- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07674498
Immune Fitness in Older Patients With Relapsed and Refractory Multiple Myeloma (PRIME)
Prediction of Response Related to IMmune Age T Cell Fitness in Elderly Patients With Relapsed and Refractory Multiple Myeloma
Relapsed/refractory multiple myeloma (RRMM) predominantly affects older adults, who exhibit marked heterogeneity in treatment outcomes despite receiving the same therapies. Clinical frailty scores, such as the International Myeloma Working Group (IMWG) Frailty Index, predict survival and treatment tolerance but provide limited information on immune competence, a key determinant of response to T-cell-based immunotherapies.
The PRIME study is a prospective, multicenter, non-interventional exploratory study designed to evaluate the relationship between immune fitness and clinical outcomes in patients aged 65 years or older with RRMM treated with standard-of-care chimeric antigen receptor T-cell (CAR-T) therapy or bispecific antibodies. Peripheral blood samples collected before treatment initiation will be analyzed to characterize T-cell differentiation, activation, senescence, exhaustion, and T-helper cell subsets using multiparametric immunophenotyping. Serum biomarkers, including soluble B-cell maturation antigen (sBCMA) and senescence-associated soluble markers, will also be assessed.
- The primary objective is to determine whether baseline immune profiles are associated with quality of response at 3 months after treatment initiation.
- Secondary objectives include evaluating the association between immune profiles and treatment-related toxicities, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), other neurological toxicities, and infectious complications. Exploratory analyses will integrate immune, geriatric, sarcopenia, and clinical variables using statistical approaches to identify novel predictors of efficacy, survival, and toxicity.
By combining immune phenotyping with frailty assessment, the PRIME study aims to improve biological risk stratification and support the development of more personalized treatment strategies for older patients with multiple myeloma.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
The PRIME study is a prospective, multicenter, non-interventional exploratory study investigating immune fitness in patients aged 65 years or older with relapsed or refractory multiple myeloma treated with standard-of-care CAR-T cell therapy or bispecific antibodies.
The study is based on the hypothesis that chronological age and clinical frailty do not fully explain the variability in efficacy and toxicity observed with T-cell-directed immunotherapies. Baseline peripheral blood samples will be collected before treatment initiation for comprehensive immune profiling using multiparametric flow cytometry. The analysis will characterize T-cell differentiation, activation, senescence, exhaustion, regulatory T cells, and T-helper cell subsets through the evaluation of markers including CD3, CD4, CD8, CD25, CD27, CD28, CD38, CD45, CD45RO, CD57, CD127, KLRG1, PD-1, TIM-3, LAG-3, TIGIT, CCR4, CCR6, and CXCR3. Serum samples will also be collected to measure soluble B-cell maturation antigen (sBCMA) and senescence-associated soluble biomarkers.
Participants will be followed according to routine clinical practice. Clinical data collected during follow-up will include disease characteristics, geriatric assessment, sarcopenia assessment, treatment response, and treatment-related toxicities. The primary objective is to evaluate the association between baseline immune fitness and treatment response at 3 months. Secondary analyses will investigate the relationship between immune profiles and adverse events, geriatric status, and sarcopenia. The results are expected to improve understanding of the biological determinants of response and toxicity to T-cell-directed immunotherapies and to support improved risk stratification in older patients with relapsed or refractory multiple myeloma.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: Marie Vercruyssen, MD
- Telefonnummer: +32497840746
- E-mail: marie.vercruyssen@hubruxelles.be
Studiesteder
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Brussels Capital
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Anderlecht, Brussels Capital, Belgien, 1070
- Rekruttering
- Institut Jules Bordet
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Kontakt:
- Marie Vercruyssen, MD
- Telefonnummer: +32497840746
- E-mail: marie.vercruyssen@hubruxelles.be
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Brussels, Brussels Capital, Belgien, 1000
- Ikke rekrutterer endnu
- CHU Saint-Pierre
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Kontakt:
- Nicolas Cilla, MD
- Telefonnummer: +32 2 535 31 11
- E-mail: marie.vercruyssen@hubruxelles.be
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Woluwe-Saint-Lambert, Brussels Capital, Belgien, 1200
- Ikke rekrutterer endnu
- Institut Roi Albert II
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Kontakt:
- Marie-Christiane Vekemans, MD, PHD
- Telefonnummer: +32 2 764 12 00
- E-mail: marie.vercruyssen@hubruxelles.be
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- ≥ 65 years old
- Relapsed/refractory multiple myeloma
- Eligible for a CAR-T cell or bispecific antibody therapies
Exclusion Criteria:
- <65 years old
- Active cancer other than myeloma
- Active AL amyloidosis
- Central nervous system (CNS) involvement
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Andet: Overall
Immunophenotyping arm
|
Multiparametric flow cytometry will be used to characterize peripheral T-cell compartment, including differentiation status, senescence-associated phenotypes and exhaustion markers, as well as Th1/Th17 and Treg. The following markers will be used : CD57, CD25, CD3, CD45RO, CD38, CD27, CD8, CD4, CD45, KLRG1, CD127, CD28, TIGIT, CCR4, LAG-3, CD3, CCR6, CD8, CD4, CD45, PD-1, CXCR3, TIM-3. A serum sample will be collected to measure sBCMA and senescence-associated soluble markers. |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Rate of ≥VGPR or better according to IMWG criteria at 3 months.
