Phase 2
Completed N=89
Phase 1/2 Dose Escalation and Efficacy Study of Anti-CD38 Monoclonal Antibody in Patients With Selected CD38+ Hematological Malignancies
Source: ClinicalTrials.gov NCT01084252 ↗Enrolled (actual)
89
Serious AEs
45.1%
Results posted
Apr 2020
Primary outcomePrimary: Phase 1: Number of Participants With Dose Limiting Toxicities (DLTs) — 1; 1; 0; 0 Participants
Summary
Primary Objective:
Phase 1:
To determine the maximum tolerated dose (MTD)/maximum administered dose (MAD) of SAR650984 (Isatuximab).
Phase 2 (stage 1):
To evaluate the activity of single-agent Isatuximab at different doses/schedules and to select dose and regimen to further evaluate the overall response rate (ORR) of Isatuximab as single agent or in combination with dexamethasone.
Phase 2 (stage 2):
To evaluate the activity in terms of overall response rate (ORR) of Isatuximab at the selected dose/schedule from stage1, as single agent (ISA arm) and in combination with dexamethasone (ISAdex arm).
Secondary Objectives:
Phase 1:
* To characterize the global safety profile including cumulative toxicities.
* To evaluate the pharmacokinetic (PK) profile of Isatuximab in the proposed dosing schedule(s).
* To assess the pharmacodynamics (PD), immune response, and preliminary disease response.
Phase 2 (stage 1): to evaluate the following objectives for Isatuximab as single agent:
* Safety
* Efficacy as measured by duration of response, clinical benefit rate, progression free survival, overall survival.
Phase 2 (stage 2): to evaluate the following objectives in each arm (ISA and ISAdex):
* Safety
* Efficacy as measured by duration of response, clinical benefit rate, progression free survival, overall survival.
* Participant-reported changes in health-related quality of life, symptoms of multiple myeloma and generic health status.
* Pharmacokinetic profile of Isatuximab.
* Immunogenicity of Isatuximab.
* Investigate the relationship between CD38 receptor density and CD38 receptor occupancy (Stage 1 only) on multiple myeloma cells and parameters of clinical response.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Phase 1: Number of Participants With Dose Limiting Toxicities (DLTs) |
1; 1; 0; 0; 0; 0 | — |
| PRIMARY Phase 1: Number of Participants With Treatment Emergent Adverse Events (TEAEs) |
16; 6; 3; 26; 18; 6 | — |
| PRIMARY Phase 2 Stage 1: Percentage of Participants With Overall Response (OR) According to International Myeloma Working Group (IMWG) Uniform Response Criteria |
4.3; 29.2; 20.0; 24.0 | — |
| PRIMARY Phase 2 Stage 2: Percentage of Participants With Overall Response According to Updated IMWG Response Criteria |
23.9; 43.6 | — |
| SECONDARY Pharmacokinetic (PK) Assessment: Phase 1: Plasma Concentration of Isatuximab Observed at the End of an Intravenous Infusion (Ceoi) |
2.08667; 13.18333; 44.22500; 125.50000; 171.43333; 148.80000 | — |
| SECONDARY PK Assessment: Phase 1: Maximum Observed Plasma Concentration (Cmax) of Isatuximab |
2.00; 12.4; 53.7; 126; 181; 154 | — |
| SECONDARY PK Assessment: Phase 1: Time to Reach Maximum Plasma Concentration Observed (Tmax) of Isatuximab |
2.49; 4.35; 6.99; 7.65; 4.28; 4.92 | — |
| SECONDARY PK Assessment: Phase 1: Plasma Concentration of Isatuximab at Week 1, 2 and 3 |
0.00223; 1.44; 15.3; 27.6; 44.2; 20.7 | — |
| SECONDARY PK Assessment: Phase 1: Predicted Cumulative Area Under the Plasma Concentration Curve (AUC) of Isatuximab Over the First Week (0-168 Hours) (AUC1W) |
222; 2624; 7174; 11566; 13480; 12680 | — |
| SECONDARY PK Assessment: Phase 1: Predicted Cumulative Area Under the Plasma Concentration Curve (AUC) of Isatuximab Over the First 2 Weeks (0-336 Hours) (AUC2W) |
