이 페이지는 자동 번역되었으며 번역의 정확성을 보장하지 않습니다. 참조하십시오 영문판 원본 텍스트의 경우.

고위험 다발성 골수종 내화성 또는 첫 번째 재발 환자에 대한 일반적인 치료 (Daratumumab, Pomalidomide, Dexamethasone 또는 Daratumumab, Carfilzomib, Dexamethasone)와 비교하여 Daratumumab 및 Teclistamab의 조사 약물 조합을 테스트합니다.

2026년 11월 3일 업데이트: National Cancer Institute (NCI)

내화성이거나 Daratumumab, Teclistamab (DT) 대 Daratumumab, Pomalidomide, Dexamethasone (DPD) 또는 Daratumumab, Carfilzomib, Dexamethasone (DKD)에 대한 고위험 다발성 골수종에 대한 무작위 2 상 시험.

This phase II trial compares the effect of the combination of daratumumab-hyaluronidase (daratumumab) and teclistamab to the usual treatment of daratumumab, pomalidomide, dexamethasone or daratumumab, carfilzomib and dexamethasone in treating patients with multiple myeloma that has not responded to previous treatment (refractory) or that has come back after a period of improvement (relapsed). Daratumumab is in a class of medications called monoclonal antibodies. It binds to a protein called CD38, which is found on some types of immune cells and cancer cells, including myeloma cells. Daratumumab may block CD38 and help the immune system kill cancer cells. Teclistamab is a bispecific antibody that can bind to two different antigens at the same time. Teclistamab binds to B-cell maturation antigen, a protein found on some B-cells and myeloma cells, and CD3 on T-cells (a type of white blood cell) and may interfere with the ability of cancer cells to grow and spread. Pomalidomide is in a class of medications called immunomodulatory agents. It works by helping the immune system kill cancer cells and by helping the bone marrow to produce normal blood cells. Dexamethasone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Carfilzomib, a type of proteasome inhibitor, blocks the action of enzymes called proteasomes, which may help keep cancer cells from growing and may kill them. Giving daratumumab and teclistamab may be more effective than the usual treatment of daratumumab, pomalidomide, dexamethasone or daratumumab, carfilzomib and dexamethasone in reducing myeloma cells to undetectable levels in patients with relapsed or refractory multiple myeloma.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

PRIMARY OBJECTIVE:

I. To determine whether patients with high-risk multiple myeloma (MM) that is refractory or in first relapse randomized to daratumumab and recombinant human hyaluronidase (daratumumab-hyaluronidase) in combination with teclistamab (DT) have superior efficacy measured by minimal residual disease (MRD)-negative status after 6 cycles of therapy compared to investigator's choice of daratumumab-hyaluronidase, pomalidomide and dexamethasone (DPd) or daratumumab-hyaluronidase, carfilzomib and dexamethasone (DKd).

SECONDARY CLINICAL OBJECTIVES:

I. To compare toxicity rates up to 6 cycles and overall on treatment between arms.

II. To compare progression-free and overall survival between arms. III. To evaluate best response per International Myeloma Working Group (IMWG) criteria after 6 cycles and overall on treatment.

IV. To evaluate safety and tolerability.

EXPLORATORY CLINICAL OBJECTIVES:

I. To evaluate treatment exposure and adherence. II. To evaluate time to progression and event free survival. III. To evaluate association of MRD-negative status after 6 cycles with best response per IMWG criteria and time to event outcomes.

EXPLORATORY THROMBOEMBOLISM RISK OBJECTIVES:

I. To estimate cumulative incidence of venous and arterial thromboembolic events.

II. To calculate IMPEDE and SAVED risk scores at baseline and at time of venous thromboembolic event.

III. To validate IMPEDE and SAVED risk stratification models. IV. To describe thromboprophylaxis strategies on treatment and assess the association with venous and arterial thromboembolic events.

V. To estimate incidence of clinically significant (major) bleeding events and assess association with thromboprophylaxis strategy.

VI. To assess the association of venous and arterial thromboembolic events and overall survival.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients are assigned to 1 of 2 treatments per investigator's choice.

Treatment I (DPD): Patients receive daratumumab-hyaluronidase subcutaneously (SC) over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6, then on day 1 of subsequent cycles. Patients also receive pomalidomide orally (PO) on days 1-21 of each cycle, dexamethasone PO or intravenously (IV) on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Treatment II (DKD): Patients are assigned to 1 of 2 options for carfilzomib.

OPTION 1: Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6, then on day 1 of subsequent cycles, carfilzomib IV on days 1, 2, 8, 9, 15, and 16 of each cycle, and dexamethasone PO or IV on days 1, 2, 8, 9, 15, and 16 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

OPTION 2: Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6 and on day 1 of subsequent cycles, carfilzomib IV on days 1, 8, and 15 of each cycle, and dexamethasone PO or IV on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

ARM B:

Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6 and on day 1 of subsequent cycles. Patients also receive teclistamab SC on day 2, 4, 8, 15 and 22 of cycle 1, on days 1, 8, 15, and 22 of cycle 2, on days 1 and 15 of cycles 3-6 and then on day 1 of subsequent cycles. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Additionally, patients undergo urine and blood sample collection, bone marrow biopsy, and fludeoxyglucose F-18 (FDG) positron emission tomography (PET)/computed tomography (CT) throughout the study.