Tidsramme: 3 months after the treatment
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The association of VGPR and immune profile will be assessed.
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3 months after the treatment
|
Samarbejdspartnere og efterforskere
Sponsor
Publikationer og nyttige links
Generelle publikationer
- Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31. doi: 10.1093/ageing/afy169.
- Palumbo A, Bringhen S, Mateos MV, Larocca A, Facon T, Kumar SK, Offidani M, McCarthy P, Evangelista A, Lonial S, Zweegman S, Musto P, Terpos E, Belch A, Hajek R, Ludwig H, Stewart AK, Moreau P, Anderson K, Einsele H, Durie BG, Dimopoulos MA, Landgren O, San Miguel JF, Richardson P, Sonneveld P, Rajkumar SV. Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood. 2015 Mar 26;125(13):2068-74. doi: 10.1182/blood-2014-12-615187. Epub 2015 Jan 27.
- Ullrich F, Brockelmann PJ, Turki AT, Khan AM, Chiru ED, Vetter M, Tresckow BV, Wirth R, Cordoba R, Ortiz-Maldonado V, Fulop T, Neuendorff NR. Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma. J Immunother Cancer. 2024 Dec 2;12(12):e009462. doi: 10.1136/jitc-2024-009462.
- Cortes-Selva D, Perova T, Skerget S, Vishwamitra D, Stein S, Boominathan R, Lau O, Calara-Nielsen K, Davis C, Patel J, Banerjee A, Stephenson T, Uhlar C, Kobos R, Goldberg J, Pei L, Trancucci D, Girgis S, Wang Lin SX, Wu LS, Moreau P, Usmani SZ, Bahlis NJ, van de Donk NWCJ, Verona RI. Correlation of immune fitness with response to teclistamab in relapsed/refractory multiple myeloma in the MajesTEC-1 study. Blood. 2024 Aug 8;144(6):615-628. doi: 10.1182/blood.2023022823.
- Bruins WSC, Smits F, Duetz C, Groen K, Korst CLBM, de Jonge AV, Verkleij CPM, Rentenaar R, Cosovic M, Eken M, Twickler I, Homan-Weert PM, Sonneveld P, Moreau P, Claesen J, van de Donk NWCJ, Zweegman S, Mutis T. A T-cell-based metric of immune age predicts outcomes in older patients with myeloma receiving daratumumab-based therapy. Blood. 2025 Nov 20;146(21):2517-2530. doi: 10.1182/blood.2025028587.
- Prabhala RH, Pelluru D, Fulciniti M, Prabhala HK, Nanjappa P, Song W, Pai C, Amin S, Tai YT, Richardson PG, Ghobrial IM, Treon SP, Daley JF, Anderson KC, Kutok JL, Munshi NC. Elevated IL-17 produced by TH17 cells promotes myeloma cell growth and inhibits immune function in multiple myeloma. Blood. 2010 Jul 1;115(26):5385-92. doi: 10.1182/blood-2009-10-246660. Epub 2010 Apr 15.
- Mehta PH, Fiorenza S, Koldej RM, Jaworowski A, Ritchie DS, Quinn KM. T Cell Fitness and Autologous CAR T Cell Therapy in Haematologic Malignancy. Front Immunol. 2021 Nov 25;12:780442. doi: 10.3389/fimmu.2021.780442. eCollection 2021.
- Liu Z, Liang Q, Ren Y, Guo C, Ge X, Wang L, Cheng Q, Luo P, Zhang Y, Han X. Immunosenescence: molecular mechanisms and diseases. Signal Transduct Target Ther. 2023 May 13;8(1):200. doi: 10.1038/s41392-023-01451-2.
