Isatuximab in Combination With Novel Agents in RRMM - Master Protocol

NCT ID: NCT04643002

Last Updated: 2025-08-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

258 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-25

Study Completion Date

2028-04-20

Brief Summary

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The purpose of this umbrella study is to evaluate isatuximab when combined with novel agents with or without dexamethasone in participants with relapsed or refractory myeloma. Substudy 01 is the control Substudy. Substudies 02, 03, and 06 are controlled experimental substudies. Substudies 04 and 05 are independent experimental substudies.

Detailed Description

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Participants will continue study treatment until disease progression, death, unacceptable toxicity, participant request to stop treatment, Investigator decision, or study termination by the Sponsor i.e., up to Aapproximately 28 months.

Conditions

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Plasma Cell Myeloma Refractory

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control Arm: isatuximab + pomalidomide + dexamethasone (Substudy 01)

* Isatuximab, intravenous (IV) doseweekly (QW) × 4 weeks (Cycle 1), followed by every two weeks (Q2W) (subsequent cycles).
* Pomalidomide dose by mouth daily Day 1 to Day 21.
* Dexamethasone dose by mouth QW.

Group Type ACTIVE_COMPARATOR

Isatuximab

Intervention Type DRUG

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Dexamethasone

Intervention Type DRUG

Pharmaceutical form: Tablet; Route of administration: Oral

Pomalidomide

Intervention Type DRUG

Pharmaceutical form: Capsule; Route of administration: Oral

isatuximab + SAR439459 + dexamethasone (Substudy 02)

SAR439459 in combination with isatuximab and dexamethasone

Part 1:

2 dose levels (DLs) of IV SAR439459:

* DL1 SAR439459 dose Q2W.
* DL2 SAR439459 dose Q2W.
* Isatuximab dose IV QW × 5 weeks (Cycle 1), followed by Q2W administrations (subsequent cycles).
* Dexamethasone fixed dose and schedule: QW by mouth In Cycle 1, the first administration of SAR439459 (Day 1) will precede isatuximab by 1 week (first dose of isatuximab will be at Cycle 1 Day 8).

Part 2:

* SAR439459 IV dose Q2W.
* Isatuximab IV dose QW × 5 weeks (Cycle 1), followed by Q2W administrations (subsequent cycles).
* Dexamethasone fixed dose and schedule: QW by mouth. In Cycle 1, the first administration of SAR439459 (Day 1) will precede isatuximab by 1 week (first dose of isatuximab will be at Cycle 1 Day 8).

Group Type EXPERIMENTAL

Isatuximab

Intervention Type DRUG

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Dexamethasone

Intervention Type DRUG

Pharmaceutical form: Tablet; Route of administration: Oral

SAR439459

Intervention Type DRUG

Pharmaceutical form: Solution for injection; Route of administration: Intravenous

isatuximab + dexamethasone + belantamab mafodotin (Substudy 03)

Belantamab mafodotin in combination with isatuximab and dexamethasone

Part 1:

1 DL of IV belantamab mafodotin in Part 1 and de-escalation dose DL-1:

* DL1 belantamab mafodotin IV dose QW4 or de-escalation dose DL-1 QW8
* Isatuximab dose, IV QW × 4 weeks (Cycle 1), followed by Q2W (subsequent cycles).
* Dexamethasone fixed dose and schedule: QW by mouth.

Part 2:

* Isatuximab IV dose QW × 4 weeks (Cycle 1), followed by Q2W (subsequent cycles).
* Belantamab mafodotin IV dose Q4W or Q8W
* Dexamethasone fixed dose and schedule: QW by mouth.

Group Type EXPERIMENTAL

Isatuximab

Intervention Type DRUG

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Dexamethasone

Intervention Type DRUG

Pharmaceutical form: Tablet; Route of administration: Oral

Belantamab mafodotin

Intervention Type DRUG

Pharmaceutical form: Solution for infusion; Route of administration: Intravenous

Isatuximab + pegenzileukin (Substudy 04)

Pegenzileukin in combination with isatuximab

Part 1- dose escalation:

* Up to 3 DLs of IV pegenzileukin are planned to be evaluated:

* DL1 will explore pegenzileukin at Q2W.
* DL2 will explore pegenzileukin at Q2W.
* DL3 will explore pegenzileukin at Q2W.
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles).

Part 1 - dose optimization:

* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles).
* Pegenzileukin at potential doses (DL A and DL B) Q2W.