After completion of study treatment, patients are followed up every 3 months for up to year 2, every 6 months up to year 5 then yearly for up to 10 years from randomization.

연구 유형

중재적

등록 (추정된)

80

단계

  • 2 단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

  • 미국
    • Idaho
      • Coeur d'Alene, Idaho, 미국, 83814
        • 모병
        • Kootenai Health - Coeur d'Alene
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
      • Post Falls, Idaho, 미국, 83854
        • 모병
        • Kootenai Clinic Cancer Services - Post Falls
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
      • Sandpoint, Idaho, 미국, 83864
        • 모병
        • Kootenai Clinic Cancer Services - Sandpoint
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
    • Illinois
      • Bloomington, Illinois, 미국, 61704
        • 모병
        • Illinois CancerCare-Bloomington
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Canton, Illinois, 미국, 61520
        • 모병
        • Illinois CancerCare-Canton
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Carthage, Illinois, 미국, 62321
        • 모병
        • Illinois CancerCare-Carthage
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Decatur, Illinois, 미국, 62526
        • 모병
        • Cancer Care Specialists of Illinois - Decatur
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
      • Decatur, Illinois, 미국, 62526
        • 모병
        • Decatur Memorial Hospital
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
      • Eureka, Illinois, 미국, 61530
        • 모병
        • Illinois CancerCare-Eureka
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Galesburg, Illinois, 미국, 61401
        • 모병
        • Illinois CancerCare-Galesburg
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Kewanee, Illinois, 미국, 61443
        • 모병
        • Illinois CancerCare-Kewanee Clinic
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Macomb, Illinois, 미국, 61455
        • 모병
        • Illinois CancerCare-Macomb
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • O'Fallon, Illinois, 미국, 62269
        • 모병
        • Cancer Care Center of O'Fallon
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
      • O'Fallon, Illinois, 미국, 62269
        • 모병
        • HSHS Saint Elizabeth's Hospital
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
      • Ottawa, Illinois, 미국, 61350
        • 모병
        • Illinois CancerCare-Ottawa Clinic
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Pekin, Illinois, 미국, 61554
        • 모병
        • Illinois CancerCare-Pekin
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Peoria, Illinois, 미국, 61615
        • 모병
        • Illinois CancerCare-Peoria
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Peru, Illinois, 미국, 61354
        • 모병
        • Illinois CancerCare-Peru
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Princeton, Illinois, 미국, 61356
        • 모병
        • Illinois CancerCare-Princeton
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
      • Springfield, Illinois, 미국, 62702
        • 모병
        • Southern Illinois University School of Medicine
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
          • Site Public Contact
          • 전화번호: 217-545-7929
      • Springfield, Illinois, 미국, 62702
        • 모병
        • Springfield Clinic
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
          • Site Public Contact
          • 전화번호: 800-444-7541
      • Springfield, Illinois, 미국, 62781
        • 모병
        • Springfield Memorial Hospital
        • 수석 연구원:
          • Bryan A. Faller
        • 연락하다:
      • Washington, Illinois, 미국, 61571
        • 모병
        • Illinois CancerCare - Washington
        • 연락하다:
        • 수석 연구원:
          • Bryan A. Faller
    • Iowa
      • Cedar Rapids, Iowa, 미국, 52403
        • 모병
        • Mercy Hospital
        • 연락하다:
          • Site Public Contact
          • 전화번호: 319-365-4673
        • 수석 연구원:
          • Deborah W. Wilbur
      • Cedar Rapids, Iowa, 미국, 52403
        • 모병
        • Oncology Associates at Mercy Medical Center
        • 수석 연구원:
          • Deborah W. Wilbur
        • 연락하다:
          • Site Public Contact
          • 전화번호: 319-363-2690
    • Louisiana
      • Baton Rouge, Louisiana, 미국, 70805
        • 모병
        • LSU Health Baton Rouge-North Clinic
        • 연락하다:
        • 수석 연구원:
          • Hana F. Safah
      • Baton Rouge, Louisiana, 미국, 70808
        • 모병
        • Our Lady of the Lake Physician Group
        • 연락하다:
        • 수석 연구원:
          • Hana F. Safah
    • Montana
      • Anaconda, Montana, 미국, 59711
        • 모병
        • Community Hospital of Anaconda
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
      • Billings, Montana, 미국, 59101
        • 모병
        • Billings Clinic Cancer Center
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
      • Great Falls, Montana, 미국, 59405
        • 모병
        • Benefis Sletten Cancer Institute
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
      • Kalispell, Montana, 미국, 59901
        • 모병
        • Logan Health Medical Center
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:
      • Missoula, Montana, 미국, 59804
        • 모병
        • Community Medical Center
        • 수석 연구원:
          • John M. Schallenkamp
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • Patient must be ≥ 18 years of age

  • Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-2 (PS 3 allowed if secondary to pain)

