Trial on the Effect of Isatuximab to Lenalidomide/Bortezomib/Dexamethasone (RVd) Induction and Lenalidomide Maintenance in Patients With Newly Diagnosed Myeloma (GMMG HD7)

A Randomized Phase III Trial Assessing the Benefit of the Addition of Isatuximab to Lenalidomide / Bortezomib / Dexamethasone (RVd) Induction and Lenalidomide Maintenance in Patients With Newly Diagnosed Multiple Myeloma

Trial in patients with newly diagnosed myeloma to evaluate the effect of isatuximab in induction therapy with lenalidomide/bortezomib/dexamethasone (RVd) and in lenalidomide maintenance treatment

Study Overview

• Status: Active, not recruiting
• Conditions: Multiple Myeloma
• Intervention / Treatment: Drug: Lenalidomide; Drug: Bortezomib; Drug: Dexamethasone; Drug: Isatuximab

Detailed Description

Prospective, multicentre, randomised, parallel group, open, phase III clinical trial, for patients with confirmed diagnosis of untreated multiple myeloma requiring systemic therapy.

Investigational Medicinal Products: Isatuximab, Lenalidomide

1. Randomization: Patients are randomized in one of 2 study arms (IA or IB) before induction therapy. Patients randomized in arm IA will receive 3 cycles RVd (Bortezomib (Velcade®), Lenalidomide (Revlimid®, each cycle is 42 days), Dexamethasone). Patients in arm IB will additionally receive the monoclonal antibody Isatuximab in the 3 cycles RVd. After induction therapy patients undergo intensifying therapy according to GMMG standard (usually mobilization therapy followed by stem cell collection and autologous stem cell transplantation).
2. Randomization: Before maintenance treatment patients are randomized in one of 2 study arms (IIA and IIB): Patients in arm IIA receive Lenalidomide maintenance therapy for three years, patients in arm IIB receive additional Isatuximab.

There are two primary objectives:

1. to compare the induction regimen (IA vs IB) regarding minimal residual disease (MRD) negativity after induction (assessed by flow cytometry; sensitivity at least 1e-5)
2. to compare the maintenance strategies (arms IIA vs IIB) regarding progression-free survival (PFS), defined as time from 2nd randomization (prior to maintenance therapy) to progression or death from any cause whichever occurs first.

The duration of the trial for each patients is expected to be 45-48 months (induction and intensification treatment: 6-9 months, 3 months rest between intensification and start of maintenance phase 36 months).