Part 2 (dose expansion):

* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles).
* Pegenzileukin IV dose Q2W.

Group Type EXPERIMENTAL

Isatuximab

Intervention Type DRUG

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Pegenzileukin

Intervention Type DRUG

Pharmaceutical form: Solution for infusion; Route of administration: Intravenous

Experimental: Isatuximab + Dexamethasone + Belumosudil (Substudy 05)

Isatuximab in combination with belumosudil and dexamethasone Part 1- dose escalation: During the first cycle, belumosudil will be evaluated in monotherapy during 2 to 4 weeks, then isatuximab and dexamethasone will be added, and continued for the subsequent cycles.

* Belumosudil by mouth at Dose Level (DL) 1, DL2, DL3, and DL4
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles)
* Dexamethasone fixed dose and schedule: QW by mouth

Part 1- dose optimization:

* Belumosudil at potential doses (DL A and DL B), daily by mouth
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles)
* Dexamethasone fixed dose and schedule: QW by mouth

Part 2- dose expansion:

* Belumosudil dose daily, by mouth
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles)
* Dexamethasone fixed dose and schedule: QW by mouth

Group Type EXPERIMENTAL

Isatuximab

Intervention Type DRUG

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Dexamethasone

Intervention Type DRUG

Pharmaceutical form: Tablet; Route of administration: Oral

Belumosudil

Intervention Type DRUG

Pharmaceutical form: tablet; route of administration: oral

Isatuximab + evorpacept + dexamethasone (Substudy 06)

Isatuximab in combination with evorpacept and dexamethasone

Part 1- dose escalation:

* Evorpacept IV dose Q2W
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles)
* Dexamethasone fixed dose and schedule: QW by mouth Part 1- dose optimization
* Evorpacept IV at potential doses (DL A and DL B), Q2W
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles)
* Dexamethasone fixed dose and schedule: QW by mouth

Part 2- dose expansion:

* Evorpacept IV dose Q2W
* Isatuximab IV dose QW × 4 weeks, followed by Q2W (subsequent cycles)
* Dexamethasone fixed dose and schedule: QW by mouth

Group Type EXPERIMENTAL

Isatuximab

Intervention Type DRUG

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Dexamethasone

Intervention Type DRUG

Pharmaceutical form: Tablet; Route of administration: Oral

Evorpacept

Intervention Type DRUG

Pharmaceutical form: Solution for infusion; Route of administration: Intravenous

Interventions

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Isatuximab

Pharmaceutical form: Concentrated solution for intravenous infusion; Route of administration: Intravenous infusion

Intervention Type DRUG

Dexamethasone

Pharmaceutical form: Tablet; Route of administration: Oral

Intervention Type DRUG

Pomalidomide

Pharmaceutical form: Capsule; Route of administration: Oral

Intervention Type DRUG

Belantamab mafodotin

Pharmaceutical form: Solution for infusion; Route of administration: Intravenous

Intervention Type DRUG

Pegenzileukin

Pharmaceutical form: Solution for infusion; Route of administration: Intravenous

Intervention Type DRUG

SAR439459

Pharmaceutical form: Solution for injection; Route of administration: Intravenous

Intervention Type DRUG

Belumosudil

Pharmaceutical form: tablet; route of administration: oral

Intervention Type DRUG

Evorpacept

Pharmaceutical form: Solution for infusion; Route of administration: Intravenous

Intervention Type DRUG

Other Intervention Names

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SAR650984 Sarclisa® Pomalyst® BLENREP® SAR444245 SAR445761, Rezurock ALX148

Eligibility Criteria

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Inclusion Criteria

* Participant must be 18 years of age inclusive or older.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
* Participants with relapsed or refractory MM who have received at least 2 prior lines of therapy for MM, including PIs and IMiDs (eg, Induction regimen with autologous stem cell transplant followed by maintenance is considered one line).
* RRMM with measurable disease:

