Multiple Myeloma (RRMM).
Detailed description
Phase 1/1b study: Phase 1 Part 1 is a weight-based dose escalation following a 3+3 design of dose-escalating cohorts. Phase 1 Part 2 includes administration at fixed doses. After enrollment, subjects may receive a lymphodepletion therapy regimen before administration of allogeneic CAR-T cells, administered as a single or multiple dose(s). Treated subjects will undergo serial measurements of safety, tolerability and response. Rimiducid may be administered as indicated. Phase 1b of the study will undergo further expansion of cohorts/arms from Phase 1 Parts 1 or 2 or an intermediate dose between cohort levels.
Interventions
BIOLOGICALP-BCMA-ALLO1 CAR-T cells
Allogeneic BCMA-targeted chimeric antigen receptor (CAR) T-cell therapy
DRUGRimiducid
Safety switch activator
DRUGMethotrexate
Anti-metabolite
Sponsors
Poseida Therapeutics, Inc.
Roche-Genentech
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Must have signed written, informed consent. 2. Males or females, ≥18 years of age. 3. Must have a confirmed diagnosis of active MM. 4. Must have measurable MM. 5. Must have relapsed / refractory MM, having received treatment with a proteasome inhibitor, immunomodulatory agent (IMiD), and anti-CD38 therapy. 6. Must be willing to practice birth control from the time of Screening and throughout the first year of the study after P-BCMA-ALLO1 administration. 7. Must have a negative serum pregnancy test at Screening and a negative urine pregnancy test within 3 days prior to initiating the lymphodepletion therapy regimen (females of childbearing potential). 8. Must be at least 90 days since autologous stem cell transplant, if performed. 9. Must have adequate vital organ function within pre-determined parameters. 10. Must have recovered from toxicities due to prior therapies. 11. Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
Exclusion criteria
1. Is pregnant or lactating. 2. Has inadequate venous access. 3. Has active hemolytic anemia, plasma cell leukemia, Waldenstrom\'s macroglobulinemia, POEMS syndrome, disseminated intravascular coagulation, leukostasis, or amyloidosis. 4. Has an active second malignancy (not disease-free for at least 5 years) in addition to MM, excluding low-risk neoplasms such as non-metastatic basal cell or squamous cell skin carcinoma. 5. Has active autoimmune disease. 6. Has a history of significant central nervous system (CNS) disease, such as stroke, epilepsy, etc. 7. Has an active systemic infection. 8. Has a history of hepatitis B, hepatitis C virus, human immunodeficiency virus (HIV), or human T-lymphotropic virus (HTLV) infection, or any immunodeficiency syndrome. Subjects with a history of treated hepatitis C can be enrolled if negative by Hepatitis C PCR on multiple occasions. 9. Is positive for cytomegalovirus (CMV) by PCR, CMV immunoglobulin M (IgM) antibody, or Coronavirus disease 2019 (COVID-19) by PCR. 10. Has New York Heart Association (NYHA) Class III or IV heart failure, unstable angina, or a history of myocardial infarction or significant arrhythmia. 11. Has any psychiatric or medical disorder that would preclude safe participation in and/or adherence to the protocol. 12. Has received prior allogeneic cellular therapy or gene therapy. 13. Has received anti-cancer medications within 2 weeks of the time of initiating conditioning LD therapy. 14. Has received monoclonal antibody therapy within 4 weeks of initiating conditioning LD therapy. 15. Has received immunosuppressive medications within 2 weeks of the time of administration of P-BCMA-ALLO1, and/or expected to require them while on study. 16. Has received systemic corticosteroid therapy within 1 week or 5 half-lives (whichever is shorter) of the administration of P-BCMA-ALLO1 or is expected to require it during the course of the study. 17. Has CNS metastases or symptomatic CNS involvement of their myeloma. 18. Has a history of severe immediate hypersensitivity reaction to any of the agents used in this study. 19. Has a history of having undergone allogeneic stem cell transplantation, or any other allogeneic or xenogeneic transplant, or has undergone autologous transplantation within 90 days. 20. Arms R, RS, RP1, RP1.5 and RP2 Only: a) Has received a live vaccine within the last 28 days of the first administration of agents used in Arm R or RS, b) Has any known hypersensitivity or severe reactions or toxicity to agents used in Arms R or RS. 21. Has received radiation within 1 week of initiating conditioning LD therapy. 22. Administration of a live vaccine within the last 28 days prior to administration of LD therapy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Phase 1 Part 1: Assess the safety and maximum tolerated dose (MTD) of P-BCMA-ALLO1 based on dose limiting toxicities (DLT) | Baseline through Day 28 | Rate of dose limiting toxicities (DLT) |
| Phase 1 Part 2: Assess the safety and tolerability of P-BCMA-ALLO1 when administered as a fixed dose of cells. | Baseline through 36 months | Frequency and severity of adverse events, including cytokine release syndrome. |
| Phase 1b: The effect of cell dose and study arm | Baseline through 36 months | Overall response rate (ORR) based on International Myeloma Working Group (IMWG) uniform response criteria |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The safety of P-BCMA-ALLO1 | Baseline through 15 years | Incidence and severity of treatment-emergent adverse events |
| The anti-myeloma effect of P-BCMA-ALLO1 (ORR) in Phase 1 Parts 1 and 2 | Baseline through 15 years | According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Overall Response Rate (ORR) - Percentage of patients with complete response (CR), very good partial response (VGPR), or partial response (PR) |
| Safety and Efficacy (anti-myeloma effect) will be used to guide the selection of RP2D | Baseline through 15 years | According to the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma: Time to Response (TTR) - Time to complete response (CR), very good partial response (VGPR), or partial response (PR) to progressive disease, Overall response rate (ORR), Duration of response (DOR), Progression free survival (PFS), and Overall survival (OS) |
Countries
United States
Contacts
STUDY_DIRECTORMaika Onishi, M.D.
Senior Medical Director
Outcome results
None listed