  • Patient must have an identifiable dominant sequence (clonotype) established based on Adaptive Biotechnologies clonoSEQ® assay

  • Patient must have received only one prior line of therapy

    • One prior line of systemic therapy is defined as 1 or more cycles of single agent or combination therapy, as well as a series of treatment regimens administered in a sequential manner (e.g., lenalidomide, bortezomib and dexamethasone induction therapy for 4 cycles followed by autologous stem cell transplantation and then lenalidomide +/- proteasome inhibitor or anti-CD38 monoclonal antibody [mAb] maintenance therapy would be considered 1 line of prior therapy)
    • NOTE: Autologous stem cell transplant is allowed provided the stem cell infusion was > 90 days prior to randomization. Allogeneic stem cell transplantation (SCT) patients are ineligible

  • Patient must be diagnosed with relapsed or refractory (RR) multiple myeloma, as defined by disease progression, either an increase in serum or urine M protein of any level, or other evidence of progression biochemical or clinical as specified in the IMWG progression criteria (including disease which becomes non-responsive or progressive on therapy or within 60 days of the last treatment in patients who had achieved a partial response or better on prior therapy)

  • Patient must be daratumumab-hyaluronidase (or isatuximab) naïve or daratumumab-hyaluronidase (or isatuximab) sensitive and > 180 days from their last dose of daratumumab-hyaluronidase (or isatuximab) at the time of randomization

  • Patient must have high-risk multiple myeloma (HR-MM) as defined by one of the following either at diagnosis or at refractory status or at first relapse:

    • Evidence of deletion 17p by fluorescence in situ hybridization (FISH) testing on bone marrow
    • Evidence of t(4;14) by FISH testing on bone marrow
    • Evidence of t(14;16) by FISH testing on bone marrow
    • Evidence of t(14;20) by FISH testing on bone marrow
    • Evidence of chromosome 1 abnormalities either gain/amp 1q or deletion 1p by FISH testing on bone marrow OR
    • Evidence of non-hyperdiploid karyotype OR
    • Revised International Staging System (R-ISS) stage III beta2 microglobulin ≥ 5.5 mg/L and serum lactate dehydrogenase (LDH) > institutional upper limit of normal (ULN) OR
    • Patient in first relapse and ≤ 24 months from the start of induction for both allogeneic stem cell transplantation (ASCT) eligible or ASCT ineligible patients (regardless of FISH, cytogenetic or RISS stage)

  • Patient must have measurable disease as defined by having one or more of the following, obtained within 28 days prior to randomization:

    • Serum M protein ≥ 0.5 g/dL (≥ 5 g/L)
    • Urine M protein ≥ 200 mg/24 hours
    • Serum free light chain (FLC) assay: Involved free light chain level ≥ 10 mg/dL (≥ 100 mg/L) provided serum FLC ratio is abnormal (< 0.26 or > 1.65)
    • Exception: patients without measurable disease in the serum or urine, but with bone or soft tissue plasmacytoma(s) ≥ 2 cm or who have bone marrow plasma cells ≥ 30% are eligible on study

  • Patient must have serum protein electrophoresis (SPEP), urine protein electrophoresis (UPEP), and serum FLC assays along with bone marrow biopsy or aspirate performed within 28 days prior to randomization

    • NOTE: UPEP (on a 24 hour collection) is required, no substitute method is acceptable. Urine must be followed monthly if the baseline urine M-spike is ≥ 200 mg/24 hr. If both serum and urine M-components are measurable, both must be followed in order to confirm response
    • NOTE: The serum free light chain test is required to be done at each cycle

  • Patient must not have any known allergies, hypersensitivity, or intolerance to corticosteroids, monoclonal antibodies or human proteins, or their excipients (refer to respective package inserts or investigator's brochure), or known sensitivity to mammalian-derived products

  • Patients who have received prior systemic therapy for myeloma, including experimental therapy and steroids must have recovered from clinically significant adverse events prior to randomization

  • Patient may not be on steroids (prednisone > 40mg/day or equivalent) at the time of randomization

  • Patient may have received prior palliative and/or localized radiation, provided that it is completed by the time of randomization

  • Patient must have the ability to understand and the willingness to sign a written informed consent document. Patients with impaired decision-making capacity (IDMC) who have a legally authorized representative (LAR) or caregiver and/or family member available will also be considered eligible

  • Absolute neutrophil count (ANC) ≥ 1,000/uL (=< 28 days prior to protocol randomization)

  • Untransfused platelet count ≥ 50,000/uL (for patients with ≥ 50% plasma cells in the marrow) and untransfused platelet count > 75,000/uL (for patients with < 50% plasma cells in the marrow) (=< 28 days prior to protocol randomization)

  • Untransfused hemoglobin ≥ 8.0 g/dL (=< 28 days prior to protocol randomization)

  • Total bilirubin ≤ 1.5 x institutional ULN (upper limit of normal) (=< 28 days prior to protocol randomization)

  • Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT)(serum glutamic pyruvic transaminase [SGPT]) ≤ 3.0 × institutional ULN (=< 28 days prior to protocol randomization)

