- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04405167
Tasquinimod for the Treatment of Relapsed or Refractory Myeloma
November 16, 2023 updated by: University of Pennsylvania
Phase 1 Study of Tasquinimod Alone and in Combination With Standard Therapy for Relapsed or Refractory Myeloma
This study is the first study of tasquinimod, an inhibitor of S100A9, in patients with multiple myeloma.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Tasquinimod has previously been studied as an anti-cancer agent in patients with other cancers, including a phase 3 randomized trial in patients with metastatic prostate cancer that showed an improvement in radiographic progression-free survival.
The side effect profile of tasquinimod is well-characterized based on this previous experience.
This trial will establish a maximum tolerated dose and optimal schedule for administration of tasquinimod in patients with multiple myeloma and then investigate the maximum tolerated dose of tasquinimod in combination with a standard myeloma regimen of ixazomib, lenalidomide, and dexamethasone (IRd).
For both single agent tasquinimod and the combination of tasquinimod with IRd, exploratory expansion cohorts will be enrolled to preliminarily characterize the antimyeloma activity of each regimen.
Study Type
Interventional
Enrollment (Estimated)
34
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Dan Vogl, MD
- Phone Number: 215-662-7140
- Email: dan.vogl@pennmedicine.upenn.edu
Study Locations
-
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- University of Pennsylvania
-
Contact:
- Dan Vogl, MD
- Phone Number: 215-662-7140
- Email: dan.vogl@pennmedicine.upenn.edu
-
Principal Investigator:
- Dan Vogl, MD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Signed informed consent
- 18 years of age or older
- Multiple myeloma (MM) diagnosed according to IMWG criteria
- Measurable disease (this is defined differently in different arms)
- Multiple myeloma relapsed or refractory to treatment (this is defined differently in different arms)
- Meet certain clinical laboratory criteria
- ECOG performance status ≤2
- Life expectancy of at least 3 months
- For women of childbearing potential, a negative serum or urine pregnancy test prior to study treatment.
- For women who are not postmenopausal (12 months of amenorrhea) or surgically sterile (absence of ovaries and/or uterus): agreement to use two methods of contraception one of which must be highly effective
- For men: agreement to use a barrier method of contraception for 1 month before start of study treatment, during the treatment period and for 6 months after the last dose of study treatment.
Exclusion Criteria:
- Failure to have fully recovered (i.e. ≤ Grade 1 toxicity) from the effects of prior chemotherapy (except for alopecia)
- Active graft versus host disease
Treatment with any of the following:
- Cytotoxic chemotherapy within 3 weeks prior to the initiation of study treatment
- Proteasome inhibitors, Imids, or monoclonal antibodies within 2 weeks prior to the initiation of study treatment
- Experimental therapy within 4 weeks or 5 half-lives, whichever is shorter
- Systemic corticosteroids >=10 mg prednisone or equivalent within 7 days prior to the initiation of study treatment
- Radiotherapy within 7 days prior to initiating study treatment
- Plasmapheresis within 4 weeks prior to the initiation of study treatment
- Tasquinimod at any time
- Known central nervous system involvement by myeloma
- Diagnosis of smoldering multiple myeloma
- Diagnosis of POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
- Active plasma cell leukemia
- Symptomatic primary (AL) amyloidosis
- Diagnosis of myelodysplastic syndrome or myeloproliferative syndrome
- Active other malignancy
- Major surgery within 4 weeks prior to initiating study treatment
- Evidence of severe or currently uncontrolled cardiovascular condition
- Ongoing or active systemic infection that requires systemic antibiotic or parenteral anti-infective therapy
- Active tuberculosis, active hepatitis A, B or C virus infection, or known human immunodeficiency virus (HIV) positive
- History of pancreatitis
- History of malabsorption or other condition that would interfere with absorption of study drugs
- Systemic treatment within 14 days prior to the initiation of study treatment with moderate or strong inhibitor or moderate or strong inducer of cytochrome P-3A4 (CYP3A4)
- Need for ongoing therapy drug substances of narrow therapeutic range that are metabolized mainly by CYP3A4 (alfentanil, fentanyl, quinidine, astemizole, terfenadine, sirolimus, tacrolimus, cyclosporine, cisapride, ergotamine)
- Need for ongoing therapy with drug substances of narrow therapeutic range metabolized mainly by CYP1A2 (duloxetine, alosetron, theophylline, tizanidine, ondansetron)
- Ongoing treatment with warfarin, unless the INR is <=3.0.
