- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03450057
Efficacy of Daratumumab in Patients With Relapsed/Refractory Myeloma With Renal Impairment (DARE)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Attica
-
Athens, Attica, Greece, 11528
- General Hospital of Athens "ALEXANDRA"
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Males and females at least 18 years of age.
- Voluntary written informed consent before performance of any study-related procedure.
Subject must have documented multiple myeloma as defined by the criteria below:
Monoclonal plasma cells in the bone marrow ≥ 10% or presence of a biopsy proven plasmacytoma.
AND any or more of the following myeloma defining events:
Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically:
- Hypercalcaemia: serum calcium >0.25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2.75 mmol/L (>11 mg/dL)
- Renal insufficiency: creatinine clearance <40 mL per min or serum creatinine >177 μmol/L (>2 mg/dL)
- Anaemia: haemoglobin value of >20 g/L below the lower limit of normal, or a haemoglobin value <100 g/L
- Bone lesions: one or more osteolytic lesions on skeletal radiography, CT, or PETCT
Any one or more of the following biomarkers of malignancy:
- Clonal bone marrow plasma cell percentage ≥60%
- Involved:uninvolved serum free light chain ratio ≥100
- >1 focal lesions on MRI studies
- Prior treatment with at least two lines of treatment that included both bortezomib- and lenalidomide based regimens.
- Documented evidence of progressive disease (PD) as defined by the modified IMWG criteria on or after the last regimen if the patient responded to previous regimens.
Subjects must have measurable disease as defined by any of the following:
- Serum monoclonal paraprotein (M-protein) level ≥ 1.0 g/dL (except for IgA subtype: ≥ 0.5 g/dL) or urine M-protein level ≥ 200 mg/24 hours; or
- Light chain multiple myeloma: Serum immunoglobulin free light chain ≥ 10 mg/dL (100 mg/L) and abnormal serum immunoglobulin kappa lambda free-light-chain ratio.
- Renal impairment defined as eGFR < 30 ml/min/1.73 m2 (calculated with the CKD-EPI formula) or in need for dialysis. Patients who undergo intraperitoneal dialysis may also be included.
- Eastern Cooperative Oncology Group (ECOG) performance status score of ≤ 2.
- Willingness and ability to participate in study procedures.
Reproductive Status
- Women of childbearing potential (WOCBP) must have two negative serum or urine pregnancy tests, one 10-14 days prior to start of the study drug and one within 24 hours prior to the start of study drug. Females are not of reproductive potential if they have been in natural menopause for at least 24 consecutive months, or have had a hysterectomy and/or bilateral oophorectomy.
- Women must not be breastfeeding.
- WOCBP must agree to follow instructions for methods of contraception for 4 weeks before the start of treatment with study drugs, for the duration of treatment with study drugs, and for 3 months after cessation of study treatment.
- Males who are sexually active must always use a latex or synthetic condom during any sexual contact with females of reproductive potential, even if they have undergone a successful vasectomy. They must also agree to follow instructions for methods of contraception for 4 weeks before the start of treatment with study drugs, for the duration of treatment with study drugs, and for a total of 3 months post-treatment completion.
- Male patients must not donate sperm for up to 90 days post treatment completion.
- Female patients must not donate eggs for up to 90 days post treatment completion.
- Azoospermic males and WOCBP who are not heterosexually active are exempt from contraceptive requirements. However, WOCBP will still undergo pregnancy testing as described in this section.
Exclusion Criteria:
- Previous therapy with daratumumab or other anti-CD38 therapy.
- Anti-myeloma treatment within 2 weeks prior to Cycle 1, Day 1.
- Cumulative dose of corticosteroids greater than or equal to the equivalent of 140mg prednisone for ≥ 4 days or a dose of corticosteroids greater than or equal to the equivalent of 40 mg/day of dexamethasone for ≥ 4 days within the 2-week period prior to Cycle 1, Day 1.
- Previous allogenic stem cell transplant; or Autologous Stem Cell Transplantation (ASCT) within 12 weeks before Cycle 1, Day 1.
- Clinical signs of meningeal involvement of multiple myeloma.
Subject has either of the following:
- Chronic obstructive pulmonary disease (COPD) with a Forced Expiratory Volume in 1 second (FEV1) <50% of predicted normal. Note that FEV1 testing is required for subjects suspected of having COPD and subjects must be excluded if FEV1 <50% of predicted normal.
- Known moderate or severe persistent asthma (see Appendix 7), within 2 years from C1D1, or currently has uncontrolled asthma of any classification. Note that subjects who currently have controlled intermittent asthma or controlled mild persistent asthma are allowed to participate in the study.
Clinically significant cardiac disease, including:
- Myocardial infarction within 1 year, or unstable or uncontrolled condition (e.g., unstable angina, congestive heart failure, New York Heart Association Class III-IV).
- Uncontrolled cardiac arrhythmia (CTCAE Grade 2 or higher) (atrial fibrillation with controlled ventricular rate is allowed) or clinically significant ECG abnormalities.
