Isatuximab, Carfilzomib, Pomalidomide, and Dexamethasone for the Treatment of Relapsed or Refractory Multiple Myeloma

NCT ID: NCT04883242

Last Updated: 2025-09-26

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-29

Study Completion Date

2031-12-31

Brief Summary

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This phase II trial studies the effect of isatuximab, carfilzomib, pomalidomide, and dexamethasone in treating patients with multiple myeloma that has come back (relapsed) or does not respond to treatment (refractory). Isatuximab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. Carfilzomib may stop the growth of cancer cells by blocking some of the proteins needed for cell growth. Pomalidomide may help shrink or slow the growth of multiple myeloma. Anti-inflammatory drugs, such as dexamethasone lower the body's immune response and are used with other drugs in the treatment of some types of cancer. Giving isatuximab, carfilzomib, pomalidomide, and dexamethasone may kill more cancer cells.

Detailed Description

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OUTLINE:

INDUCTION: Patients receive isatuximab intravenously (IV) on days 1, 8, 15, and 22 of cycle 1 and days 1 and 15 of subsequent cycles carfilzomib IV over 30 minutes on days 1, 8, and 15, pomalidomide orally (PO) once daily (QD) on days 1-21, and dexamethasone PO or IV on days 1,8, 15, and 22. Treatment repeats every 28 days for 6 cycles in the absence of disease progression or unacceptable toxicity.

MAINTENANCE: Patients receive isatuximab IV days 1 and 15, carfilzomib IV over 30 minutes on days 1 and 15, pomalidomide PO QD on days 1-21, and dexamethasone PO or IV on days 1, 8, 15, and 22. Cycles repeat every 28 days for up to 24 months in the absence of disease progression or unacceptable toxicity.

All patients undergo bone marrow aspirate and biopsy during screening, skeletal x-ray, computed tomography (CT), positron emission tomography (PET)-CT, or magnetic resonance imaging (MRI), bone marrow and blood sample collection throughout the study.

After completion of study treatment, patients are followed up at 30 days, then for up to 5 years.

Conditions

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Recurrent Multiple Myeloma Refractory Multiple Myeloma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment (isatuximab, carfilzomib, pomalidomide, steroid)

INDUCTION: Patients receive isatuximab IV on days 1, 8, 15, and 22 of cycle 1 and days 1 and 15 of subsequent cycles carfilzomib IV over 30 minutes on days 1, 8, and 15, pomalidomide PO QD on days 1-21, and dexamethasone PO or IV on days 1,8, 15, and 22. Treatment repeats every 28 days for 6 cycles in the absence of disease progression or unacceptable toxicity.

MAINTENANCE: Patients receive isatuximab IV days 1 and 15, carfilzomib IV over 30 minutes on days 1 and 15, pomalidomide PO QD on days 1-21, and dexamethasone PO or IV on days 1, 8, 15, and 22. Cycles repeat every 28 days for up to 24 months in the absence of disease progression or unacceptable toxicity.

All patients undergo bone marrow aspirate and biopsy during screening, skeletal x-ray, CT, PET-CT, or MRI, bone marrow and blood sample collection throughout the study.

