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Validating DW-MRI and Fat Fraction in Multiple Myeloma Post-ASCT: The RAC-FAT Study"

7 de septiembre de 2026 actualizado por: Fondazione EMN Italy Onlus

Multicenter Observational Study for the Validation of the Predictive Role of Diffusion-Weighted Whole-body MRI (DW-MRI) Imaging Response According to MY-RADS Criteria (RAC Score) and Fat Fraction (rFF%) After Autologous Stem Cell Transplantation in Multiple Myeloma Patients Treated With First-Line Anti-CD38-Based Therapy (RAC-FAT Study)

This is a multicenter, observational, retrospective-prospective study designed to validate the predictive role of advanced imaging in patients with newly diagnosed multiple myeloma (NDMM). The main purpose of this study is to estimate the prevalence of radiological response categories (Response Assessment Category, RAC score) and evaluate the predictive value of relative Fat Fraction (rFF%) using Diffusion-Weighted Whole-Body Magnetic Resonance Imaging (DW-MRI) in patients who have undergone autologous stem cell transplantation (ASCT) after receiving first-line anti-CD38-based quadruplet induction therapy.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Descripción detallada

The role of functional imaging in Multiple Myeloma (MM) has become essential for assessing treatment response. This study focuses on the Myeloma Response Assessment and Diagnosis System (MY-RADS) guidelines and the quantitative parameter of rFF% to identify "functional high-risk" patients who may experience early relapse despite achieving conventional deep responses.The study will involve two cohorts:Retrospective Cohort: Includes patients treated since January 1st, 2020, with available post-ASCT DW-MRI data performed during routine clinical practice.Prospective Cohort: Includes newly diagnosed patients enrolled after their standard-of-care ASCT and post-transplant DW-MRI assessment.Participants will not receive any investigational or trial-specific treatment. All diagnostic and therapeutic procedures follow the current standard of care. Data regarding clinical characteristics, treatment details (induction, ASCT, maintenance), DW-MRI parameters (RAC score, apparent diffusion coefficient [ADC], and rFF% values), and minimal residual disease (MRD) will be collected and recorded in an anonymized electronic Case Report Form (eCRF).The study aims to enroll a minimum of 92 participants to evaluate:Primary Endpoint: Prevalence of RAC1 and RAC≥2 categories post-ASCT.Secondary Endpoints: Progression-free survival (PFS) and Overall Survival (OS) stratified by RAC score and rFF%, and the concordance between imaging results and bone marrow MRD.

Tipo de estudio

De observación

Inscripción (Estimado)

92

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Ubicaciones de estudio

  • Italia
      • Bari, Italia
        • IRCCS Istituto Tumori "G. Paolo II - U.O.C. Ematologia e Terapia Cellulare
      • Bologna, Italia
        • A.O.U. di Bologna - Policlinico S. Orsola Malpighi
      • Brescia, Italia
      • Castelfranco Veneto, Italia
      • Como, Italia
        • Ospedale Classificato Valduce
        • Contacto:
      • Milan, Italia
      • Milan, Italia
      • Novara, Italia
      • Pavia, Italia
      • Rome, Italia
        • ASL Roma 1

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Método de muestreo

Muestra no probabilística

Población de estudio

The study population consists of adult patients with Newly Diagnosed Multiple Myeloma (NDMM) who are eligible for transplantation and have been treated according to the most recent standards of care.

Descripción

Inclusion criteria:

  • Newly diagnosed MM participants eligible for ASCT, treated with anti-CD38-based quadruplet induction therapy and ASCT, with post-ASCT/premaintenance DW-MRI available (in tandem ASCT, DW-MRI after second ASCT will be considered).
  • Age ≥18 years.
  • Participant must sign an informed consent form (ICF) that he or she understands the purpose of, and procedures required for the trial and is willing to participate in the trial.