- Rodriguez IJ, Lalinde Ruiz N, Llano Leon M, Martinez Enriquez L, Montilla Velasquez MDP, Ortiz Aguirre JP, Rodriguez Bohorquez OM, Velandia Vargas EA, Hernandez ED, Parra Lopez CA. Immunosenescence Study of T Cells: A Systematic Review. Front Immunol. 2021 Jan 15;11:604591. doi: 10.3389/fimmu.2020.604591. eCollection 2020.
- Cai L, Zuo L, Wang G, Li Q, Ma C, Wu J, Sun C, Hu Y. T Cells Dysfunction in Multiple Myeloma. Immunotargets Ther. 2025 Sep 11;14:997-1014. doi: 10.2147/ITT.S534784. eCollection 2025.
- Philipp N, Kazerani M, Nicholls A, Vick B, Wulf J, Straub T, Scheurer M, Muth A, Hanel G, Nixdorf D, Sponheimer M, Ohlmeyer M, Lacher SM, Brauchle B, Marcinek A, Rohrbacher L, Leutbecher A, Rejeski K, Weigert O, von Bergwelt-Baildon M, Theurich S, Kischel R, Jeremias I, Bucklein V, Subklewe M. T-cell exhaustion induced by continuous bispecific molecule exposure is ameliorated by treatment-free intervals. Blood. 2022 Sep 8;140(10):1104-1118. doi: 10.1182/blood.2022015956.
- Bruins WSC, Smits F, Duetz C, Nasserinejad K, Groen K, Korst CLBM, de Jonge AV, Rentenaar R, Hageman T, Cosovic M, Eken M, Twickler I, Homan-Weert PM, Verkleij CPM, Frerichs K, Levin MD, van der Spek E, Nijhof IS, van Kampen R, van de Donk NWCJ, Zweegman S, Mutis T. Immune signatures in older patients with newly diagnosed multiple myeloma are associated with survival outcomes of first-line therapy irrespective of frailty levels. Hemasphere. 2025 Oct 5;9(10):e70210. doi: 10.1002/hem3.70210. eCollection 2025 Oct.
- Lin Y, Qiu L, Usmani S, Joo CW, Costa L, Derman B, Du J, Einsele H, Fernandez de Larrea C, Hajek R, Ho PJ, Kastritis E, Martinez-Lopez J, Mateos MV, Mikhael J, Moreau P, Nagarajan C, Nooka A, O'Dwyer M, Schjesvold F, Sidana S, van de Donk NW, Weisel K, Zweegman S, Raje N, Otero PR, Anderson LD Jr, Kumar S, Martin T; International Myeloma Working Group. Consensus guidelines and recommendations for the management and response assessment of chimeric antigen receptor T-cell therapy in clinical practice for relapsed and refractory multiple myeloma: a report from the International Myeloma Working Group Immunotherapy Committee. Lancet Oncol. 2024 Aug;25(8):e374-e387. doi: 10.1016/S1470-2045(24)00094-9. Epub 2024 May 28.
- Dimopoulos MA, Terpos E, Boccadoro M, Moreau P, Mateos MV, Zweegman S, Cook G, Engelhardt M, Delforge M, Hajek R, Schjesvold F, Gay F, Manier S, Weisel KC, Kaiser M, van de Donk NWCJ, Zamagni E, Rodriguez-Otero P, Perrot A, Driessen C, Bila J, Laane E, Dytfeld D, Touzeau C, Beksac M, Raab MS, Cavo M, Mohty M, Spencer A, Ludwig H, Einsele H, San-Miguel J, Sonneveld P. EHA-EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma. Nat Rev Clin Oncol. 2025 Sep;22(9):680-700. doi: 10.1038/s41571-025-01041-x. Epub 2025 Jul 7.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Karsygdomme
- Hjerte-kar-sygdomme
- Neoplasmer
- Sygdomme i immunsystemet
- Neoplasmer efter histologisk type
- Hæmatologiske sygdomme
- Lymfoproliferative lidelser
- Immunproliferative lidelser
- Neoplasmer, Plasmacelle
- Hæmostatiske lidelser
- Paraproteinæmier
- Blodproteinforstyrrelser
- Hæmoragiske lidelser
- Hemiske og lymfatiske sygdomme
- Myelomatose
Andre undersøgelses-id-numre
- HUB20260367
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
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