Group Type EXPERIMENTAL

Carfilzomib

Intervention Type DRUG

Given IV

Dexamethasone

Intervention Type DRUG

Given PO or IV

Isatuximab

Intervention Type BIOLOGICAL

Given IV

Pomalidomide

Intervention Type DRUG

Given PO

Bone Marrow Biopsy

Intervention Type PROCEDURE

Undergo bone marrow biopsy

Bone Marrow Aspiration

Intervention Type PROCEDURE

Undergo bone marrow aspiration

Skeletal Survey X-Ray

Intervention Type PROCEDURE

Undergo skeletal x-ray

Computed Tomography

Intervention Type PROCEDURE

Undergo CT

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo PET-CT

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Undergo MRI

Interventions

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Carfilzomib

Given IV

Intervention Type DRUG

Dexamethasone

Given PO or IV

Intervention Type DRUG

Isatuximab

Given IV

Intervention Type BIOLOGICAL

Pomalidomide

Given PO

Intervention Type DRUG

Bone Marrow Biopsy

Undergo bone marrow biopsy

Intervention Type PROCEDURE

Bone Marrow Aspiration

Undergo bone marrow aspiration

Intervention Type PROCEDURE

Skeletal Survey X-Ray

Undergo skeletal x-ray

Intervention Type PROCEDURE

Computed Tomography

Undergo CT

Intervention Type PROCEDURE

Positron Emission Tomography

Undergo PET-CT

Intervention Type PROCEDURE

Magnetic Resonance Imaging

Undergo MRI

Intervention Type PROCEDURE

Other Intervention Names

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Kyprolis PR-171 Carfilnat CFZ Aacidexam Adexone Aknichthol Dexa Alba-Dex Alin Alin Depot Alin Oftalmico Amplidermis Anemul mono Auricularum Auxiloson Baycadron Baycuten Baycuten N Cortidexason Cortisumman Decacort Decadrol Decadron Decadron DP Decalix Decameth Decasone R.p. Dectancyl Dekacort Deltafluorene Deronil Desamethasone Desameton Dexa-Mamallet Dexa-Rhinosan Dexa-Scheroson Dexa-sine Dexacortal Dexacortin Dexafarma Dexafluorene Dexalocal Dexamecortin Dexameth Dexamethasone Intensol Dexamethasonum Dexamonozon Dexapos Dexinoral Dexone Dinormon Dxevo Fluorodelta Fortecortin Gammacorten Hemady Hexadecadrol Hexadrol Lokalison-F Loverine Methylfluorprednisolone Millicorten Mymethasone Orgadrone Spersadex TaperDex Visumetazone ZoDex Hu 38SB19 Isatuximab-irfc SAR 650984 SAR650984 Sarclisa SAR-650984 4-Aminothalidomide Actimid CC-4047 Imnovid Pomalyst CC4047 CAT Scan Computed Axial Tomography PET scan MRI

Eligibility Criteria

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Inclusion Criteria

* Patients with relapsed or refractory multiple myeloma, with \>= 1 prior therapy
* Must have received prior lenalidomide therapy
* Must have measurable disease, as defined by International Myeloma Working Group criteria, having one or more of the following:

* Serum M protein \>= 0.5 g/dL
* Urine M protein \>= 200 mg/24 hours
* Involved serum free light chain level \>= 10 mg/dL with abnormal kappa/lambda ratio
* Measurable biopsy-proven plasmacytomas (\>= 1 lesion has a single diameter \>= 2 cm)
* Bone marrow plasma cells \>= 30%
* Age 18 years and older, and have the capacity to give informed consent
* Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
* Subjects should have resolution of any toxicities from prior therapy to grade =\< 1 or baseline prior to enrollment (with the exception of peripheral neuropathy)
* Subjects are required to have grade =\< 2 peripheral neuropathy to enroll
* Prior autologous stem cell transplant is allowed; patients must be \>= 6 months post- autologous stem cell transplantation to enroll
* Estimated glomerular filtration rate (eGFR) \>= 20 ml/min
* Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 3 x upper limit of normal (ULN)
* Total bilirubin =\< 2 x ULN
* Absolute neutrophil count (ANC) \>= 1,000/uL
* Platelets \>= 50,000/uL
* Hemoglobin \>= 8 g/dL
* Growth factor use or transfusions may be used to meet the eligibility requirement for ANC, platelets, and hemoglobin
* Female patients of childbearing potential and male patients must agree to use 2 effective forms of contraception or continuously abstain from heterosexual intercourse during the period of therapy, and for 6 months after discontinuation of study treatment for females and 3 months after discontinuation of study treatment for males

Exclusion Criteria

* History of clinically significant cardiovascular disease, including congestive heart failure New York Heart Association (NYHA) class 3-4, symptomatic ischemia, left ventricular ejection fraction \< 40%, uncontrolled conduction abnormalities, myocardial infarction in last 6 months
* Uncontrolled hypertension as determined by the principal investigator (PI) or designee
* Active plasma cell leukemia or systemic amyloid light-chain (AL) amyloidosis
* History of another primary malignancy that has not been in remission for at least 1 year

* However, the following diagnoses are eligible for inclusion: non-melanoma skin cancer, localized prostate cancer, superficial bladder cancer, cervical carcinoma in situ, on biopsy or any prior malignancy with an estimated \> 90% 1-year cure rate per sponsor-investigator
* For patients with chronic hepatitis B viral infection, the hepatitis B virus (HBV) polymerase chain reaction (PCR) must be undetectable on suppressive therapy
* Patients with a history of Hepatitis C viral infection must have been treated and cured. For patients on treatment for hepatitis C, they are eligible if they have an undetectable hepatitis C virus (HCV) viral load
* Subjects with active uncontrolled infection
* Concurrent use of other anticancer agents or experimental treatments
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Genzyme, a Sanofi Company

INDUSTRY

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rahul Banerjee, MD

Role: PRINCIPAL_INVESTIGATOR

Fred Hutch/University of Washington Cancer Consortium

Locations

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Fred Hutch/University of Washington Cancer Consortium

Seattle, Washington, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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NCI-2021-03406

Identifier Type: REGISTRY

Identifier Source: secondary_id

10690

Identifier Type: OTHER

Identifier Source: secondary_id

RG1121154

Identifier Type: -

Identifier Source: org_study_id

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