* Serum M protein ≥0.5 g/dL measured using serum protein immunoelectrophoresis and/or
* Urine M protein ≥200 mg/24 hours measured using urine protein immunoelectrophoresis and/or
* Serum free light chain (sFLC) MM without measurable M protein in serum or urine per previous criteria (serum Ig free light chain ≥10 mg/dL and abnormal serum Ig kappa lambda free light chain ratio \<0.26 or \>1.65).
* Men or woman or childbearing potential should agree to use contraception.
* Substudy 01, 06: Anti-CD38 therapy naïve or prior exposure to such drugs with a wash out of at least 12 months after the last dose. "Exposure" is defined as at least 2 cycles of therapy.
* Substudies 02, 03: Anti-CD38 therapy naïve or prior exposure to such drugs without being refractory but with a wash out of at least 6 months after the last dose. "Refractory" is defined as progressing within 60 days of last dose of anti-CD38 targeting therapy.
* Substudy 04: Anti-CD38 and anti-B cell maturation antigen (BCMA) therapy (if available) prior exposed participants with RRMM. For anti-CD38, "Exposure" is defined as at least 2 cycles of therapy. For anti-BCMA therapy if available, exposure is defined by at least 2 cycles of therapy.
* Substudy 05: Participants with RRMM with at least 2 cycles of prior exposure to anti-CD38 therapy. For participants to whom BCMA targeted therapy is available (ie, approved in their region and can be reimbursed), at least 2 cycles of prior exposure to a BCMA targeted agent is mandatory.

Exclusion Criteria

* Primary systemic amyloid light chain amyloidosis, plasma cell leukemia, monoclonal gammopathy of undetermined significance, or smoldering myeloma.
* Uncontrolled infection within 14 days prior to first study intervention administration.
* Clinically significant cardiac (including valvular) or vascular disease within 3 months prior to first study intervention administration., eg, myocardial infarction, unstable angina, coronary (eg, coronary artery bypass graft, percutaneous coronary intervention) or peripheral artery revascularization, left ventricular ejection fraction \<40%, heart failure New York Heart Association Classes III and IV, stroke, transient ischemic attack, pulmonary embolism, other thromboembolic event, or cardiac arrhythmia (Grade 3 or higher by NCI CTCAE Version 5.0).
* Known acquired immunodeficiency syndrome-related illness or known human immunodeficiency virus (HIV) disease requiring antiviral treatment or active hepatitis A.
* Uncontrolled or active hepatitis B virus (HBV) infection.
* Active hepatitis C virus (HCV) infection.
* Any of the following within 3 months prior to first study intervention administration: treatment resistant peptic ulcer disease, erosive esophagitis or gastritis, infectious or inflammatory bowel disease.
* Second malignancy other than basal cell or squamous cell carcinoma of the skin or in situ carcinoma, unless they are successfully treated with curative intent for more than 3 years before first study intervention administration.
* Any anti-MM drug treatment within 14 days before first study intervention administration, including dexamethasone.
* Participants with a contraindication to treatment.
* Vaccination with a live vaccine 4 weeks before the start of the study.
* Seasonal flu and COVID-19 vaccines that do not contain live virus are permitted.
* Hemoglobin \<8 g/dL.
* Platelets \<50 × 10\^9/L.
* Absolute neutrophil count \<1.0 × 10\^9/L.
* Creatinine clearance \<30 mL/min/1.73m2.
* Total bilirubin \>1.5 × ULN, except for known Gilbert syndrome in which direct bilirubin should be ≤2.5 × ULN.
* Aspartate aminotransferase and/or alanine aminotransferase \>3 × ULN.
* Patients with grade 3 or 4 hypercalcemia.

Substudy 01:

-Malabsorption syndrome or any condition that can significantly impact the absorption of pomalidomide.

Substudy 02:

* History of resected/ablated basal or squamous cell carcinoma (SCC) of the skin or carcinoma in situ of the cervix, or other local tumors, even if considered cured by local treatment.
* Therapeutic doses of anticoagulants or antiplatelet agents within 7 days prior to the first dose of SAR439459.
* Prothrombin time or INR \>1.5 × upper limit of normal (ULN).

Substudy 03:

* Current corneal epithelial disease except mild punctate keratopathy.
* Patients who have received prior therapy with belantamab mafodotin.

Substudy 04:

* Central nervous system or leptomeningeal disease.
* Medical history of seizure.
* Participants currently receiving hepatically metabolized narrow therapeutic index drugs (eg, digoxin, warfarin) if cannot be closely monitored.
* Active, known, or suspected autoimmune disease that has required systemic treatment in the past 2 years (ie, with use of disease modifying agents, corticosteroids or immunosuppressive drugs), except controlled by replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc). The following are not exclusionary: vitiligo, childhood asthma that has resolved, psoriasis that does not require systemic treatment.
* Prior allogeneic hematopoietic stem cell transplant (allo-HSCT).

Substudy 05:

\- Participant unable to swallow tablets.