- For subjects enrolled on the IRd combination arms, prior dose-limiting toxicity with lenalidomide or ixazomib or absolute contraindication to concomitant thrombosis prophylaxis
- Peripheral neuropathy grade ≥2 (NCI-CTCAE)
- Known hypersensitivity to tasquinimod or any excipients in the study treatments
- Pregnant or nursing (lactating) women
- Any other condition that would, in the Investigator's judgment, contraindicate subject's participation in the clinical study due to safety concerns or compliance with clinical study procedures
- Prior inclusion in this study
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: A1: Tasquinimod single agent dose escalation
There are up to 5 planned dose levels, with 3 de-escalation dose levels available in case dose level 1 is determined to exceed the MTD.
This arm will enroll 15-30 subjects if all dose levels are explored.
|
Tasquinimod will be supplied as oral capsules.
|
Experimental: A2: Tasquinimod single agent expansion
Additional subjects will enroll in arm A2 at the MTD and optimal schedule, so that 12 subjects total who are evaluable for response will have received the MTD/optimal schedule of single agent tasquinimod.
Enrollment in arm A2 will not begin until enrollment in arm A1 has been completed and a single agent MTD/optimal schedule has been established.
|
Tasquinimod will be supplied as oral capsules.
|
Experimental: B1: Tasquinimod+IRd dose escalation
Dose levels will be defined according to the same tasquinimod doses as in the single agent (Arm A1) dose escalation.
Enrollment in arm B1 will not begin until enrollment in arm A1 has been completed and an MTD/optimal schedule has been established for single agent tasquinimod.
Initial subjects in arm B1 will be enrolled at the lower of dose level 1 or one dose level below the single agent MTD .
If this initial dose level is determined to exceed the combination MTD, further subjects will be enrolled at one dose level lower.
Enrollment is not planned in arm B1 at doses higher than the single agent MTD.
There are 9-12 planned subjects if all dose levels are explored.
|
Tasquinimod will be supplied as oral capsules.
IRd chemotherapy with ixazomib, lenalidomide, and dexamethasone
Other Names:
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Experimental: B2: Tasquinimod+IRd expansion
Additional subjects will enroll in arm B2 at the MTD and optimal schedule, so that 12 subjects total who are both evaluable for response and previously refractory to their most recent Imid/PI combination will have received the MTD/optimal schedule of tasquinimod in combination with ixazomib, lenalidomide, and dexamethasone.
To facilitate rapid enrollment and gain more experience with the combination therapy, up to 12 additional subjects with triple-class refractory myeloma (who are not previously refractory to their most recent Imid/PI combination) may be enrolled in cohort B2.
Enrollment in arm B2 will not begin until enrollment in arm B1 has been completed and a combination MTD/optimal schedule has been established.
|
Tasquinimod will be supplied as oral capsules.
IRd chemotherapy with ixazomib, lenalidomide, and dexamethasone
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Optimal Dose
Time Frame: approximately 3 years
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Maximum tolerated dose of single agent tasquinimod (mg).
|
approximately 3 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Preliminary Single-Agent Toxicity Profile
Time Frame: approximately 3 years
|
Percentage of subjects experiencing treatment-emergent grade 3/4 adverse events during therapy with single-agent tasquinimod (using the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE), version 5)
|
approximately 3 years
|
Preliminary Combination Therapy Toxicity Profile
Time Frame: approximately 3 years
|
Percentage of subjects experiencing treatment-emergent grade 3/4 adverse events during therapy with tasquinimod, ixazomib, lenalidomide, and dexamethasone (using the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE), version 5)
|
approximately 3 years
|
Preliminary Single-Agent Response
Time Frame: approximately 3 years
|
Percentage of subjects achieving a partial response or better with single-agent tasquinimod (using the response criteria of the International Myeloma Working Group)
|
approximately 3 years
|
Preliminary Assessment of Clinical Response Combination Therapy
Time Frame: approximately 3 years
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Percentage of subjects achieving a partial response or better with tasquinimod, ixazomib, lenalidomide, and dexamethasone (using the response criteria of the International Myeloma Working Group)
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approximately 3 years
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Dan Vogl, MD, University of Pennsylvania
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
July 10, 2020
Primary Completion (Estimated)
July 1, 2024
Study Completion (Estimated)
July 1, 2025
Study Registration Dates
First Submitted
March 11, 2020
First Submitted That Met QC Criteria
May 26, 2020
First Posted (Actual)
May 28, 2020
Study Record Updates
Last Update Posted (Estimated)
November 20, 2023
Last Update Submitted That Met QC Criteria
November 16, 2023
Last Verified
November 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
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Immunologic Factors
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Protease Inhibitors
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Dexamethasone
- Lenalidomide
- Ixazomib
Other Study ID Numbers
- 842603, UPCC 45419
- UPCC 45419 (Other Identifier: University of Pennsylvania)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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.
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