  • Calculated creatinine clearance > 30 mL/min (=< 28 days prior to protocol randomization)

    • NOTE: Cockcroft-Gault equation should be used to calculate creatinine clearance

  • Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used

    • All patients of childbearing potential must have a blood test or urine study within 14 prior to randomization to rule out pregnancy. Patients randomized to Arm A and to receive the daratumumab-hyaluronidase, pomalidomide, dexamethasone (DPd) regimen must also have a second pregnancy test within 24 hours prior to the first dose of pomalidomide and agree to ongoing pregnancy testing while on protocol treatment
    • A patient of childbearing potential is defined as anyone, regardless of whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)

  • Patient must not expect to conceive or father children by using accepted and effective method(s) of contraception or by abstaining from sexual intercourse for the duration of their participation in the study and for 5 months after the last dose of protocol treatment for patients on Arm B and for 3 months after the last dose of protocol treatment for patients on Arm A. In addition, patients randomized to Arm A and receive the daratumumab-hyaluronidase, pomalidomide, dexamethasone (DPd) regimen must also agree to register to the mandatory Risk Evaluation and Mitigation Strategies (REMS®) program and be willing and able to comply with the requirements of the REMS program. All patients must not breastfeed while on protocol treatment and for patients on Arm B they must not breastfeed for an additional 5 months after the last dose of protocol treatment

  • Patient may have primary plasma cell leukemia (pPCL), secondary plasma cell leukemia (sPCL) or extramedullary myeloma (EMM)

  • Patient must not have evidence of active or untreated central nervous system (CNS) positive MM. Patients with prior CNS involvement are eligible provided they had demonstrated evidence of CNS disease resolution by imaging and/or 2 consecutively negative cerebrospinal fluid (CSF) samples for the presence of plasma cells

  • Patient must not have active autoimmune disease

  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of randomization are eligible for this trial

  • For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

  • Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial

  • Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better

  • Patients with a history of chronic obstructive pulmonary disease (COPD) must have forced expiratory volume in 1 second (FEV1) testing done within 28 days prior to randomization and the forced expiratory volume in 1 second (FEV1) must be >= 50% of predicted normal

  • Patient must not have moderate or severe persistent asthma within 2 years prior to randomization

    • NOTE: Patients who currently have controlled intermittent asthma or controlled mild persistent asthma are eligible

  • Investigator must declare the intended chemotherapy regimen at the time of randomization should their patient be randomized to Arm A from the two options

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
활성 비교기: Arm A Treatment I (DPd)

Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6, then on day 1 of subsequent cycles. Patients also receive pomalidomide PO on days 1-21 of each cycle, dexamethasone PO or IV on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo urine and blood sample collection, bone marrow biopsy, and FDG PET/CT throughout the study.
절차: Bone Marrow Biopsy

Undergo bone marrow biopsy

다른 이름들:
  • 골수 생검
  • 생검, 골수
의약품: Dexamethasone

Given PO or IV

다른 이름들:
  • 데카드론
  • 헤마디
  • Aacidexam
  • 아덱손
  • 아크니히톨 덱사
  • 알바덱스
  • 알린
  • 알린 디포
  • 알린 오프탈미코
  • 증폭
  • 안물모노
  • 오리쿨라룸
  • 옥실로손
  • 베이카드론
  • 바이큐텐
  • 베이큐튼 N
  • 코르티덱사손
  • 코르티섬만
  • 데카코트
  • 데카드롤
  • 데카드론 DP
  • 데칼릭스
  • 데카메스
  • 데카손 R.p.
  • 데탄실
  • 델타플루오렌
  • 데로닐
  • 데사메타손
  • 데사메톤
  • 덱사-마말렛
  • 덱사-코뿔소
  • 덱사-스케로손
  • 덱사 사인
  • 덱사피질
  • 덱사코르틴
  • 덱사파마
  • 덱사플루오렌
  • 덱사로컬
  • 덱사메코르틴
  • 덱사메스
  • 덱사메타손 인텐솔
  • 덱사메타소눔
  • 덱사모노존
  • 덱사포스
  • 덱시노랄
  • 덱손
  • 다이노르몬
  • 드제보
  • 플루오로델타
  • 포르테코틴
  • 감마코르텐
  • 헥사데카드롤
  • 헥사드롤
  • 로컬리슨-F
  • 로베린
  • 메틸플루오르프레드니솔론
  • 밀리코트
  • 마이메타손
  • 오르가드론
  • 스퍼사덱스
  • 테이퍼덱스
  • 비스메타존
  • 조덱스
  • 레나덱스
절차: Biospecimen Collection

Undergo urine and blood sample collection

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
  • 샘플 수집
의약품: Daratumumab and Recombinant Human Hyaluronidase