Exclusion Criteria:

- Absence of post-ASCT/pre-maintenance DW-MRI.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

Cohortes e Intervenciones

Grupo / Cohorte
Intervención / Tratamiento
Observational: MM Patient Cohort
This cohort includes transplant-eligible patients with newly diagnosed multiple myeloma (NDMM) who have completed first-line anti-CD38-based quadruplet induction therapy and autologous stem cell transplantation (ASCT).
Prueba de diagnóstico: DW-MRI (MY-RADS/RAC score)
Collection and analysis of Diffusion-Weighted Whole-body MRI data performed post-ASCT. The radiological response is evaluated using the Response Assessment Category (RAC) score (1 to 5) according to MY-RADS criteria.
Prueba de diagnóstico: Fat Fraction (rFF%)
Quantitative assessment of the relative Fat Fraction (percentage of fat within skeletal regions) measured on residual focal lesions after transplantation to identify functional high-risk (FHR) patients.
Otro: Clinical Data Collection
Retrospective and prospective collection of clinical outcomes, including Progression-Free Survival (PFS), Overall Survival (OS), and Minimal Residual Disease (MRD) status from medical records.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Radiological Response Categories (RAC1 and RAC≥2)
Periodo de tiempo: Post-ASCT / Pre-maintenance (approx. 3-4 months after ASCT))
Prevalence of radiological response categories evaluated by post-ASCT DW-MRI according to MY-RADS criteria.
Post-ASCT / Pre-maintenance (approx. 3-4 months after ASCT))

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Progression-Free Survival (PFS) according to RAC score
Periodo de tiempo: Minimum 2 years, up to 4 years
Defined as the time from the date of ASCT to the first documented disease progression (per IMWG criteria) or death from any cause.
Minimum 2 years, up to 4 years
Overall Survival (OS) according to RAC score
Periodo de tiempo: Minimum 2 years, up to 4 years
Defined as the time from the date of ASCT to death from any cause.
Minimum 2 years, up to 4 years
PFS and OS according to relative Fat Fraction (rFF%)
Periodo de tiempo: Minimum 2 years, up to 4 years
Evaluation of survival outcomes based on the 17.2% rFF% threshold identified on residual focal skeletal lesions.
Minimum 2 years, up to 4 years
RAC Score and IMWG Response Concordance
Periodo de tiempo: 4 months post-ASCT
To assess RAC score in relation to response according to IMWG criteria
4 months post-ASCT
Concordance between RAC score and bone marrow MRD
Periodo de tiempo: Pre-maintenance (approx. 100 days post-ASCT)
Assessment of the agreement between radiological response (RAC score) and Minimal Residual Disease (MRD) status (when available).
Pre-maintenance (approx. 100 days post-ASCT)
Early Relapse Rate and rFF%
Periodo de tiempo: 18 months post-ASCT)
Proportion of participants with early relapse (within 18 months post-ASCT) associated with rFF% < 17.2%.
18 months post-ASCT)
PFS by Combined MRD and RAC Score
Periodo de tiempo: Through study completion, an average of 2 years
Evaluation of post-ASCT progression-free survival (PFS) stratified by the combined assessment of bone marrow minimal residual disease (MRD) status and radiological Response Assessment Category (RAC) score.
Through study completion, an average of 2 years
OS by Combined MRD and RAC Score
Periodo de tiempo: Through study completion, an average of 2 years.
Evaluation of post-ASCT overall survival (OS) stratified by the combined assessment of bone marrow minimal residual disease (MRD) status and radiological Response Assessment Category (RAC) score.
Through study completion, an average of 2 years.

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Fondazione EMN Italy Onlus

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de octubre de 2026

Finalización primaria (Estimado)

1 de agosto de 2028

Finalización del estudio (Estimado)

1 de agosto de 2030

Fechas de registro del estudio

Enviado por primera vez

21 de julio de 2026

Primero enviado que cumplió con los criterios de control de calidad

30 de julio de 2026

Publicado por primera vez (Actual)

4 de agosto de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

9 de septiembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

7 de septiembre de 2026

Última verificación

1 de septiembre de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • RAC-FAT

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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