• Study Type: Interventional
• Enrollment (Actual): 662
• Phase: Phase 3

Contacts and Locations

Study Locations

• Germany
  • Aachen, Germany, 52074
    • Uniklinik RWTH Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation
  • Aschaffenburg, Germany, 63739
    • Studienzentrum Aschaffenburg
  • Bad Saarow, Germany, 15526
    • Helios Klinikum Bad Saarow, Klinik für Hämatologie, Onkologie und Palliativmedizin
  • Berlin, Germany, 12200
    • Charité, Campus Benjamin Franklin , III. Medizinische Abteilung (Hämatologie/Onkologie)
  • Berlin, Germany, 12351
    • Vivantes Klinikum Neukölln, Klinik für Hämatologie und Onkologie
  • Berlin, Germany, 13125
    • HELIOS Klinikum, Klinik für Hämatologie, Onkologie und Immunologie
  • Bielefeld, Germany, 33604
    • Studiengesellschaft Onkologie Bielefeld GbR
  • Bielefeld, Germany, D-33604
    • Klinikum Bielefeld, Klinik für Hämatologie, Onkologie und Palliativmedizin
  • Bochum, Germany, D-44892
    • Medizinische Universitätsklinik, Knappschaftskrankenhaus
  • Bonn, Germany, 53105
    • Universitätsklinikum Bonn, Medizinische Klinik und Poliklinik III, Schwerpunkt Onkologie, Hämatologie und Rheumatologie
  • Bonn, Germany, 53113
    • Johanniter Krankenhaus Bonn
  • Bonn, Germany, 53113
    • Zentrum für ambulante Hämatologie und Onkologie (ZAHO)
  • Braunschweig, Germany, 38114
    • Städtisches Klinikum Braunschweig, Med. Klinik III, Hämatologie und Onkologie
  • Chemnitz, Germany, D-09116
    • Klinikum Chemnitz GmbH, Innere Medizin III
  • Cottbus, Germany, 03048
    • Carl-Thiem-Klinikum Cottbus gGmbH, II. Medizinische Klinik
  • Darmstadt, Germany, 64283
    • Onkologisches Studienzentrum Darmstadt
  • Darmstadt, Germany, D-64283
    • Klinikum Darmstadt, Med. Klinik V, Hämatologie/Onkologie
  • Dresden, Germany, 01307
    • Universitätsklinikum Carl Gustav Carus Dresden, an der Technischen Universität Dresden, Medizinische Klinik und Poliklinik I
  • Duisburg, Germany, 47166
    • HELIOS St. Johannes Klinik, Akademisches Krankenhaus der Heinrich-Heine-Universität Düsseldorf
  • Düsseldorf, Germany, 40479
    • Marien Hospital Dusseldorf GmbH, Klinik Fur Onkologie, Hamatologie Und Palliativmedizin
  • Düsseldorf, Germany, D-40225
    • Universitätsklinikum Düsseldorf, Klinik für Hämatologie,Onkologie und Klin. Immunologie
  • Erlangen, Germany, 91054
    • Universitätsklinik Erlangen
  • Eschweiler, Germany, 52249
    • St. Antonius-Hospital Eschweiler, Klinik für Hämatologie / Onkologie
  • Essen, Germany, D-45147
    • Universitatsklinikum Essen, Klinik fur Hamatologie
  • Essen, Germany, D-45239
    • Ev. Krankenhaus Essen-Werden gGmbH, Zentrum für Innere Medizin, Klinik für Hämatologie, Onkologie und Stammzelltransplantation
  • Frankfurt (Oder), Germany, 15236
    • Klinikum Frankfurt (Oder) GmbH
  • Frankfurt (Oder), Germany, 15236
    • Gemeinschaftspraxis Prof. Dr. Michael Kiehl und Dipl. Med. Wolfgang Stein
  • Frankfurt am Main, Germany, 60389
    • Centrum fur Hamatologie und Onkologie Bethanien
  • Frankfurt am Main, Germany, 60431
    • Agaplesion Markus Krankenhaus, Med. Klinik I
  • Frankfurt am Main, Germany, 60488
    • Krankenhaus Nordwest, Institut für Klinisch-Onkologische Forschung
  • Frankfurt am Main, Germany, 60590
    • Universitätsklinikum Frankfurt, Goethe-Universität Medizinische Klinik II
  • Fulda, Germany, 36043
    • Klinikum Fulda, Klinisches Studienzentrum GmbH
  • Gießen, Germany, 35385
    • Universitätsklinik der Justus-Liebig-Universität, Medizinische Klinik IV
  • Goch, Germany, 47574
    • Katholisches Karl-Leisner-Klinikum gGmbH, Wilhelm-Anton-Hospital Goch, Klinik für Hämatologie - Onkologie
  • Hagen, Germany, D-58095
    • Kath. Krankenhaus Hagen gGmbH, Abt. Hämatologie/Onkologie
  • Hamburg, Germany, 20099
    • Asklepios Klinik Hamburg St. Georg
  • Hamburg, Germany, 20246
    • Universitätsklinikum Hamburg Eppendorf, Zentrum für Onkologie, Studienzentrale der II. Medizinischen Klinik
  • Hamburg, Germany, D-22763