Given SC

다른 이름들:
  • RHuPH20과 공동 제형화된 DARA
  • 다라/rHuPH20
  • 다라투무맙 + rHuPH20
  • RHuPH20 포함 다라투무맙
  • 다라투무맙-rHuPH20
  • Daratumumab/Hyaluronidase-fihj
  • 다라투무맙/rHuPH20 복합제제
  • 다잘렉스 파스프로
  • 다잘렉스/rHuPH20
  • 휴맥스-CD38-rHuPH20
  • Daratumumab과 혼합된 재조합 인간 Hyaluronidase
  • 다라투무맙 및 히알루로니다제-fihj
  • 다라투무맙과 히알루로니다제
  • 다라투무맙 및 보히알루로니다제
  • 다라투무맙 및 보히알루로니다제 알파
  • 다르즈쿠로
절차: Computed Tomography

Undergo FDG PET/CT

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
  • 진단 CAT 스캔
  • 진단 CAT 스캔 서비스 유형
의약품: Pomalidomide

Given PO

다른 이름들:
  • 포말리스트
  • 임노비드
  • 4-아미노탈리도마이드
  • 액티미드
  • CC-4047
  • CC4047
  • CC 4047
절차: FDG-Positron Emission Tomography

Undergo FDG PET/CT

다른 이름들:
  • FDG
  • FDG-펫
  • FDG-PET 이미징
활성 비교기: Arm A Treatment II Option 1 (DKd)

Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6, then on day 1 of subsequent cycles, carfilzomib IV on days 1, 2, 8, 9, 15, and 16 of each cycle, and dexamethasone PO or IV on days 1, 2, 8, 9, 15, and 16 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo urine and blood sample collection, bone marrow biopsy, and FDG PET/CT throughout the study.
절차: Bone Marrow Biopsy

Undergo bone marrow biopsy

다른 이름들:
  • 골수 생검
  • 생검, 골수
의약품: Carfilzomib

Given IV

다른 이름들:
  • 키프롤리스
  • PR-171
  • CFZ
  • PR171
  • 카르필나트
  • PR 171
의약품: Dexamethasone

Given PO or IV

다른 이름들:
  • 데카드론
  • 헤마디
  • Aacidexam
  • 아덱손
  • 아크니히톨 덱사
  • 알바덱스
  • 알린
  • 알린 디포
  • 알린 오프탈미코
  • 증폭
  • 안물모노
  • 오리쿨라룸
  • 옥실로손
  • 베이카드론
  • 바이큐텐
  • 베이큐튼 N
  • 코르티덱사손
  • 코르티섬만
  • 데카코트
  • 데카드롤
  • 데카드론 DP
  • 데칼릭스
  • 데카메스
  • 데카손 R.p.
  • 데탄실
  • 델타플루오렌
  • 데로닐
  • 데사메타손
  • 데사메톤
  • 덱사-마말렛
  • 덱사-코뿔소
  • 덱사-스케로손
  • 덱사 사인
  • 덱사피질
  • 덱사코르틴
  • 덱사파마
  • 덱사플루오렌
  • 덱사로컬
  • 덱사메코르틴
  • 덱사메스
  • 덱사메타손 인텐솔
  • 덱사메타소눔
  • 덱사모노존
  • 덱사포스
  • 덱시노랄
  • 덱손
  • 다이노르몬
  • 드제보
  • 플루오로델타
  • 포르테코틴
  • 감마코르텐
  • 헥사데카드롤
  • 헥사드롤
  • 로컬리슨-F
  • 로베린
  • 메틸플루오르프레드니솔론
  • 밀리코트
  • 마이메타손
  • 오르가드론
  • 스퍼사덱스
  • 테이퍼덱스
  • 비스메타존
  • 조덱스
  • 레나덱스
절차: Biospecimen Collection

Undergo urine and blood sample collection

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
  • 샘플 수집
의약품: Daratumumab and Recombinant Human Hyaluronidase

Given SC

다른 이름들:
  • RHuPH20과 공동 제형화된 DARA
  • 다라/rHuPH20
  • 다라투무맙 + rHuPH20
  • RHuPH20 포함 다라투무맙
  • 다라투무맙-rHuPH20
  • Daratumumab/Hyaluronidase-fihj
  • 다라투무맙/rHuPH20 복합제제
  • 다잘렉스 파스프로
  • 다잘렉스/rHuPH20
  • 휴맥스-CD38-rHuPH20
  • Daratumumab과 혼합된 재조합 인간 Hyaluronidase
  • 다라투무맙 및 히알루로니다제-fihj
  • 다라투무맙과 히알루로니다제
  • 다라투무맙 및 보히알루로니다제
  • 다라투무맙 및 보히알루로니다제 알파
  • 다르즈쿠로
절차: Computed Tomography

Undergo FDG PET/CT

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
  • 진단 CAT 스캔
  • 진단 CAT 스캔 서비스 유형
절차: FDG-Positron Emission Tomography

Undergo FDG PET/CT

다른 이름들:
  • FDG
  • FDG-펫
  • FDG-PET 이미징
활성 비교기: Arm A Treatment II Option 2 (DKd)

Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6 and on day 1 of subsequent cycles, carfilzomib IV on days 1, 8, and 15 of each cycle, and dexamethasone PO or IV on days 1, 8, 15, and 22 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo urine and blood sample collection, bone marrow biopsy, and FDG PET/CT throughout the study.
절차: Bone Marrow Biopsy

