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与通常的治疗相比，测试达拉特珠单抗和teclistamab的研究性药物组合（daratumumab，pomalidomide，pomalidomide，dexamethasone或daratumumab，carfilzomib，Dexamethasone）对于高风险多发性骨髓瘤或首先复制的患者

2026年11月3日 更新者：National Cancer Institute (NCI)

一项针对难治性的高风险多发性骨髓瘤的随机II期试验，或与达拉特蛋白单抗，三甲甲酰胺（DT）与达拉特珠单抗，pomalidomamide，pomalidomide，dexamethasone（DPD）或daratumumumab，daratumumab，carfilzomib，dexamethasone（dkd）相比

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.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

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.

研究类型

介入性

注册 (估计的)

80

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

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

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
有源比较器：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.
程序：Bone Marrow Biopsy

Undergo bone marrow biopsy

其他名称：
  • 骨髓活检
  • 活组织检查，骨髓
药品：Dexamethasone

Given PO or IV

其他名称：
  • 十进制
  • 赫马迪
  • 酸检验
  • 阿地松
  • Aknichthol Dexa
  • Alba-Dex
  • 阿林
  • 阿林得宝
  • 阿林·奥夫塔尔米科
  • 羊皮
  • 银莲花
  • 木耳
  • 辅助素
  • 贝卡龙
  • 贝库腾
  • 贝库腾 N
  • 皮质激素
  • 皮质素
  • 迪卡特
  • 癸二酚
  • Decadron DP
  • 蜡纸
  • 十杀
  • 十卡松 R.p.
  • 癸烷基
  • 地卡可特
  • Δ芴
  • 德罗尼尔
  • 地塞米松
  • 地美通
  • Dexa-Mamallet
  • Dexa-Scheroson公司
  • 地塞辛
  • 皮质醇
  • 地塞法玛
  • 右旋芴
  • 地塞米松 Intensol
  • 右心醛
  • 地塞因
  • 恐龙兽
  • 德赛沃
  • 氟代尔塔
  • 复方皮质素
  • 伽马考腾
  • 十六酚
  • 己二醇
  • Lokalison-F
  • 情人
  • 甲基氟泼尼松龙
  • 米利克顿
  • 米米松
  • Orgadrone
  • Spersadex
  • TaperDex
  • 维舒美松
  • ZoDex
  • 利纳得克萨斯
程序：Biospecimen Collection

Undergo urine and blood sample collection

其他名称：
  • 生物样本采集
  • 收集的生物样本
  • 标本采集
  • 样本收集
药品：Daratumumab and Recombinant Human Hyaluronidase

Given SC

其他名称：
  • DARA 与 rHuPH20 共同配制
  • DARA/rHuPH20
  • 达雷木单抗 + rHuPH20
  • Daratumumab 与 rHuPH20
  • 达雷木单抗-rHuPH20
  • Daratumumab/透明质酸酶-fihj
  • Daratumumab/rHuPH20 复合制剂
  • Darzalex Faspro
  • Darzalex/rHuPH20
  • HuMax-CD38-rHuPH20
  • 重组人透明质酸酶与 Daratumumab 混合
  • 达雷妥尤单抗和透明质酸酶-fihj
  • 达雷妥尤单抗和透明质酸酶
  • 达雷妥尤单抗和原透明质酸酶
  • 达雷妥尤单抗和 Vorhyaluronidase Alfa
  • 达尔兹库罗
程序：Computed Tomography

Undergo FDG PET/CT

其他名称：
  • CT
  • 猫
  • 电脑扫描
  • 计算机轴向断层扫描
  • 计算机断层扫描
  • CT扫描
  • 断层扫描
  • 计算机轴向断层扫描（程序）
  • 计算机断层扫描 (CT) 扫描
  • 诊断猫扫描
  • 诊断猫扫描服务类型
药品：Pomalidomide

Given PO

其他名称：
  • Pomalyst
  • 免疫力
  • 4-氨基沙利度胺
  • 阿克泰米德
  • CC-4047
  • CC4047
  • CC 4047
程序：FDG-Positron Emission Tomography

Undergo FDG PET/CT

其他名称：
  • 葡萄糖
  • FDG-PET
  • FDG-PET 成像
有源比较器：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.
程序：Bone Marrow Biopsy

Undergo bone marrow biopsy

其他名称：
  • 骨髓活检
  • 活组织检查，骨髓
药品：Carfilzomib

Given IV

其他名称：
  • Kyprolis
  • PR-171
  • CFZ
  • PR171
  • 卡菲尔纳
  • 公关 171
药品：Dexamethasone