    • Asklepios Klinik Hamburg Altona, II. Med. Klinik
  • Hannover, Germany, 30449
    • Immunologisch-onkologisches MVZ am Siloah Krankenhaus
  • Hannover, Germany, 30459
    • KRH Klinikum Siloah, Klinik für Hämatologie und Onkologie
  • Heidelberg, Germany, 69115
    • Onkologische Schwerpunktpraxis Heidelberg
  • Heidelberg, Germany, 69117
    • Krankenhaus St. Vincentius der evangelischen Stadtmission Heidelberg, Abt. Hämatologie, Onkologie, Rheumatologie
  • Heidelberg, Germany, D-69120
    • University Hospital Heidelberg, Med. Klinik V
  • Heilbronn, Germany, D-74078
    • SLK Kliniken Heilbronn, Med. Klinik III
  • Herne, Germany, 44625
    • Marien hospital Herne
  • Homburg (Saar), Germany, 66421
    • Universitätsklinikum des Saarlandes, Innere Medizin I
  • Kaiserslautern, Germany, 67655
    • Westpfalz-Klinikum GmbH, Klinik für Innere Medizin I
  • Karlsruhe, Germany, 76133
    • Städtisches Klinikum Karlsruhe
  • Koblenz, Germany, D-56068
    • Praxisklinik für Hämatologie und Onkologie
  • Köln, Germany, 50937
    • Uniklinik Köln, Klinik I für Innere Medizin
  • Lebach, Germany, 66822
    • Gemeinschaftspraxis für Hämatologie und Onkologie am Caritas Krankenhaus
  • Leipzig, Germany, 04103
    • Universitätsklinikum Leipzig AöR, Medizinische Klinik und Poliklinik I-Hämatologie und Zelltherapie, Internistische Onkologie, Hämostaseologie
  • Ludwigshafen am Rhein, Germany, 67063
    • Med. Klinik A, Klinikum der Stadt Ludwigshafen am Rhein gGmbH
  • Mainz, Germany, D-55131
    • Universitätsmedizin der Johannes Gutenberg-Universität Mainz, III. Med. Klinik
  • Mannheim, Germany, 68167
    • III. Medizinische Klinik Hämatologie und Internistische Onkologie
  • Mannheim, Germany, D-68161
    • Mannheimer Onkologie Praxis
  • Marburg, Germany, 35032
    • Philipps-Universität Marburg, Hämatologie/Onkologie/Immunologie
  • Minden, Germany, 32429
    • Mühlenkreiskliniken (AöR) Johannes Wesling Klinikum Minden, Hämatologie/Onkologie, Hämostaseologie und Palliativmedizin
  • Mönchengladbach, Germany, D-41063
    • Krankenhaus Maria Hilf GmbH, Franziskuskrankenhaus, Med. Klinik I
  • Münster, Germany, 48149
    • Universitätsklinikum Münster, Med. Klinik A
  • Osnabrück, Germany, 49076
    • Klinikum Osnabrück GmbH
  • Paderborn, Germany, 33098
    • Brüderkrankenhaus St. Josef Paderborn, Klinik für Hämatologie und Onkologie
  • Regensburg, Germany, 93049
    • Krankenhaus Barmherzige Brüder, Klinik für Onkologie und Hämatologie
  • Saarlouis, Germany, 66740
    • Gemeinschaftspraxis für Hämatologie und Onkologie, Onkologisches Zentrum
  • Schwäbisch Hall, Germany, 74523
    • Diakonie-Klinikum Schwäbisch Hall gGmbH, Innere Medizin III
  • Siegburg, Germany, D-53721
    • ZAHO-Zentrum für ambulante Hämatologie und Onkologie, Standort Siegburg
  • Speyer, Germany, D-67346
    • Onkologische Schwerpunktpraxis Speyer
  • Stuttgart, Germany, 70174
    • Klinikum Stuttgart, Stuttgart Cancer Center, Tumorzentrum Eva Mayr-Stihl
  • Trier, Germany, 54290
    • Klinikum Mutterhaus der Borromäerinnen gGmbH
  • Tübingen, Germany, D-72076
    • University Hospital Tübingen, Med. Klinik und Poliklinik, Abt. II
  • Ulm, Germany, 89081
    • Bundeswehrkrankenhaus Ulm, Abteilung Innere Medizin - Hämatologie und internistische Onkologie
  • Villingen-Schwenningen, Germany, 78052
    • Schwarzwald-Baar Klinikum, Innere Medizin II
  • Winnenden, Germany, 71364
    • Rems-Murr-Kliniken gGmbH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 68 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Confirmed diagnosis of untreated multiple myeloma requiring systemic therapy (diagnostic criteria (IMWG updated criteria (2014)1) see appendix IA. For some patients systemic therapy may be required though these diagnostic criteria are not fulfilled. In this case the GMMG study office has to be consulted prior to inclusion.)
2. Patient is eligible for high dose therapy and autologous stem cell transplantation.