Undergo bone marrow biopsy

다른 이름들:
  • 골수 생검
  • 생검, 골수
의약품: Carfilzomib

Given IV

다른 이름들:
  • 키프롤리스
  • PR-171
  • CFZ
  • PR171
  • 카르필나트
  • PR 171
의약품: Dexamethasone

Given PO or IV

다른 이름들:
  • 데카드론
  • 헤마디
  • Aacidexam
  • 아덱손
  • 아크니히톨 덱사
  • 알바덱스
  • 알린
  • 알린 디포
  • 알린 오프탈미코
  • 증폭
  • 안물모노
  • 오리쿨라룸
  • 옥실로손
  • 베이카드론
  • 바이큐텐
  • 베이큐튼 N
  • 코르티덱사손
  • 코르티섬만
  • 데카코트
  • 데카드롤
  • 데카드론 DP
  • 데칼릭스
  • 데카메스
  • 데카손 R.p.
  • 데탄실
  • 델타플루오렌
  • 데로닐
  • 데사메타손
  • 데사메톤
  • 덱사-마말렛
  • 덱사-코뿔소
  • 덱사-스케로손
  • 덱사 사인
  • 덱사피질
  • 덱사코르틴
  • 덱사파마
  • 덱사플루오렌
  • 덱사로컬
  • 덱사메코르틴
  • 덱사메스
  • 덱사메타손 인텐솔
  • 덱사메타소눔
  • 덱사모노존
  • 덱사포스
  • 덱시노랄
  • 덱손
  • 다이노르몬
  • 드제보
  • 플루오로델타
  • 포르테코틴
  • 감마코르텐
  • 헥사데카드롤
  • 헥사드롤
  • 로컬리슨-F
  • 로베린
  • 메틸플루오르프레드니솔론
  • 밀리코트
  • 마이메타손
  • 오르가드론
  • 스퍼사덱스
  • 테이퍼덱스
  • 비스메타존
  • 조덱스
  • 레나덱스
절차: Biospecimen Collection

Undergo urine and blood sample collection

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
  • 샘플 수집
의약품: Daratumumab and Recombinant Human Hyaluronidase

Given SC

다른 이름들:
  • RHuPH20과 공동 제형화된 DARA
  • 다라/rHuPH20
  • 다라투무맙 + rHuPH20
  • RHuPH20 포함 다라투무맙
  • 다라투무맙-rHuPH20
  • Daratumumab/Hyaluronidase-fihj
  • 다라투무맙/rHuPH20 복합제제
  • 다잘렉스 파스프로
  • 다잘렉스/rHuPH20
  • 휴맥스-CD38-rHuPH20
  • Daratumumab과 혼합된 재조합 인간 Hyaluronidase
  • 다라투무맙 및 히알루로니다제-fihj
  • 다라투무맙과 히알루로니다제
  • 다라투무맙 및 보히알루로니다제
  • 다라투무맙 및 보히알루로니다제 알파
  • 다르즈쿠로
절차: Computed Tomography

Undergo FDG PET/CT

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
  • 진단 CAT 스캔
  • 진단 CAT 스캔 서비스 유형
절차: FDG-Positron Emission Tomography

Undergo FDG PET/CT

다른 이름들:
  • FDG
  • FDG-펫
  • FDG-PET 이미징
실험적: Arm B (daratumumab, teclistamab)

Patients receive daratumumab-hyaluronidase SC over 3-5 minutes on days 1, 8, 15, and 22 of cycles 1 and 2, on days 1 and 15 of cycles 3-6 and on day 1 of subsequent cycles. Patients also receive teclistamab SC on day 2, 4, 8, 15 and 22 of cycle 1, on days 1, 8, 15, and 22 of cycle 2, on days 1 and 15 of cycles 3-6 and then on day 1 of subsequent cycles. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo urine and blood sample collection, bone marrow biopsy, and FDG PET/CT throughout the study.
절차: Bone Marrow Biopsy

Undergo bone marrow biopsy

다른 이름들:
  • 골수 생검
  • 생검, 골수
의약품: Teclistamab

Given SC

다른 이름들:
  • JNJ-64007957
  • 텍바일리
  • JNJ 64007957
  • JNJ64007957
  • 테클리스타맙-cqyv
절차: Biospecimen Collection

Undergo urine and blood sample collection

다른 이름들:
  • 생물학적 샘플 수집
  • 생체 표본 수집
  • 표본 수집
  • 샘플 수집
의약품: Daratumumab and Recombinant Human Hyaluronidase

Given SC

다른 이름들:
  • RHuPH20과 공동 제형화된 DARA
  • 다라/rHuPH20
  • 다라투무맙 + rHuPH20
  • RHuPH20 포함 다라투무맙
  • 다라투무맙-rHuPH20
  • Daratumumab/Hyaluronidase-fihj
  • 다라투무맙/rHuPH20 복합제제
  • 다잘렉스 파스프로
  • 다잘렉스/rHuPH20
  • 휴맥스-CD38-rHuPH20
  • Daratumumab과 혼합된 재조합 인간 Hyaluronidase
  • 다라투무맙 및 히알루로니다제-fihj
  • 다라투무맙과 히알루로니다제
  • 다라투무맙 및 보히알루로니다제
  • 다라투무맙 및 보히알루로니다제 알파
  • 다르즈쿠로
절차: Computed Tomography