Given PO or IV

其他名称：
  • 十进制
  • 赫马迪
  • 酸检验
  • 阿地松
  • Aknichthol Dexa
  • Alba-Dex
  • 阿林
  • 阿林得宝
  • 阿林·奥夫塔尔米科
  • 羊皮
  • 银莲花
  • 木耳
  • 辅助素
  • 贝卡龙
  • 贝库腾
  • 贝库腾 N
  • 皮质激素
  • 皮质素
  • 迪卡特
  • 癸二酚
  • Decadron DP
  • 蜡纸
  • 十杀
  • 十卡松 R.p.
  • 癸烷基
  • 地卡可特
  • Δ芴
  • 德罗尼尔
  • 地塞米松
  • 地美通
  • Dexa-Mamallet
  • Dexa-Scheroson公司
  • 地塞辛
  • 皮质醇
  • 地塞法玛
  • 右旋芴
  • 地塞米松 Intensol
  • 右心醛
  • 地塞因
  • 恐龙兽
  • 德赛沃
  • 氟代尔塔
  • 复方皮质素
  • 伽马考腾
  • 十六酚
  • 己二醇
  • Lokalison-F
  • 情人
  • 甲基氟泼尼松龙
  • 米利克顿
  • 米米松
  • Orgadrone
  • Spersadex
  • TaperDex
  • 维舒美松
  • ZoDex
  • 利纳得克萨斯
程序：Biospecimen Collection

Undergo urine and blood sample collection

其他名称：
  • 生物样本采集
  • 收集的生物样本
  • 标本采集
  • 样本收集
药品：Daratumumab and Recombinant Human Hyaluronidase

Given SC

其他名称：
  • DARA 与 rHuPH20 共同配制
  • DARA/rHuPH20
  • 达雷木单抗 + rHuPH20
  • Daratumumab 与 rHuPH20
  • 达雷木单抗-rHuPH20
  • Daratumumab/透明质酸酶-fihj
  • Daratumumab/rHuPH20 复合制剂
  • Darzalex Faspro
  • Darzalex/rHuPH20
  • HuMax-CD38-rHuPH20
  • 重组人透明质酸酶与 Daratumumab 混合
  • 达雷妥尤单抗和透明质酸酶-fihj
  • 达雷妥尤单抗和透明质酸酶
  • 达雷妥尤单抗和原透明质酸酶
  • 达雷妥尤单抗和 Vorhyaluronidase Alfa
  • 达尔兹库罗
程序：Computed Tomography

Undergo FDG PET/CT

其他名称：
  • CT
  • 猫
  • 电脑扫描
  • 计算机轴向断层扫描
  • 计算机断层扫描
  • CT扫描
  • 断层扫描
  • 计算机轴向断层扫描（程序）
  • 计算机断层扫描 (CT) 扫描
  • 诊断猫扫描
  • 诊断猫扫描服务类型
程序：FDG-Positron Emission Tomography

Undergo FDG PET/CT

其他名称：
  • 葡萄糖
  • FDG-PET
  • FDG-PET 成像
有源比较器：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.
程序：Bone Marrow Biopsy

Undergo bone marrow biopsy

其他名称：
  • 骨髓活检
  • 活组织检查，骨髓
药品：Carfilzomib

Given IV

其他名称：
  • Kyprolis
  • PR-171
  • CFZ
  • PR171
  • 卡菲尔纳
  • 公关 171
药品：Dexamethasone

Given PO or IV

其他名称：
  • 十进制
  • 赫马迪
  • 酸检验
  • 阿地松
  • Aknichthol Dexa
  • Alba-Dex
  • 阿林
  • 阿林得宝
  • 阿林·奥夫塔尔米科
  • 羊皮
  • 银莲花
  • 木耳
  • 辅助素
  • 贝卡龙
  • 贝库腾
  • 贝库腾 N
  • 皮质激素
  • 皮质素
  • 迪卡特
  • 癸二酚
  • Decadron DP
  • 蜡纸
  • 十杀
  • 十卡松 R.p.
  • 癸烷基
  • 地卡可特
  • Δ芴
  • 德罗尼尔
  • 地塞米松
  • 地美通
  • Dexa-Mamallet
  • Dexa-Scheroson公司
  • 地塞辛
  • 皮质醇
  • 地塞法玛
  • 右旋芴
  • 地塞米松 Intensol
  • 右心醛
  • 地塞因
  • 恐龙兽
  • 德赛沃
  • 氟代尔塔
  • 复方皮质素
  • 伽马考腾
  • 十六酚
  • 己二醇
  • Lokalison-F
  • 情人
  • 甲基氟泼尼松龙
  • 米利克顿
  • 米米松
  • Orgadrone
  • Spersadex
  • TaperDex
  • 维舒美松
  • ZoDex
  • 利纳得克萨斯
程序：Biospecimen Collection

Undergo urine and blood sample collection

其他名称：
  • 生物样本采集
  • 收集的生物样本
  • 标本采集
  • 样本收集
药品：Daratumumab and Recombinant Human Hyaluronidase

Given SC

其他名称：
  • DARA 与 rHuPH20 共同配制
  • DARA/rHuPH20
  • 达雷木单抗 + rHuPH20
  • Daratumumab 与 rHuPH20
  • 达雷木单抗-rHuPH20
  • Daratumumab/透明质酸酶-fihj
  • Daratumumab/rHuPH20 复合制剂
  • Darzalex Faspro
  • Darzalex/rHuPH20
  • HuMax-CD38-rHuPH20
  • 重组人透明质酸酶与 Daratumumab 混合
  • 达雷妥尤单抗和透明质酸酶-fihj
  • 达雷妥尤单抗和透明质酸酶
  • 达雷妥尤单抗和原透明质酸酶
  • 达雷妥尤单抗和 Vorhyaluronidase Alfa
  • 达尔兹库罗
程序：Computed Tomography

