Treatment of relapsed and refractory multiple myeloma using CAR-T cells

An Investigator-initiated Trial Evaluating the Efficacy and Safety of Anti-GPRC5D CAR-T Cells Therapy in the Treatment of Relapsed / Refractory(r/r) Multiple Myeloma(MM)

This study is testing a new CAR-T cell therapy for people with relapsed and refractory multiple myeloma to see if it is safe and effective.

Quick facts

• Phase: Phase1; Phase2
• Study type: Interventional
• Enrollment: 18 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China (Academic / other)
• Drugs / interventions: CAR-T, chemotherapy, chimeric antigen receptor, cyclophosphamide, fludarabine
• Locations: 2 sites (Kunming, Yunnan and 1 other locations)
• Trial ID: NCT05739188 on ClinicalTrials.gov

What this trial studies

This is a single-center, open-label, single-arm trial evaluating the safety and efficacy of anti-GPRC5D CAR-T cell therapy for patients with relapsed and refractory multiple myeloma. Participants will undergo a leukapheresis procedure to collect T cells, which will then be modified to express the anti-GPRC5D CAR. Following this, patients will receive lymphodepleting therapy before the infusion of the CAR-T cells. The study aims to assess the treatment's effectiveness and safety through follow-up evaluations.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18-75 with relapsed or refractory multiple myeloma who have failed at least three prior treatments.

Not a fit: Patients who have not been diagnosed with multiple myeloma or those who have not failed multiple lines of therapy may not benefit from this study.

Why it matters

Potential benefit: If successful, this therapy could provide a new treatment option for patients with difficult-to-treat multiple myeloma.

How similar studies have performed: Other studies using CAR-T cell therapy for multiple myeloma have shown promising results, indicating potential for success in this approach.

Eligibility criteria

Inclusion Criteria:

1. The patient or his/her guardian understands and voluntarily signs the informed consent, and is expected to complete the follow-up examination and treatment of the study procedure;
2. Age 18-75 years old, gender unlimited;
3. Patients diagnosed with multiple myeloma according to International Myeloma Working Group(IMWG) diagnostic criteria;
4. Subjects who had failed treatment with at least 3 drugs of different mechanisms (including chemotherapy, proteasome inhibitors, immunomodulators, etc.), or had progressed or relapsed during the last treatment period or within 6 months after the end of treatment;
5. The presence of measurable lesions at screening was determined according to any of the following criteria, defined as: (1) serum monoclonal immunoglobulin (M-protein) level ≥1.0 g/dL; (2) urine M protein level ≥200 mg/ 24h; (3) Light chain multiple myeloma diagnosed with no measurable lesion in serum or urine: serum immunoglobulin free light chain ≥10 mg/dL and serum immunoglobulin κ/γ free light chain ratio abnormal;
6. The patient has recovered from the toxicity of the prior treatment, i.e., CTCAE toxicity grade \< 2 (unless the abnormality is related to the tumor or is stable as judged by the investigator and has little impact on safety or efficacy);
7. Eastern cooperative oncology group (ECOG) score is 0-2;
8. Survival is expected to be greater than 3 months;
9. Adequate liver , kidney and cardiopulmonary function;
10. Willingness to complete the informed consent process and to comply with study procedures and visit schedule.

Exclusion Criteria:

1. Have been diagnosed with or treated for aggressive malignancies other than multiple myeloma;
2. Prior antitumor therapy (prior to blood collection for CAR-T preparation) : targeted therapy, epigenetic therapy, or investigational drug therapy within 14 days or at least 5 half-lives, whichever is shorter;
3. It is suspected that MM has involved the central nervous system or meninges and has been confirmed by MRI or CT, or there are other active central nervous system diseases;
4. Clinically significant central nervous system diseases, such as epilepsy, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, psychosis, active central nervous system involvement or cancerous meningitis;
5. HBsAg or HBcAb are positive, and the quantitative detection of hepatitis B virus(HBV) DNA in peripheral blood is more than 100 copies / L;hepatitis C virus (HCV) antibody and HCV RNA in peripheral blood are positive; HIV antibody positive; Syphilis antibody is positive in the first screening;
6. Pregnant or breastfeeding;
7. Severe active viral, bacterial or uncontrolled systemic fungal infections; Hereditary bleeding / coagulation diseases, history of non traumatic bleeding or thromboembolism, other diseases that may increase the risk of bleeding, etc;Patients who received autologous hematopoietic stem cell transplantation (ASCT) within 8 weeks before screening, or who plan to undergo ASCT during the study period;
8. Any unstable systemic disease: including but not limited to unstable angina, cerebrovascular accident or transient cerebral ischemia (within 6 months before screening), myocardial infarction (within 6 months before screening), congestive heart failure \[New York Heart Association (NYHA) classification ≥ grade III\], severe arrhythmia with poor drug control, liver, kidney or metabolic diseases;
9. Had hypersensitivity or intolerance to any drug used in this study;
10. Persons with serious mental illness;
11. Alcoholics or persons with a history of drug abuse;
12. Systemic diseases judged by researchers to be unstable: including but not limited to severe liver, kidney or metabolic diseases requiring drug treatment;
13. Patients with acute/chronic graft-versus-host disease (GVHD) or requiring immunosuppressive therapy for GVHD within 6 months prior to screening;
14. Any unsuitable to participate in this trial judged by the investigator.

Where this trial is running

Kunming, Yunnan and 1 other locations

• 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China — Kunming, Yunnan, China (Recruiting)
• No.212 Daguan Road, Xishan District — Kunming, Yunnan, China (Recruiting)

Study contacts

• Principal investigator: Sanbin Wang, MD — 920th Hospital of Joint Logistics Support Force of People's Liberation Army of China
• Study coordinator: Sanbin Wang, MD

Conditions Multiple Myeloma in Relapse; Multiple Myeloma, Refractory; CAR-T; GPRC5D