3. Measurable disease, defined as any quantifiable monoclonal protein value, defined by at least one of the following three measurements:2

   • Serum M-protein ≥ 10g/l (for IgA ≥ 5g/l)
   • Urine light-chain (M-protein) of ≥ 200 mg/24 hours
   • Serum FLC assay: involved FLC level ≥ 10 mg/dl provided sFLC ratio is abnormal
4. Age 18 - 70 years inclusive
5. WHO performance status 0-2
6. Negative pregnancy test at inclusion (females of childbearing potential)
7. All patients must agree on the requirements regarding the lenalidomide pregnancy prevention plan described in section 6. For all men and females of childbearing potential: patients must be willing and capable to use adequate contraception during the complete therapy.

8. All patients must

   • agree to abstain from donating blood while taking lenalidomide and for 28 days following discontinuation of lenalidomide therapy
   • agree not to share study drug lenalidomide with another person and to return all unused study drug to the investigator or pharmacist
9. Ability of patient to understand character and individual consequences of the clinical trial
10. Provide written informed consent (must be available before enrolment in the trial)

Exclusion Criteria

1. Patient has known hypersensitivity (or contraindication) to dexamethasone, sucrose histidine (as base and hydrochloride salt), boron, mannitol, and polysorbate 80 or any of the components of study therapy that are not amenable to premedication with steroids or H2 blockers that would prohibit further treatment with these agents.
2. Systemic AL amyloidosis (except for AL amyloidosis of the skin or the bone marrow)
3. Plasma cell leukemia
4. Previous chemotherapy or radiotherapy during the past 5 years except local radiotherapy in case of local myeloma progression. (Note: patients may have received a cumulative dose of up to 160 mg of dexamethasone or equivalent as emergency therapy.) Previous therapy due to smouldering myeloma may be acceptable. In this case the GMMG study office has to be consulted prior to inclusion
5. Severe cardiac dysfunction (NYHA classification III-IV), ejection fraction < 40%
6. Significant hepatic dysfunction (ASAT and/or ALAT ≥ 3 times normal level and/or serum bilirubin ≥ 1.5 times normal level if not due to hereditary abnormalities as Gilbert's disease), unless related to myeloma.
7. Patients with active or history of hepatitis B or C
8. HIV positivity
9. Patients with active, uncontrolled infections
10. Patients with severe renal insufficiency (Creatinine Clearance < 30ml/min)
11. Patients with peripheral neuropathy or neuropathic pain, CTC grade 2 or higher (as defined by the NCI Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0)
12. Patients with a history of active malignancy during the past 5 years with the exception of following malignancies after curative therapy: basal cell carcinoma of the skin, squamous cell skin carcinoma, stage 0 cervical carcinoma or any in situ malignancy
13. Patients with acute diffuse infiltrative pulmonary and/or pericardial disease
14. Autoimmune hemolytic anemia with positive Coombs test or immune thrombocytopenia
15. Platelet count < 75 x 109/l
16. Haemoglobin < 8.0 g/dl, unless related to myeloma
17. Absolute neutrophil count (ANC) < 1.0 x 109/l (the use of colony stimulating factors within 14 days before the test is not allowed)
18. Corrected serum calcium > 14 mg/dl (> 3.5 mmol/l)
19. Unable or unwilling to undergo thromboprophylaxis
20. Pregnancy and lactation
21. Participation in other clinical trials. This does not include long-term follow-up periods without active drug treatment of previous studies during the last 6 months.
22. Prisoners or subjects who are legally institutionalized, or those unwilling or unable to comply with scheduled visits, drug administration plan, laboratory tests, other study procedures, and study restrictions.

No patients will be allowed to enrol in this trial more than once.