Undergo FDG PET/CT

其他名称：
  • CT
  • 猫
  • 电脑扫描
  • 计算机轴向断层扫描
  • 计算机断层扫描
  • CT扫描
  • 断层扫描
  • 计算机轴向断层扫描（程序）
  • 计算机断层扫描 (CT) 扫描
  • 诊断猫扫描
  • 诊断猫扫描服务类型
程序：FDG-Positron Emission Tomography

Undergo FDG PET/CT

其他名称：
  • 葡萄糖
  • FDG-PET
  • FDG-PET 成像
实验性的：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.
程序：Bone Marrow Biopsy

Undergo bone marrow biopsy

其他名称：
  • 骨髓活检
  • 活组织检查，骨髓
药品：Teclistamab

Given SC

其他名称：
  • JNJ-64007957
  • 特茨瓦伊利
  • 强健 64007957
  • JNJ64007957
  • 特克他单抗-cqyv
程序：Biospecimen Collection

Undergo urine and blood sample collection

其他名称：
  • 生物样本采集
  • 收集的生物样本
  • 标本采集
  • 样本收集
药品：Daratumumab and Recombinant Human Hyaluronidase

Given SC

其他名称：
  • DARA 与 rHuPH20 共同配制
  • DARA/rHuPH20
  • 达雷木单抗 + rHuPH20
  • Daratumumab 与 rHuPH20
  • 达雷木单抗-rHuPH20
  • Daratumumab/透明质酸酶-fihj
  • Daratumumab/rHuPH20 复合制剂
  • Darzalex Faspro
  • Darzalex/rHuPH20
  • HuMax-CD38-rHuPH20
  • 重组人透明质酸酶与 Daratumumab 混合
  • 达雷妥尤单抗和透明质酸酶-fihj
  • 达雷妥尤单抗和透明质酸酶
  • 达雷妥尤单抗和原透明质酸酶
  • 达雷妥尤单抗和 Vorhyaluronidase Alfa
  • 达尔兹库罗
程序：Computed Tomography

Undergo FDG PET/CT

其他名称：
  • CT
  • 猫
  • 电脑扫描
  • 计算机轴向断层扫描
  • 计算机断层扫描
  • CT扫描
  • 断层扫描
  • 计算机轴向断层扫描（程序）
  • 计算机断层扫描 (CT) 扫描
  • 诊断猫扫描
  • 诊断猫扫描服务类型
程序：FDG-Positron Emission Tomography

Undergo FDG PET/CT

其他名称：
  • 葡萄糖
  • FDG-PET
  • FDG-PET 成像

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Minimal residual disease (MRD) negativity
大体时间：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

次要结果测量

结果测量
措施说明
大体时间
Incidence of adverse events (AEs)
大体时间：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
大体时间：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)
大体时间：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)
大体时间：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
大体时间：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

其他结果措施

结果测量
措施说明
大体时间
无事件生存
大体时间：从随机分组到早期的非协议治疗，由于任何原因而导致的死亡，最多可评估10年
从随机分组到早期的非协议治疗，由于任何原因而导致的死亡，最多可评估10年
进展的时间
大体时间：从随机分组到记录的进展时间，或在上次疾病评估日期进行审查（如果还活着或因疾病进展而死亡），则评估长达10年
从随机分组到记录的进展时间，或在上次疾病评估日期进行审查（如果还活着或因疾病进展而死亡），则评估长达10年
治疗持续时间
大体时间：从随机分组到治疗端，或在上次治疗之日进行审查，评估长达10年
从随机分组到治疗端，或在上次治疗之日进行审查，评估长达10年
Cumulative dose intensity
大体时间：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)
大体时间：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
大体时间：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)
大体时间：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)
大体时间：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
大体时间：Up to 10 years

Will be assessed according to concurrent thromboprophylaxis type and dose.
Up to 10 years
Venous thromboembolism risk
大体时间：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
大体时间：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
大体时间：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)

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

National Cancer Institute (NCI)

调查人员

  • 首席研究员：Muhamed Baljevic、ECOG-ACRIN Cancer Research Group

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2027年5月22日

初级完成 (估计的)

2028年2月28日

研究完成 (估计的)

2028年2月28日

研究注册日期

首次提交

2025年4月26日

首先提交符合 QC 标准的

2025年4月26日

首次发布 (实际的)

2025年4月29日

研究记录更新

最后更新发布 (实际的)

2026年11月4日

上次提交的符合 QC 标准的更新

2026年11月3日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • NCI-2025-02986
  • U10CA180820 (美国 NIH 拨款/合同)
  • NCI-2025-02986 (注册表标识符：CTRP (Clinical Trial Reporting Program))
  • EAA232 (其他标识符：CTEP)
  • EAA232 (其他标识符：ECOG-ACRIN Cancer Research Group)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

是的

IPD 计划说明

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.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

在美国制造并从美国出口的产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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