Undergo FDG PET/CT

다른 이름들:
  • CT
  • 고양이
  • 고양이 스캔
  • 컴퓨터 축 단층 촬영
  • 전산화 단층 촬영
  • CT 스캔
  • 단층 촬영
  • 컴퓨터 축 단층 촬영(시술)
  • 컴퓨터 단층촬영(CT) 스캔
  • 진단 CAT 스캔
  • 진단 CAT 스캔 서비스 유형
절차: FDG-Positron Emission Tomography

Undergo FDG PET/CT

다른 이름들:
  • FDG
  • FDG-펫
  • FDG-PET 이미징

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Minimal residual disease (MRD) negativity
기간: After 6 cycles of treatment (cycle length = 28 days), assessed at 6 months

Will be determined by the Adaptive Biotechnologies clonoSEQ assay result. Analysis will be performed using Cochran-Mantel-Haenszel (CMH) test, stratified on prior anti-CD38 antibody therapy and investigator's choice of therapy if assigned to Arm A. MRD-negative status requires both MRD negativity and achievement of complete response. Will be summarized using descriptive statistics by treatment arm with two-sided exact binomial 80% confidence intervals (CI), Clopper-Pearson. The corresponding CMH odds ratio (OR) estimate with an 80% CI, and p-value will be reported. Logistic regression will be used to assess the treatment effect within subgroups including but not limited to age 70 status, prior anti-CD38 antibody therapy and high-risk by fluorescence in situ hybridization status.
After 6 cycles of treatment (cycle length = 28 days), assessed at 6 months

2차 결과 측정

결과 측정
측정값 설명
기간
Incidence of adverse events (AEs)
기간: Up to 6 cycles (cycle length = 28 days) and overall assessed up to 10 years

Will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) and classified by Medical Dictionary for Regulatory Activities (MedDRA) system organ class. Maximum grade toxicity by AE type will be tabulated. Summaries (count and percentages) will be reported by AE type by arm.
Up to 6 cycles (cycle length = 28 days) and overall assessed up to 10 years
Incidence of grade 3 or higher hematologic and/or non-hematologic AEs
기간: Up to 6 cycles (cycle length = 28 days) and overall assessed up to 10 years

Will be graded according to the NCI CTCAE and classified by MedDRA system organ class. Maximum grade toxicity by AE type will be tabulated. Summaries (count and percentages) will be reported by AE type by arm. Rates of maximum grade 3 or higher (including grade 5) non-hematologic, hematologic and overall toxicity will be calculated along with 90% CIs. AEs will be further analyzed by arm in subsets of serious AEs per protocol, lethal AEs and treatment-emergent AEs status.
Up to 6 cycles (cycle length = 28 days) and overall assessed up to 10 years
Progression-free survival (PFS)
기간: From randomization until the earlier of progression or death due to any cause, assessed up to 10 years

PFS will be estimated in the treated population using the Kaplan-Meier method and compared between arms using the stratified log-rank test. Stratified cox proportional hazards (PH) regression will be used to produce the treatment hazard ratio (HR) along with the 90% CI, provided PH assumption is valid. Sensitivity analyses excluding untreated patients will be conducted.
From randomization until the earlier of progression or death due to any cause, assessed up to 10 years
Overall survival (OS)
기간: From randomization to death due to any cause, assessed up to 10 years

OS will be estimated in the treated population using the Kaplan-Meier method and compared between arms using the stratified log-rank test. Stratified cox PH regression will be used to produce the treatment HR along with the 90% CI, provided PH assumption is valid. Sensitivity analyses excluding untreated patients will be conducted.
From randomization to death due to any cause, assessed up to 10 years
Response rates
기간: After 6 cycles of treatment (cycle length = 28 days) and overall, assessed up to 10 years

Will be reported by treatment arm. Rates of stringent complete response (CR) or better, very good partial response (VGPR) or better and partial response (PR) or better will be computed along with 90% CIs in all treated patients. Stratified CMH test will be used to test the difference in VGPR or better rates between arms. Sensitivity analyses excluding untreated patients will be conducted.
After 6 cycles of treatment (cycle length = 28 days) and overall, assessed up to 10 years

기타 결과 측정

결과 측정
측정값 설명
기간
이벤트없는 생존
기간: 무작위 배정에서 비 프로토콜 요법, 진행 또는 사망 원인으로 인한 사망까지 최대 10 년까지 평가되었습니다.
무작위 배정에서 비 프로토콜 요법, 진행 또는 사망 원인으로 인한 사망까지 최대 10 년까지 평가되었습니다.
진행 시간
기간: 무작위에서 문서화 된 진행의 시간으로, 마지막 질병 평가 날짜에 검열이 발생하거나 질병 진행으로 인해 살아 있거나 사망이 10 년까지 평가되었습니다.
무작위에서 문서화 된 진행의 시간으로, 마지막 질병 평가 날짜에 검열이 발생하거나 질병 진행으로 인해 살아 있거나 사망이 10 년까지 평가되었습니다.
치료 기간
기간: 무작위 배정에서 치료 종료까지 또는 마지막 치료 일에 검열되어 최대 10 년 동안 평가되었습니다.
무작위 배정에서 치료 종료까지 또는 마지막 치료 일에 검열되어 최대 10 년 동안 평가되었습니다.
Cumulative dose intensity
기간: Up to 24 months (cycle length = 28 days)

