Autologous Memory-like NK Cell Therapy With BHV-1100 and Low Dose IL-2 in Multiple Myeloma Patients

A Phase 1 Study of Autologous Memory-like Natural Killer (NK) Cell Immunotherapy With BHV-1100 and IVIG Followed by Low Dose IL-2 as Early Post-Autologous Transplant Consolidation in Minimal Residual Disease Positive, Multiple Myeloma (MM) Patients in First or Second Remission

This is an open-label single center Phase 1a/1b study with the primary objective of establishing the safety and exploring the efficacy of infusing the ex vivo combination product of BHV-1100 plus cytokine induced memory-like (CIML) NK cells plus IVIG and low dose IL-2 in the peri-transplant setting in MM patients with minimal residual disease (MRD+) in first or second remission.

Study Overview

• Status: Completed
• Conditions: Multiple Myeloma
• Intervention / Treatment: Combination product: BHV-1100 plus cytokine induced memory-like (CIML) NK cells plus IVIG and low dose IL-2

• Study Type: Interventional
• Enrollment (Actual): 7
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02215
      • Dana Farber Cancer Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Had measurable disease according to Standard Diagnostic Criteria at the time of initial Multiple Myeloma diagnosis
• Meets criteria for symptomatic multiple myeloma at the time of induction chemotherapy
• Is transplant eligible based on clinician judgement
• Willing to undergo ASCT in first or second remission
• Achieve partial response or better with induction chemotherapy prior to ASCT according to the IMWG Uniform Response Criteria for Multiple Myeloma
• Be MRD+ upon restaging prior to stem cell collection and ASCT
• Eastern Cooperative Oncology Group (EGOG) performance status score of less than 2
• Life expectancy greater than six months
• Have a creatinine clearance > 45 mL/min/m2 at the time of transplant evaluation
• If frozen stem cells from earlier mobilized leukapheresis are unavailable at the time of mobilized leukapheresis, patients must meet parameters/criteria according to institutional SOP for autologous stem cell apheresis
• Be willing and clinically stable to undergo stem-cell mobilized and collect enough CD34+ cells sufficient for 2 ASCT per institutional guidelines or investigator discretion or have sufficient frozen cells from a SoC collection prior to signing study consent
• Be willing and clinically stable to undergo a non-mobilized MNC-Apheresis while admitted to the hospital to generate CIML NK cells
• Be willing to undergo maintenance after ASCT per NCCN guidelines based on disease risk
• If a woman of child-bearing potential, be willing to follow birth control and pregnancy testing practice as recommended
• Be willing to undergo bone marrow aspirate and biopsy as per treatment plan
• Patients must meet adequate organ function/reserve based on institutional SOP for autologous stem cell transplant eligibility
• Non-secretory MM can participate if they have measurable disease in the bone marrow and are amenable to be followed by MRD testing

Exclusion Criteria:

• Prior autologous or allogeneic hematopoietic stem cell transplant
• Prior cellular therapies, including NK cell therapy
• Prior treatment with monoclonal antibodies, within 28 days of MCN apheresis
• Prior treatment with high dose melphalan
• Prior treatment with immunosuppressive or immunomodulatory agents with exception of 5 mg or less of prednisone daily, within 14 days of MCN-Apheresis
• Disease progression at the time of study treatment
• History of Plasma Cell Leukemia at any time prior to enrollment
• Patients seropositive for the human immunodeficiency virus (HIV)
• Uncontrolled, Hepatitis C Virus or Hepatitis B Virus infection
• Patient receiving other investigational therapy
• Patients with active, clinically significant autoimmune diseases
• Patients with active, clinically significant cancer other than multiple myeloma
• Patients with severe, uncontrolled psychiatric or neurological conditions that make difficult the assessment of neurologic toxicity of the study treatment
• Patients who have received anti-MM therapy (with the exclusion of monoclonal antibodies) within 14 days of study treatment
• More than two prior lines of anti-myeloma therapy, with induction therapy followed by maintenance being considered as one line and CyBorD to RVD transition in the absence of progressive disease being considered as one line

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: BHV-1100 Combination Treatment	Combination product: BHV-1100 plus cytokine induced memory-like (CIML) NK cells plus IVIG and low dose IL-2; Single dose infusion of BHV-1100 plus CIML NK Cells plus IVIG, followed by low dose IL-2

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Dose limiting toxicities following Combination Product administration	90-100 days post Combination Product administration
Incidence and severity of side effects related to the Combination Product	90-100 days post Combination Product administration

Secondary Outcome Measures

Outcome Measure	Time Frame
Rate of MRD conversion from positive to negative	1 year post-ASCT
Rate of PFS	1 year post Combination Product administration
Best overall response rate per the International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma	90-100 days post-ASCT, 1 year post-ASCT, and overall during maintenance phase (approximately 3 years)
Incidence and severity of cytokine release syndrome per ASBMT consensus grading	100 days post Combination Product administration
Incidence and severity of other Immune-related toxicities by CTCAE version 5.0	100 days post Combination Product administration
Rate of MRD (by ClonoSEQ®) conversion from positive to negative at 90-100 days after transplantation	90-100 days post-ASCT
Rate of MRD conversion from positive to negative at any time during the maintenance phase	Start of maintenance therapy 90-100 days post ASCT until disease progression (approximately 2-3 years)
Rate of OS	1 year post Combination Product administration
PK of BHV-1100 by determining plasma Tmax	4 days post Combination Product administration
PK of BHV-1100 by determining plasma Cmax	4 days post Combination Product administration
PK of BHV-1100 by determining plasma Cmin	4 days post Combination Product administration
PK of BHV-1100 by determining plasma AUC	4 days post Combination Product administration
PK of BHV-1100 by determining plasma t1/2	4 days post Combination Product administration

Collaborators and Investigators

• Sponsor: Biohaven Pharmaceuticals, Inc.
• Collaborators: Dana-Farber Cancer Institute

Study record dates

Study Major Dates

• Study Start (Actual): October 21, 2021
• Primary Completion (Actual): January 10, 2025
• Study Completion (Actual): January 10, 2025

Study Registration Dates

• First Submitted: October 21, 2020
• First Submitted That Met QC Criteria: November 12, 2020
• First Posted (Actual): November 18, 2020

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 16, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Keywords: Cell Therapy; immunotherapy; hematological malignancies; multiple myeloma; plasma cells; ADCC; CIML NK cell therapy; cytokine induced memory-like natural killer cell therapy; antibody-dependent cell-mediated cytotoxicity; CD38 positive; CD38+
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Neoplasms; Immune System Diseases; Neoplasms by Histologic Type; Hematologic Diseases; Lymphoproliferative Disorders; Immunoproliferative Disorders; Hemostatic Disorders; Paraproteinemias; Blood Protein Disorders; Hemorrhagic Disorders; Multiple Myeloma; Neoplasms, Plasma Cell
• Other Study ID Numbers: BHV1100-101

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