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Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: IA; Patients in arm IA are treated with 3 cycles RVd (lenalidomide 25 mg/d p.o. d1 - 14 and d22 - 35; bortezomib 1.3 mg/m2 s.c. d1, 4, 8, 11, 22, 25, 29, 32; dexamethasone p.o. 20 mg/d d1-2, 4-5, 8-9, 11-12, 15, 22-23, 25-26, 29-30, 32-33).Treatment repeats every 42 days (d43 = cycle 2 d1). Standard intensification: For all patients, stem cells are mobilized by GMMG Standard protocols (CAD: cyclophosphamide, doxorubicin, dexamethasone) and G-CSF. At least 7.5x106 CD34+ cells/kg body weight are harvested. High dose treatment (melphalan 200mg/m², HDT) followed by autologous stem cell transplantation (ASCT) is started 4 - 6 weeks after CAD. For patients not in CR after HDT1, a second HDT is performed within 3 months.	Drug: Lenalidomide; 25 mg per os on day 1-14 and d22-35 in induction cycle 1-3 (Arms IA and IB) 10 mg p.o. on day 1-28 in maintenance cycle 1-3, 15 mg p.o. on day 1-28 in maintenance cycle 4-39 (Arms IIA and IIB); Other Names: Revlimid; Drug: Bortezomib; all arms: 1,3 mg/m^2 subcutaneous on day 1, 4, 8, 11, 22, 25, 29 32 in 3 induction cycles; Other Names: Velcade; Drug: Dexamethasone; 20 mg per os on day 1,2 and 4,5 and 8,9 and 11,12 and 15 and 22,23 and 25,26 and 29,30 and 32,33 in induction cycles 1-3 (Arms IA and IB). Maintenance cycle 1 on day 1, 8, 15, 22 Dexamethasone 20 mg/d per os (Arm IIA). In Arm IIB Dexamethasone 20 mg i.v. on days of Isatuximab infusion in the first maintenance cycle (d 1, 8, 15, 22), dexamethasone will be administered intravenously as part of the premedication. If an isatuximab dose is skipped or discontinued dexamethasone should be administered orally.
Experimental: IB; Patients in arm IB are treated with 3 cycles RVd + Isatuximab (lenalidomide 25 mg/d p.o. d1 - 14 and d22 - 35; bortezomib 1.3 mg/m2 s.c. d1, 4, 8, 11, 22, 25, 29, 32;dexamethasone p.o. 20 mg/d d1-2, 4-5, 8-9, 11-12, 15, 22-23, 25-26, 29-30, 32-33).Isatuximab (10 mg/kg i.v. C1: d 1, 8, 15, 22, 29; C2-3: d 1, 15, 29).Treatment repeats every 42 days (d43 = cycle 2 d1). Standard intensification: For all patients, stem cells are mobilized by GMMG Standard protocols (CAD: cyclophosphamide, doxorubicin, dexamethasone) and G-CSF. At least 7.5x106 CD34+ cells/kg body weight are harvested. High dose treatment (melphalan 200mg/m², HDT) followed by autologous stem cell transplantation (ASCT) is started 4 - 6 weeks after CAD. For patients not in CR after HDT1, a second HDT is performed within 3 months.	Drug: Lenalidomide; 25 mg per os on day 1-14 and d22-35 in induction cycle 1-3 (Arms IA and IB) 10 mg p.o. on day 1-28 in maintenance cycle 1-3, 15 mg p.o. on day 1-28 in maintenance cycle 4-39 (Arms IIA and IIB); Other Names: Revlimid; Drug: Bortezomib; all arms: 1,3 mg/m^2 subcutaneous on day 1, 4, 8, 11, 22, 25, 29 32 in 3 induction cycles; Other Names: Velcade; Drug: Dexamethasone; 20 mg per os on day 1,2 and 4,5 and 8,9 and 11,12 and 15 and 22,23 and 25,26 and 29,30 and 32,33 in induction cycles 1-3 (Arms IA and IB). Maintenance cycle 1 on day 1, 8, 15, 22 Dexamethasone 20 mg/d per os (Arm IIA). In Arm IIB Dexamethasone 20 mg i.v. on days of Isatuximab infusion in the first maintenance cycle (d 1, 8, 15, 22), dexamethasone will be administered intravenously as part of the premedication. If an isatuximab dose is skipped or discontinued dexamethasone should be administered orally.; Drug: Isatuximab; 10 mg/kg in the vein( i.v) on day 1,8,15, 22, 29 in induction cycle 1 on day 1, 15 and 29 in induction cycle 2 and 3 (Arm IB). 10 mg/kg i.v. on day 1,8, 15 and 22 in maintenance cycle 1, 10 mg/kg i.v. on day 1 and 15 in maintenance cycle 2 and 3, 10 mg/kg i.v. on day 1 in maintenance cycle 4 - 39 (Arm IIB)
Active Comparator: IIA; maintenance treatment with Lenalidomide 10mg/d (increased to 15mg/d after 3 months) repeated every 28d. Maintenance treatment is planned for up to 36 months or until progression if progression occurs first.	Drug: Lenalidomide; 25 mg per os on day 1-14 and d22-35 in induction cycle 1-3 (Arms IA and IB) 10 mg p.o. on day 1-28 in maintenance cycle 1-3, 15 mg p.o. on day 1-28 in maintenance cycle 4-39 (Arms IIA and IIB); Other Names: Revlimid
Experimental: IIB; maintenance treatment with Lenalidomide 10mg/d (increased to 15mg/d after 3 months) + Isatuximab (10 mg/kg; C1: d1, 8, 15, 22; C2-C3: d1 + 15; C4-39:d1, repeated every 28d). Within the trial, maintenance treatment is planned for up to 36 months or until progression if progression occurs first.	Drug: Lenalidomide; 25 mg per os on day 1-14 and d22-35 in induction cycle 1-3 (Arms IA and IB) 10 mg p.o. on day 1-28 in maintenance cycle 1-3, 15 mg p.o. on day 1-28 in maintenance cycle 4-39 (Arms IIA and IIB); Other Names: Revlimid; Drug: Isatuximab; 10 mg/kg in the vein( i.v) on day 1,8,15, 22, 29 in induction cycle 1 on day 1, 15 and 29 in induction cycle 2 and 3 (Arm IB). 10 mg/kg i.v. on day 1,8, 15 and 22 in maintenance cycle 1, 10 mg/kg i.v. on day 1 and 15 in maintenance cycle 2 and 3, 10 mg/kg i.v. on day 1 in maintenance cycle 4 - 39 (Arm IIB)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
MRD negativity after induction Treatment (comparison of arms IA and IB)	Detection of minimal residual disease by flow cytometry (sensitivity at least 1e-5)	18 weeks after start of study treatment
Progression Free Survival (PFS) after second randomization (arms IIA and IIB)	Response Evaluation by IMWG criteria	time from 2. randomization to progression or death from any cause whichever comes first, censored after three years of maintenance therapy