222; 3076; 9546; 14876; 18967; 30187 | — |
| SECONDARY Pharmacodynamic (PD) Assessment: Phase 1: Change From Baseline in Serum/Plasma Markers |
163.181; 179.783; 352.974; 340.799; 503.462; 342.664 | — |
| SECONDARY Immunogenicity Assessment: Phase 1: Number of Participants With Treatment-Emergent And Treatment-Boosted Anti-drug Antibodies (ADA) Response |
2; 0; 0; 1; 1; 1 | — |
| SECONDARY Clinical Assessment: Phase 1: Percentage of Participants With Overall Response and Clinical Benefit: Assessed Using European Society for Blood and Marrow Transplantation (EBMT) Criteria |
33.3; 0; 33.3; 28.0; 16.7; 33.3 | — |
| SECONDARY Clinical Assessment: Phase 1: Duration of Response (DOR) |
20.21; 7.16; 5.76; 10.70; 14.31; 3.94 | — |
| SECONDARY Clinical Assessment: Phase 1: Time to First Response (TTR) |
0.95; 6.41; 2.52; 1.96; 1.38; 1.18 | — |
| SECONDARY Clinical Assessment: Phase 1: Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) (Karnofsky Performance Status)-Shift From Baseline Value to Best Value During Treatment |
11; 2; 11 | — |
| SECONDARY Clinical Assessment: Phase 1: Number of Participants With Eastern Cooperative Oncology Group Performance Status (Karnofsky Performance Status)-Shift From Baseline Value to Worst Value During Treatment |
8; 1; 3; 20; 1; 2 | — |
| SECONDARY Phase 2 Stage 1: Number of Participants With Treatment Emergent Adverse Events (TEAEs) |
22; 24; 25; 25 | — |
| SECONDARY Phase 2 Stage 2: Number of Participants With Treatment Emergent Adverse Events (TEAEs) |
101; 51 | — |
| SECONDARY Phase 2 Stage 1: Duration of Response |
1.91; 11.17; 7.31; 8.11 | — |
| SECONDARY Phase 2 Stage 2: Duration of Response |
8.6; 10.9 | — |
| SECONDARY Phase 2 Stage 1: Percentage of Participants With Clinical Benefit |
4.3; 41.7; 32.0; 36.0 | — |
| SECONDARY Phase 2 Stage 2: Percentage of Participants With Clinical Benefit |
43.1; 54.5 | — |
| SECONDARY Phase 2 Stage 1: Progression Free Survival (PFS) |
2.1; 9.6; 4.4; 3.6 | — |
| SECONDARY Phase 2 Stage 2: Progression Free Survival |
4.86; 10.15 | — |
| SECONDARY Phase 2 Stage 1: Overall Survival (OS) |
15.277; 18.628; NA; NA | — |
| SECONDARY Phase 2 Stage 2: Overall Survival |
18.92; 17.25 | — |
| SECONDARY Phase 2 Stage 1: Change From Baseline in Health Related Quality of Life (HRQL) European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Scores: Global Health Status |
-8.33; 2.22; -3.95; 0.00; 0.00; -0.76 | — |
| SECONDARY Phase 2 Stage 1: Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Multiple Myeloma Specific Module With 20 Items (EORTC QLQ-MY20) Scores: Disease Symptom Subscale Score |
5.56; -3.42; 0.93; 2.61; 7.94; -5.05 | — |
| SECONDARY Phase 2 Stage 1: Change From Baseline in Euro Quality of Life 5 Dimension (EQ-5D) Generic Health Status - Visual Analogue Scale Scores |
-5.75; 2.00; -4.78; 4.89; -2.50; -6.00 | — |
| SECONDARY Pharmacokinetic Assessment: Phase 2 Stage 2: Area Under the Plasma Concentration Versus Time Curve of Isatuximab Over 1 Week Interval |
37096; 35423 | — |
| SECONDARY Pharmacokinetic Assessment: Phase 2 Stage 2: Area Under the Plasma Concentration Versus Time Curve of Isatuximab Over 2 Weeks Interval |
91271; 86761 | — |
| SECONDARY Pharmacokinetic Assessment: Phase 2 Stage 2: Area Under the Plasma Concentration Versus Time Curve of Isatuximab Over 4 Weeks Interval |
236360; 226372 | — |
| SECONDARY Pharmacokinetic Assessment: Phase 2 Stage 2: Plasma Concentration of Isatuximab Before Treatment Administration (Ctrough) |
137; 128; 230; 214; 360; 305 | — |
