Multiple Myeloma in Relapse, Multiple Myeloma Refractory
Conditions
Keywords
CAR-T, BCMA
Brief summary
A Phase 1, first in human, study to evaluate the safety and the effects of in vivo BCMA-CAR T cell therapy (VV169) in patients with Multiple Myeloma that has been previously treated and has come back, or does not respond to standard treatments. Eligible patients will receive VV169, a T-cell targeted lentiviral vector, via infusion. Patients will be monitored for safety and tolerability for up to 2 years, until progressive disease or start of next treatment, whichever is earlier.
Detailed description
Eligible patients will be recruited into either the dose escalation phase or dose expansion phase. Eligible patients will be adults who have received prior therapy, or are ineligible for, or did not tolerate standard approved treatment and have no available therapies open to them are eligible. Additional patients will be recruited in the expansion phase once an optimal dose has been identified. In the expansion phase, T cell engagers therapies and anti-BCMA ADC \> 6 months prior, and CAR-T therapy received \> 9 months prior to study enrollment will be permitted.
Interventions
BIOLOGICALVV169
T-cell Targeted (CD3- targeted lentiviral vector)
Sponsors
Vyriad, Inc.
Mayo Clinic
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Able and willing to sign the informed consent form and comply with the protocol and the restrictions and assessments therein. 2. ≥ 18 years of age. 3. Active relapsed or refractory multiple myeloma with at least 3 prior lines of therapy, OR ineligible for or did not tolerate standard approved treatment and have no available therapies open to them. 1. For Dose Escalation Phase: No prior T-cell engager therapies. No prior BCMA targeting antibody-drug conjugate (ADC) therapy. CAR-T therapy received ≥2 years prior to study enrollment is permitted. 2. For Expansion Phase: T cell engagers therapies and anti-BCMA ADC \> 6 months prior, and CAR-T therapy received \> 9 months prior to study enrollment is permitted. 4. Measurable disease as defined by RECIST. 5. ECOG Performance Status (PS) 0 or 1. 6. Life expectancy ≥12 weeks. 7. For those who received prior autologous stem cell transplant, they must be at least 100 days post-transplant, prior to registration and have recovered from side-effects of stem cell transplant. 8. For those who received prior allogeneic stem cell transplant or donor lymphocyte infusion, they must be at least 100 days post-transplant prior to registration with no signs of acute or chronic graft-versus-host disease.
Exclusion criteria
1. Has monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, or AL amyloidosis. Has Waldenstrom macroglobulinemia, primary amyloid light chains (AL) amyloidosis, primary plasma cell leukemia, or polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin abnormalities (POEMS) syndrome. Patients with secondary plasma cell leukemia or extramedullary myeloma disease are permitted. 2. Failed to recover from acute, reversible effects of prior therapy regardless of interval since last treatment. EXCEPTION: Grade 1 peripheral (sensory) neuropathy that has been stable for at least 1 month since completion of prior treatment. 3. Any of the following because this study involves an integrating lentiviral vector. * Pregnant * Nursing * Women of childbearing potential (and persons able to father a child) who are unwilling to employ adequate contraception 4. Known hypersensitivity to VV169 or any of its excipients. 5. Has active (untreated or relapsed) CNS involvement of multiple myeloma. 6. Major surgery ≤ 28 days prior to registration. 7. Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens. 8. Acute DVT or pulmonary embolism diagnosed within 3 months of registration. 9. Immunocompromised patients and patients known to be HIV positive (current and previous, as HIV antiretroviral therapy is expected to interfere with the lentiviral delivery mechanism of VV169). 10. Has significant and symptomatic cardiovascular disease (such as congestive heart failure New York Heart Association class III or higher, myocardial infarction, cerebrovascular disease, unstable angina, unstable arrhythmia) within the 3 months prior to study drug. 11. Has another malignant disease requiring treatment, with the exception of curatively treated in-situ or Stage I malignancies or malignancies with very low potential for recurrence or progression. 12. Known active central nervous system (CNS) metastases and/or carcinomatous meningitis. 13. Known active infection with hepatitis B or hepatitis C, defined by a detectable viral load. Note: Testing is not required for eligibility.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Safety and tolerability of VV169 and determine the maximum tolerated dose | 2 years | Assess incidence, type and severity of AEs, SAEs, DLTs, and clinically relevant laboratory abnormalities. |
| Determine the recommended phase 2 dose of VV169 | 28 days post last patient last dose in the Dose Escalation phase. | Incidence of DLTs and SAEs per dose level in dose escalation phase. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anti-tumor activity of the in vivo generated BCMA+ CAR-T cells | 2 years | Objective Response Rate |
Countries
United States
Outcome results
None listed