CAR-T therapy targeting BCMA for multiple myeloma treatment
A Phase 2, Multicohort Open-Label Study of JNJ-68284528, a Chimeric Antigen Receptor T Cell (CAR-T) Therapy Directed Against BCMA in Subjects With Multiple Myeloma
PHASE2 · Janssen Research & Development, LLC · NCT04133636
This study is testing a new CAR-T therapy that targets a specific protein in multiple myeloma patients to see if it can help them achieve better treatment results.
Quick facts
| Phase | PHASE2 |
|---|---|
| Study type | Interventional |
| Enrollment | 237 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Janssen Research & Development, LLC (industry) |
| Drugs / interventions | daratumumab, CAR-T, chimeric antigen receptor, chemotherapy, prednisone |
| Locations | 47 sites (San Diego, California and 46 other locations) |
| Trial ID | NCT04133636 on ClinicalTrials.gov |
What this trial studies
This study evaluates the effectiveness of JNJ-68284528, a CAR-T therapy specifically designed to target B-cell maturation antigen (BCMA), in patients with multiple myeloma. Participants will be assessed for the rate of minimal residual disease (MRD) negativity after receiving this innovative treatment. The study includes various cohorts based on prior treatment history and disease progression, allowing for a tailored approach to therapy. The intervention also involves the use of additional medications such as lenalidomide and bortezomib to enhance treatment efficacy.
Who should consider this trial
Good fit: Ideal candidates include adults with multiple myeloma who have undergone specific prior therapies and meet the inclusion criteria for one of the study cohorts.
Not a fit: Patients with newly diagnosed multiple myeloma who have not received any prior therapy may not benefit from this study.
Why it matters
Potential benefit: If successful, this therapy could significantly improve treatment outcomes for patients with multiple myeloma by reducing residual disease.
How similar studies have performed: Other studies utilizing CAR-T therapies for hematological malignancies have shown promising results, indicating potential success for this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Cohort A: Received a minimum of 1 to a maximum of 3 prior lines of therapy including a proteasome inhibitor (PI) and immunomodulatory therapy (IMiD), and lenalidomide refractory per International Myeloma Working Group (IMWG) guidelines * Cohort B: Received one line of prior therapy including a PI and an IMiD, and disease progression per IMWG criteria less than or equal to (\<=) 12 months after treatment with autologous stem cell transplantation (ASCT) or \<=12 months from the start of anti-myeloma therapy for participants who have not had an ASCT * Cohort C: Previously treated with a PI, an IMiD, an anti-CD38 monoclonal antibody and B-cell maturation antigen (BCMA)-directed therapy * Cohort D: Newly diagnosed multiple myeloma per IMWG with a history of 4 to 8 total cycles of initial therapy, including induction, high-dose therapy, and ASCT with or without consolidation * Cohort E: Have newly diagnosed multiple myeloma without prior therapy (one cycle of prior therapy before enrollment is acceptable) and classified as high risk defined as either: 1) International Staging System (ISS) stage III criteria, Beta 2 microglobulin greater than or equal to (\>=) 5.5 milligrams per liter (mg/L) (via local or central laboratory assessment) or 2) high risk cytogenetic features del(17/17p), t (14;16), t(14;20), 1q amplification (at least 4 total copies) in at least 20 percent (%) of the total plasma cell population * Cohort F: * Participant must have a documented efficacy response of very good partial response (VGPR) or better, without progressive disease prior to enrollment, as assessed per IMWG 2016 criteria * Received initial therapy as specified below. The dose/schedule of cycles administered will be as per standard of care. It is acceptable for up to 1 cycle of the protocol-specified regimens to be missing one of the listed agents (example, held due to toxicity). Acceptable combinations include: At least 5 to 8 cycles of initial therapy with daratumumab, bortezomib, lenalidomide and dexamethasone (D-VRd). The dose/schedule of cycles administered will be as per standard of care or; at least 4 to 8 cycles of initial therapy with daratumumab, lenalidomide and dexamethasone (D-Rd) or; at least 4 to 8 cycles of initial therapy with a carfilzomib-based triplet or quadruplet regimen * Cohort G: Not considered for high-dose chemotherapy with autologous stem cell transplantation (ASCT) due to: a) Ineligibility due to advanced age; or b) Ineligibility due to presence of comorbid condition(s) likely to have a negative impact on tolerability of high-dose chemotherapy with ASCT; or c) Subject refusal of high-dose chemotherapy with ASCT as initial treatment * Cohort H: Considered a candidate for high-dose chemotherapy with ASCT as initial treatment * Cohorts A, B, C, E, G, H: * Serum monoclonal paraprotein (M-protein) level greater than or equal to (\>=) 1.0 gram per deciliter (g/dL) or urine M-protein level \>=200 milligrams (mg)/24 hours * Light chain multiple myeloma in whom only measurable disease is by serum free light chain (FLC) levels in the serum: Serum immunoglobulin FLC \>=10 mg/dL and abnormal serum immunoglobulin kappa lambda FLC ratio * Cohort A: For participants with neither serum nor urine measurable disease, baseline positron emission tomography/ computed tomography (PET/CT) or whole -body magnetic resonance imaging (MRI) may be used to satisfy the measurable disease criteria. A minimum of one lesion with a bi-dimensional measurement of at least 1 centimeter (cm)\*1 cm is required * Cohorts B, C: For participants with neither serum nor urine measurable disease, baseline positron emission tomography/ computed tomography (PET/CT) or whole body magnetic resonance imaging (MRI) may be used to satisfy the measurable disease criteria * Cohorts A, B, C, D, E, F, G, H: Eastern Cooperative Oncology Group (ECOG) performance status grade of 0 or 1 Exclusion Criteria: * Cohorts A, B, D, F: Any therapy that is targeted to BCMA * Cohorts A, B, C, D, F: Prior treatment with chimeric antigen receptor T (CAR-T) therapy directed at any target * Cohorts A, B, C, D, F: * Ongoing toxicity from previous anticancer therapy must resolve to baseline levels or to Grade 1 or less except for alopecia or peripheral neuropathy * Received a cumulative dose of corticosteroids equivalent to \>=70 mg of prednisone within the 7 days (Cohort A, B, C, F) or 14 days (Cohort D) prior to apheresis * Serious underlying medical condition, such as (a) evidence of active viral or bacterial infection requiring systemic antimicrobial therapy, or uncontrolled systemic fungal infection; (b) active autoimmune disease or a history of autoimmune disease within 3 years; (c) overt clinical evidence of dementia or altered mental status; (d) any history of Parkinson's disease or other neurodegenerative disorder * Cohorts A, B, C, D, E, F: Known active, or prior history of central nervous system (CNS) involvement or exhibits clinical signs of meningeal involvement of multiple myeloma * Cohorts F, G, and H: Active malignancies (that is, progressing or requiring treatment change in the last 24 months) other than the disease being treated under study. 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) non-invasive cervical cancer treated within the last 24 months that is considered completely cured; d) localized prostate cancer (N0M0): with a Gleason score of greater than or equal to (=\>)6, treated within the last 24 months or untreated and under surveillance, with a Gleason score of 3+4 that has been treated more than 6 months prior to full study screening and considered to have a very low risk of recurrence, or history of localized prostate cancer and receiving androgen deprivation therapy and considered to have a very low risk of recurrence, e) 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; f) malignancy that is considered cured with minimal risk of recurrence * Cohorts E, G, and H: Frailty index of \>= 2 according to Myeloma Geriatric Assessment score