Substudy 06:

* History of active autoimmune disorders.
* History of autoimmune hemolytic anemia or autoimmune. thrombocytopenia.
* Active graft versus host disease (GVHD) or ongoing immunosuppression for GVHD.
* Prior allogenic hematopoietic stem cell transplant (allo-HSCT).
* Patient with chronic active EBV infection.
* Patients with known history of HLH.
* Hemoglobin \< 9 g/dL.
* Prior therapy with any anti-CD47 or anti signal regulatory protein alpha agent.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Sciences & Operations

Role: STUDY_DIRECTOR

Sanofi

Locations

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Winship Cancer Institute, Emory University- Site Number : 8400010

Atlanta, Georgia, United States

Site Status RECRUITING

University of Illinois-Chicago - College of Medicine- Site Number : 8400007

Chicago, Illinois, United States

Site Status COMPLETED

University of Michigan Health System - Ann Arbor- Site Number : 8400004

Ann Arbor, Michigan, United States

Site Status RECRUITING

Roswell Park Cancer Institute- Site Number : 8400008

Buffalo, New York, United States

Site Status RECRUITING

Investigational Site Number : 0360006

Wollongong, New South Wales, Australia

Site Status RECRUITING

Investigational Site Number : 0360002

Melbourne, Victoria, Australia

Site Status RECRUITING

Investigational Site Number : 0360001

Richmond, Victoria, Australia

Site Status RECRUITING

Investigational Site Number : 2500002

Lille, , France

Site Status RECRUITING

Investigational Site Number : 2500001

Nantes, , France

Site Status RECRUITING

Investigational Site Number : 2500004

Paris, , France

Site Status RECRUITING

Investigational Site Number : 2500003

Paris, , France

Site Status RECRUITING

Investigational Site Number : 2760006

Frankfurt, , Germany

Site Status RECRUITING

Investigational Site Number : 2760008

Lübeck, , Germany

Site Status RECRUITING

Investigational Site Number : 3000002

Athens, , Greece

Site Status RECRUITING

Investigational Site Number : 3000001

Athens, , Greece

Site Status RECRUITING

Investigational Site Number : 3760002

Jerusalem, , Israel

Site Status RECRUITING

Investigational Site Number : 3760003

Ramat Gan, , Israel

Site Status RECRUITING

Investigational Site Number : 3760001

Tel Aviv, , Israel

Site Status RECRUITING

Investigational Site Number : 3800001

Meldola, Reggio Emilia, Italy

Site Status RECRUITING

Investigational Site Number : 5780001

Oslo, , Norway

Site Status RECRUITING

Investigational Site Number : 6200001

Coimbra, , Portugal

Site Status RECRUITING

Investigational Site Number : 6200002

Porto, , Portugal

Site Status RECRUITING

Puerto Rico Medical Research Center- Site Number : 8400005

HATO REY, Puerto Rico, Puerto Rico

Site Status RECRUITING

Investigational Site Number : 4100004

Seoul, Seoul-teukbyeolsi, South Korea

Site Status RECRUITING

Investigational Site Number : 4100002

Seoul, Seoul-teukbyeolsi, South Korea

Site Status RECRUITING

Investigational Site Number : 4100003

Seoul, Seoul-teukbyeolsi, South Korea

Site Status RECRUITING

Investigational Site Number : 4100001

Seoul, Seoul-teukbyeolsi, South Korea

Site Status RECRUITING

Countries

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United States Australia France Germany Greece Israel Italy Norway Portugal Puerto Rico South Korea

Central Contacts

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Trial Transparency email recommended (Toll free number for US & Canada)

Role: CONTACT

800-633-1610 ext. option 6

Facility Contacts

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Alexandre NUNG

Role: primary

+33 03.20.44.57.13

David MONDERER

Role: primary

+33 02 53 48 24 77

Rafik BOUALI

Role: primary

+33 01 44 49 56 63

Louise ANEMET

Role: primary

+33 01 42 17 82 28

Fabiana Mammoli, Dr

Role: primary

+39 0543 739442

Joana Dias

Role: primary

+351 966 329 381

Miguel do Adro

Role: primary

936152658

Other Identifiers

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U1111-1244-2598

Identifier Type: REGISTRY

Identifier Source: secondary_id

2024-514988-25

Identifier Type: REGISTRY

Identifier Source: secondary_id

2020-003024-16

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ACT16482

Identifier Type: -

Identifier Source: org_study_id

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