- ECG showing a baseline QT interval as corrected by Fridericia's formula (QTcF) >470 msec.
Any of the following:
- Known active hepatitis A
- Patient is seropositive for hepatitis B (defined by a positive test for hepatitis B surface antigen [HBsAg]). Subjects with resolved infection (ie, subjects who are HBsAg negative but positive for antibodies to hepatitis B core antigen [anti-HBc] and/or antibodies to hepatitis B surface antigen [anti-HBs]) must be screened using real-time polymerase chain reaction (PCR) measurement of hepatitis B virus (HBV) DNA levels. Those who are PCR positive will be excluded. EXCEPTION: Subjects with serologic findings suggestive of HBV vaccination (anti-HBs positivity as the only serologic marker) AND a known history of prior HBV vaccination, do not need to be tested for HBV DNA by PCR.
- Known to be seropositive for hepatitis C (except in the setting of a sustained virologic response [SVR], defined as aviremia at least 12 weeks after completion of antiviral therapy).
- Known to be seropositive for human immunodeficiency virus (HIV).
Amyloidosis, or any prior or concurrent malignancy, except for the following:
- Adequately treated basal cell or squamous cell skin cancer.
- Any cancer (other than in-situ) from which the subject has been disease-free for 3 years prior to study entry.
Any of the following laboratory test results during screening:
- Absolute neutrophil count ≤ 1.0 × 10^9/L;
- Hemoglobin level ≤ 7.5 g/dL (≤ 4.65 mmol/L);
- Platelet count < 75 × 10^9/L in patients in whom < 50% of bone marrow nucleated cells are plasma cells and < 50x10^9/L in patients in whom more than 50% of bone marrow nucleated cells are plasma cells;
- Alanine aminotransferase level ≥ 2.5 times the upper limit of normal (ULN);
- Pregnant or nursing women.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Single arm trial receiving daratumumab with dexamethasone (DaraD)
Daratumumab was given at a dose of 16 mg/kg administered as an intravenous (IV) infusion at weekly intervals (QW) for 8 weeks, then every 2 weeks (Q2W) for an additional 16 weeks, then every 4 weeks (Q4W) thereafter.
Dexamethasone was administered according to the standard recommended dose of 40 mg (20 mg for patients > 75 years of age) orally once daily on Days 1, 8, 15, and 22 of each 28-day treatment cycle.
|
Daratumumab: Daratumumab was given at a dose of 16 mg/kg administered as an intravenous (IV) infusion at weekly intervals (QW) for 8 weeks, then every 2 weeks (Q2W) for an additional 16 weeks, then every 4 weeks (Q4W) thereafter. Subjects received pre-infusion medications before infusions to mitigate potential infused-related reactions (IRRs). Dexamethasone: Dexamethasone was administered at 40 mg (20 mg for patients >75 years of age) orally, once daily on Days 1, 8, 15, and 22 of each 28-day treatment cycle.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Evaluation of Progression Free Survival (PFS) in Subjects With Relapsed or Refractory Multiple Myeloma and Renal Impairment Treated With Daratumumab and Dexamethasone.
Time Frame: Duration from first daratumumab administration until death or last assessment, months.
|
Progression free survival was defined as the time, in months, from treatment initiation (C1D1) to the date of the first documented disease progression or death due to any cause, whichever came first.
Clinical deterioration was not considered progression.
For patients who neither progressed nor died, the survival time was censored at the date of their last disease assessment.
For patients who started a new anti-tumor treatment, survival time was censored at the date of the start of the new treatment.
|
Duration from first daratumumab administration until death or last assessment, months.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall Response Rate (ORR)
Time Frame: From first dose of Daratumumab until end of treatment, PD or death (approximately up to 30 months)
|
Overall response rate was defined as the proportion of subjects who achieve a best response of PR or better using modified IMWG criteria as their best overall response.
|
From first dose of Daratumumab until end of treatment, PD or death (approximately up to 30 months)
|
Renal Response Rate (RRR)
Time Frame: From first dose of Daratumumab until end of treatment, PD or death (approximately up to 30 months )
|
Renal response rate was defined as the proportion of enrolled subjects who achieve a best response of renal partial response (PRRenal) or better using the IMWG criteria.
|
From first dose of Daratumumab until end of treatment, PD or death (approximately up to 30 months )
|
Duration of Response in Patients With RI
Time Frame: Assessed monthly from first dose of Daratumumab until PD or death from any cause (approximately up to 30 months)
|
Duration of response was restricted to the subjects that achieve a best objective response of PR or better.
It was measured from the time, in months, that the criteria for objective response are first met until the date of a progression event (according to the primary definition of PFS).
|
Assessed monthly from first dose of Daratumumab until PD or death from any cause (approximately up to 30 months)
|
Time to Next Therapy
Time Frame: From first dose until the date to next anti-neoplastic therapy or death from any cause, whichever comes first (approximately up to 30 months)
|
Time to next therapy was defined as the time, in months, from Cycle 1 Day 1 to the date to next anti-neoplastic therapy or death from any cause, whichever comes first.
|
From first dose until the date to next anti-neoplastic therapy or death from any cause, whichever comes first (approximately up to 30 months)
|
Overall Survival
Time Frame: Time from first dose of study treatment to death (approximately up to 30 months)
|
Overall survival was defined as the time, in months, from the first dose of therapy to the date of death from any cause.
|
Time from first dose of study treatment to death (approximately up to 30 months)
|
To Assess the Safety and Tolerability of Daratumumab With Dexamethasone in Patients With Refractory and Relapsed Multiple Myeloma (RRMM) and Renal Impairment (RI).