Where this trial is running
San Diego, California and 46 other locations
- University Of California San Diego — San Diego, California, United States (RECRUITING)
- University of California San Francisco — San Francisco, California, United States (ACTIVE_NOT_RECRUITING)
- Yale University School Of Medicine — New Haven, Connecticut, United States (RECRUITING)
- Moffitt Cancer Center — Tampa, Florida, United States (RECRUITING)
- Emory University — Atlanta, Georgia, United States (ACTIVE_NOT_RECRUITING)
- Northwestern University — Chicago, Illinois, United States (COMPLETED)
- University of Chicago — Chicago, Illinois, United States (COMPLETED)
- Indiana University — Indianapolis, Indiana, United States (RECRUITING)
- University of Iowa Hospitals and Clinics — Iowa City, Iowa, United States (RECRUITING)
- University of Kansas Cancer Center — Westwood, Kansas, United States (RECRUITING)
- Norton Cancer Institute — Louisville, Kentucky, United States (RECRUITING)
- Dana Farber Cancer Institute — Boston, Massachusetts, United States (COMPLETED)
- Barbara Ann Karmanos Cancer Institute — Detroit, Michigan, United States (RECRUITING)
- Mayo Clinic Rochester — Rochester, Minnesota, United States (RECRUITING)
- Washington University School Of Medicine — Saint Louis, Missouri, United States (ACTIVE_NOT_RECRUITING)
- Hackensack University Medical Center — Hackensack, New Jersey, United States (COMPLETED)
- Rutgers Cancer Institute of New Jersey — New Brunswick, New Jersey, United States (COMPLETED)
- Montefiore Medical Center — Bronx, New York, United States (COMPLETED)
- Roswell Park Cancer Institute — Buffalo, New York, United States (COMPLETED)
- Mount Sinai Medical Center — New York, New York, United States (RECRUITING)
- Memorial Sloan-Kettering Cancer Center — New York, New York, United States (ACTIVE_NOT_RECRUITING)
- Levine Cancer Institute, Carolinas HealthCare System — Charlotte, North Carolina, United States (RECRUITING)
- Cleveland Clinic — Cleveland, Ohio, United States (RECRUITING)
- Oregon Health And Science University — Portland, Oregon, United States (RECRUITING)
- University of Pennsylvania — Philadelphia, Pennsylvania, United States (RECRUITING)
- Thomas Jefferson University — Philadelphia, Pennsylvania, United States (RECRUITING)
- University of Pittsburgh — Pittsburgh, Pennsylvania, United States (RECRUITING)
- University of Texas Southwestern Medical Center — Dallas, Texas, United States (RECRUITING)
- University of Utah — Salt Lake City, Utah, United States (RECRUITING)
- University of Virginia — Charlottesville, Virginia, United States (RECRUITING)
- Virginia Commonwealth University - Massey Cancer Center — Richmond, Virginia, United States (RECRUITING)
- Fred Hutchinson Cancer Center — Seattle, Washington, United States (RECRUITING)
- University of Wisconsin Carbone Cancer Center — Madison, Wisconsin, United States (RECRUITING)
- UZ Gent — Gent, Belgium (ACTIVE_NOT_RECRUITING)
- UZ Leuven — Leuven, Belgium (ACTIVE_NOT_RECRUITING)
- CHRU de Lille Hopital Claude Huriez — Lille, France (COMPLETED)
- C.H.U. Hotel Dieu - France — Nantes, France (COMPLETED)
- Hopital Saint Louis — Paris cedex 10, France (COMPLETED)
- Universitaetsklinikum Hamburg Eppendorf — Hamburg, Germany (ACTIVE_NOT_RECRUITING)
- Universitatsklinikum Wurzburg — Wuerzburg, Germany (ACTIVE_NOT_RECRUITING)
- Sheba Medical Center Tel Hashomer — Ramat Gan, Israel (COMPLETED)
- Tel Aviv Sourasky Medical Center — Tel-Aviv, Israel (ACTIVE_NOT_RECRUITING)
- VU Medisch Centrum — Amsterdam, Netherlands (ACTIVE_NOT_RECRUITING)
- University Medical Center Groningen — Groningen, Netherlands (ACTIVE_NOT_RECRUITING)
- King Faisal Specialist Hospital & Research Center — Riyadh, Saudi Arabia (ACTIVE_NOT_RECRUITING)
- Clinica Univ. de Navarra — Pamplona, Spain (ACTIVE_NOT_RECRUITING)
- Hosp Clinico Univ de Salamanca — Salamanca, Spain (ACTIVE_NOT_RECRUITING)
Study contacts
- Study coordinator: Study Contact
- Email: Participate-In-This-Study1@its.jnj.com
- Phone: 844-434-4210
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Multiple Myeloma, Cellular Therapy, CAR-T Therapy, BCMA CAR-T