Will be defined as the sum of all doses taken across all cycles. Will be characterized using descriptive statistics.
Up to 24 months (cycle length = 28 days)
Number of dose modifications (DM)
기간: Up to 6 cycles (cycle length = 28 days) and overall, assessed up to 10 years

The number of DMs, DM status (planned versus unplanned) and reason for DM by cycle and overall treatment will be characterized using descriptive statistics. Reasons off treatment and every DM will also be tabulated.
Up to 6 cycles (cycle length = 28 days) and overall, assessed up to 10 years
Relative dose intensity
기간: Up to 6 cycles (cycle length = 28 days) and overall, assessed up to 10 years

Will be defined as the dose received as percentage of planned dose of each cycle. Will be characterized using descriptive statistics.
Up to 6 cycles (cycle length = 28 days) and overall, assessed up to 10 years
Incidence of venous thromboembolism (VTE)
기간: Up to 10 years

The cumulative incidence of VTE overall and within dichotomized risk groups will be assessed using Fine and Gray model with and without adjustment for age and competing risk of death. To assess the impact of thrombosis on survival, incidence of VTE will be treated as a time-dependent covariate in Cox PH regression models of survival follow-up. Computed HR and 90% CI will be reported. Additionally, landmark (LM) analyses with patients alive classified by occurrence of VTE after 6 cycles of treatment based on Kaplan Meier from that timepoint will be conducted.
Up to 10 years
Incidence of arterial thrombotic events (ATE)
기간: Up to 10 years

The cumulative incidence of ATE overall and within dichotomized risk groups will be assessed using Fine and Gray model with and without adjustment for age and competing risk of death. To assess the impact of thrombosis on survival, incidence of ATE will be treated as a time-dependent covariate in Cox PH regression models of survival follow-up. Computed HR and 90% CI will be reported. Additionally, LM analyses with patients alive classified by occurrence of ATE after 6 cycles of treatment based on Kaplan Meier from that timepoint will be conducted.
Up to 10 years
Incidence of clinically significant bleeding events
기간: Up to 10 years

Will be assessed according to concurrent thromboprophylaxis type and dose.
Up to 10 years
Venous thromboembolism risk
기간: At baseline and at time of VTE, assessed up to 24 months

IMPEDE and SAVED risk scores will be calculated. Patients will be classified into 3 risk groups (low, intermediate, high) and dichotomized (low vs. intermediate-high) based on IMPEDE risk score while patients will be classified into 2 risk groups (low and high) based on SAVED risk score. Descriptive statistics will be used to characterize IMPEDE and SAVED risk variables and scores. The accuracy of IMPEDE and SAVED risk models will be assessed based on positive predictive value.
At baseline and at time of VTE, assessed up to 24 months
Thromboprophylaxis
기간: Up to 24 months (cycle length = 28 days)

Descriptive statistics (count and percentages) will be used to characterize thromboprophylaxis strategies (type and dose).
Up to 24 months (cycle length = 28 days)
Impact of MRD-negative status on PFS and OS
기간: After 6 cycles (cycle length = 28 days)

Kaplan Meier plots will be produced by MRD-negative status as defined in this study. Alternative definitions of MRD-negative status and MRD levels will also be assessed. MRD assessment will also be evaluated in the context of disease response based on standard International Myeloma Working Group (IMWG) criteria. The proportion of patients with marrow MRD-negative status will be cross-tabulated with IMWG response categories (PR, VGPR, CR, stringent complete response). Sensitivity analyses excluding untreated patients will be conducted.
After 6 cycles (cycle length = 28 days)

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

National Cancer Institute (NCI)

수사관

  • 수석 연구원: Muhamed Baljevic, ECOG-ACRIN Cancer Research Group

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2027년 5월 22일

기본 완료 (추정된)

2028년 2월 28일

연구 완료 (추정된)

2028년 2월 28일

연구 등록 날짜

최초 제출

2025년 4월 26일

QC 기준을 충족하는 최초 제출

2025년 4월 26일

처음 게시됨 (실제)

2025년 4월 29일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 11월 4일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 11월 3일

마지막으로 확인됨

2026년 9월 1일

추가 정보

이 연구와 관련된 용어

추가 관련 MeSH 약관

기타 연구 ID 번호

  • NCI-2025-02986
  • U10CA180820 (미국 NIH 보조금/계약)
  • NCI-2025-02986 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
  • EAA232 (기타 식별자: CTEP)
  • EAA232 (기타 식별자: ECOG-ACRIN Cancer Research Group)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

예

IPD 계획 설명

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

예

미국 FDA 규제 기기 제품 연구

아니

미국에서 제조되어 미국에서 수출되는 제품

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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