Time Frame: Continuously throughout the study, starting from informed consent until 30 days after last study treatment (approximately up to 30 months).
|
The incidence of Adverse Events and Treatment Emergent Adverse Events in patients with refractory and relapsed multiple myeloma and renal impairment treated with daratumumab with dexamethasone was assessed according to the common Terminology Criteria for Adverse Events.
|
Continuously throughout the study, starting from informed consent until 30 days after last study treatment (approximately up to 30 months).
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Efstathios Kastritis, Assoc Prof, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Hematologic Diseases
- Hemorrhagic Disorders
- Hemostatic Disorders
- Paraproteinemias
- Blood Protein Disorders
- Multiple Myeloma
- Neoplasms, Plasma Cell
- Physiological Effects of Drugs
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Dexamethasone
- Daratumumab
Other Study ID Numbers
- EAE-2017/MM02
- 2017-003950-18 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Relapsed/Refractory Multiple Myeloma
-
Oncopeptides ABTerminatedRelapsed Multiple Myeloma | Relapsed-Refractory Multiple MyelomaSerbia, Greece, Russian Federation, Czechia, Bulgaria, Georgia, Norway, Poland, Spain, Ukraine, Germany
-
Novartis PharmaceuticalsCompletedRefractory Multiple Myeloma | Multiple Myeloma in Relapse | Relapsed and Bortezomib Refractory Multiple MyelomaUnited States
-
University of NebraskaM.D. Anderson Cancer CenterTerminatedCabozantinib as a Targeted Strategy to Reverse Carfilzomib Resistance in Refractory Multiple MyelomaMultiple Myeloma | Refractory Multiple Myeloma | Relapsed/Refractory Multiple MyelomaUnited States
-
Ionis Pharmaceuticals, Inc.Active, not recruitingRefractory Multiple Myeloma | Relapsed Multiple MyelomaUnited States
-
TakedaCompletedRefractory Multiple Myeloma | Relapsed Multiple MyelomaUnited States, Canada
-
Carl Ola Landgren, MD, PhDBristol-Myers SquibbRecruitingRefractory Multiple Myeloma | Relapsed Multiple MyelomaUnited States
-
AmgenCompletedRefractory Multiple Myeloma | Relapsed Multiple MyelomaCanada, Belgium, Spain, United States, Korea, Republic of, Australia, Czechia, Taiwan, Hungary, Austria, Romania, Japan, United Kingdom, Greece, Turkey, Bulgaria, France, Russian Federation, Poland
-
Regeneron PharmaceuticalsActive, not recruitingRefractory Multiple Myeloma | Relapsed Multiple MyelomaUnited States
-
Dana-Farber Cancer InstituteBeth Israel Deaconess Medical Center; Brigham and Women's Hospital; H. Lee Moffitt...CompletedMultiple Myeloma | Refractory Multiple Myeloma | Relapsed Multiple MyelomaUnited States
-
BeBetter Med IncCompletedRelapsed or Refractory Multiple Myeloma | Relapsed or Refractory Non-Hodgkin's LymphomaChina
Clinical Trials on Daratumumab with dexamethasone
-
Oslo University HospitalUniversity Hospital of North Norway; Helse Stavanger HF; Haukeland University... and other collaboratorsRecruiting
-
Air Force Military Medical University, ChinaNot yet recruitingImmunoglobulin Light-chain Amyloidosis
-
Thomas Jefferson UniversityJanssen Scientific Affairs, LLCActive, not recruitingPlasma Cell MyelomaUnited States
-
Universitätsklinikum Hamburg-EppendorfGemeinsamer Bundesausschuss (G-BA); Staburo GmbHRecruiting
-
Assistance Publique - Hôpitaux de ParisActive, not recruiting
-
Abdullah KhanTerminatedRefractory Plasma Cell Myeloma | Recurrent Plasma Cell MyelomaUnited States
-
Janssen Research & Development, LLCActive, not recruitingSmoldering Multiple MyelomaUnited States, Netherlands, Belgium, Canada, Israel, Czechia, Denmark, Japan, Hungary, Turkey, United Kingdom, Spain, Sweden, France, Germany, Italy, Russian Federation, Poland, Mexico, Australia, Brazil, Greece, Argentina, Norway
-
Augusta UniversityJanssen Scientific Affairs, LLCNot yet recruitingMultiple Myeloma | Renal FailureUnited States
-
Boston Medical CenterJanssen PharmaceuticalsCompleted
-
National Cancer Institute (NCI)RecruitingLymphoma, Primary EffusionUnited States