| SECONDARY Pharmacokinetic Assessment: Phase 2 Stage 2: Accumulation Ratio of Isatuximab Based on Ctrough |
521.38338; 3.24370; 3.58378; 3.95950 | — |
| SECONDARY Immunogenicity Assessment: Phase 2 Stage 2: Number of Participants With Anti-drug Antibodies to Isatuximab |
1; 0; 0; 0 | — |
Eligibility Criteria
Inclusion criteria
Phase 1:
- For dose escalation cohorts, participants with confirmed selected CD38+ hematological malignancies as specified below who had progressed on after standard therapy or for whom there was no effective standard therapy (refractory/relapsed participants). B-cell Non-Hodgkin-lymphoma/leukemia (NHL) participants with at least 1 measurable lesion. Multiple myeloma (MM) participants with measurable M-protein serum and/or 24-hour urine. Acute myeloid leukemia (AML) participants, all types except M3 based on French-American-British (FAB) classification. Acute Lymphoblastic Leukemia (B-cell ALL) participants. Chronic lymphocytic leukemia (CLL) participants.
- For expansion cohorts, participants with relapsed/refractory MM with measurable M-protein (serum M-protein of >0.5 g/dL and/or urine M-protein of >200 mg (24-hr urine)) or elevated serum free light chains (FLC) >10 mg/dL with abnormal FLC ratio) who had progressed on or after standard therapy that included an Immunomodulatory drug (IMiD) and a proteasome inhibitor and who met the protocol defined criteria for standard risk or high risk.
Phase 2:
- Participants had a known diagnosis of multiple myeloma with evidence of measurable disease, and have evidence of disease progression based on International Myeloma Working Group (IMWG) criteria: Serum M-protein ≥1 g/dL, or urine M-protein >=200 mg/24 hours or in the absence of measurable m-protein, serum FLC >=10 mg/dL, and abnormal serum immunoglobulin kappa lambda FLC ratio ( 1.65).
- Participants who received at least three prior lines of therapy for MM and had treatment with an IMiD (for >=2 cycles or >=2 months of treatment) and a proteasome inhibitor (PI) (for >=2 cycles or >=2 months of treatment) OR participants whose disease was double refractory to an IMiD and a PI. For participants who had received more than 1 type of IMiD and PI, their disease must be refractory to the most recent one.
- Participants who had achieved a minimal response or better to at least one prior line of therapy.
- Participants who had received an alkylating agent (>=2 cycles or >=2 months) either alone or in combination with other MM treatments.
- Stage 2 only: Participants who had evidence of disease progression on or after the most recent prior regimen based on IMWG criteria.
Exclusion criteria
Phase 1:
- Karnofsky performance status 2 (stage 2).
- Poor bone marrow reserve
- Poor organ function
- Known intolerance to infused protein products, sucrose, histidine, polysorbate 80 or known hypersensitivity to any of the components of the study therapy that was not amenable to pre-medication with steroids and H2 blockers
- Any serious active disease (including clinically significant infection that was chronic, recurrent, or active) or co-morbid condition, which, in the opinion of the investigator, interfered with the safety, the compliance with the study or with the interpretation of the results
- Any severe underlying medical conditions including presence of laboratory abnormalities, which impaired the ability to participate in the study or the interpretation of its results
The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Data sourced from ClinicalTrials.gov (NCT01084252). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.