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
to compare the four treatment arms (IA-IIA, IA-IIB, IB-IIA, IB-IIB) regarding Progression free survival (PFS)	Response evaluation by IMWG criteria	time from 1. randomization (study inclusion) to progression or death whichever comes first (assessed up to 79 months)
to compare all 4 treatment arms (IA-IIA, IA-IIB, IB-IIA, IB-IIB) regarding overall survival (OS) from time of 1.randomization	survival status	time from randomisation to time of death from any cause (assessed up to 79 months)
Overall survival from second randomization	survival status	time from 2. randomization to time of death from any cause (assessed up to 75 months)
Complete Response (CR) rates after induction therapy	Response Evaluation by IMWG criteria	After induction treatment (18 weeks after start of treatment)
Complete Response (CR) after high dose therapy	Response Evaluation by IMWG criteria	After high dose therapy (9 or 12 months after start of therapy)
Complete Response (CR) during/after maintenance therapy	Response Evaluation by IMWG criteria	During/after maintenance therapy (6 months after start of therapy up to 36 months of maintenance therapy)
MRD negativity after high dose therapy	Detection of minimal residual disease by flow cytometry (sensitivity at least 1e-5)	After high dose therapy (9 or 12 months after start of therapy)
MRD negativity during and after maintenance therapy	Detection of minimal residual disease by flow cytometry (sensitivity at least 1e-5)	up to 36 months after start of maintenance therapy
Best response to treatment during the trial	Response evaluation by IMWG criteria	response assessment after 3 months, 4,5 months, 5,5 months, 9 months (if applicable: 3 months later after 2. high dose therapy) subsequently every 3 months during maintenance treatment, up to 48 months after start of study treatment
PFS 2 (PFS after next line of therapy) from 2. randomization	Response evaluation by IMWG criteria	time from 2. randomization to time of overall end of trial (up to 75 months)
Toxicity during induction and maintenance with respect to adverse events of CTC grade >3 (and specific adverse events of CTC grade > 2 as defined in the protocol and serious adverse events	toxicity according CTCAE Version v5.0	: from first administration of study drug until 30 days after last administration of study drug or any drug of the study treatment or upon start of a new subsequent chemotherapy, whichever occurs first
Quality of Life Assessment	EORTC (European Organization of Research and Treatment of Cancer) -QLQC30 Questionnaire to assess the quality of life of cancer patients. Impairment of daily life is asked in 4 scales from "not at all" (best) to "very much" (worst scale), EORTC-QLQMY20 questionnaire to assess health-related quality of life in patients with multiple myeloma with 4 scales from "not at all (best scale) to "very much" (worst scale); EQ(EuroQol Group)-5D-5L Health questionnaire comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. Additionally a visual analogue scale from 100 (best) to 0 (worst scale) is used to assess the quality of health questionnaires.	assessed at baseline, after ca. 4.5 months, 9 months, (additionally after 12 months,if a second high dose therapy is administered) after 12 months of maintenance and at end of study (up to 50 months)
Pharmakokinetic analyses of Isatuximab in induction treatment of patients in Arm IB (selected sites only)	Determination of serum concentration of isatuximab at different timepoints before, during and after isatuximab infusion	Up to 18 weeks in induction treatment (C1: D1, before infusion, at end of infusion, 1 h after infusion, C1 D8,15,22,29 before infusion; C2 and 3:D1 before infusion
Pharmakokinetic analyses of Isatuximab in maintenance treatment of patients in Arm IIB (selected sites only)	Determination of serum concentration of isatuximab at different timepoints	Up to 9 months (C1: D1, before infusion, at end of infusion, 1 h after infusion, C1 D8,15,22 before infusion, C2 -9, D1: before infusion

Collaborators and Investigators

• Sponsor: University of Heidelberg Medical Center
• Investigators: Principal Investigator: Hartmut Goldschmidt, Prof. Dr., Med. Klinik V, University Hospital Heidelberg

Publications and helpful links

General Publications

• Goldschmidt H, Mai EK, Bertsch U, Fenk R, Nievergall E, Tichy D, Besemer B, Durig J, Schroers R, von Metzler I, Hanel M, Mann C, Asemissen AM, Heilmeier B, Weinhold N, Huhn S, Kriegsmann K, Luntz SP, Holderried TAW, Trautmann-Grill K, Gezer D, Klaiber-Hakimi M, Muller M, Khandanpour C, Knauf W, Scheid C, Munder M, Geer T, Riesenberg H, Thomalla J, Hoffmann M, Raab MS, Salwender HJ, Weisel KC; German-Speaking Myeloma Multicenter Group (GMMG) HD7 investigators. Addition of isatuximab to lenalidomide, bortezomib, and dexamethasone as induction therapy for newly diagnosed, transplantation-eligible patients with multiple myeloma (GMMG-HD7): part 1 of an open-label, multicentre, randomised, active-controlled, phase 3 trial. Lancet Haematol. 2022 Nov;9(11):e810-e821. doi: 10.1016/S2352-3026(22)00263-0.

Study record dates

Study Major Dates

• Study Start (Actual): October 18, 2018
• Primary Completion (Anticipated): May 1, 2025
• Study Completion (Anticipated): December 1, 2025

Study Registration Dates

• First Submitted: July 24, 2018
• First Submitted That Met QC Criteria: July 31, 2018
• First Posted (Actual): August 6, 2018

Study Record Updates

• Last Update Posted (Actual): May 12, 2023
• Last Update Submitted That Met QC Criteria: May 11, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• 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; Immunologic Factors; Antiemetics; Gastrointestinal Agents; Glucocorticoids; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Antineoplastic Agents, Hormonal; Angiogenesis Inhibitors; Angiogenesis Modulating Agents; Growth Substances; Growth Inhibitors; Dexamethasone; Lenalidomide; Bortezomib
• Other Study ID Numbers: GMMG HD7

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No