Phase 2
N=221
A Study to Investigate the Efficacy and Safety of Two Doses of GSK2857916 in Participants With Multiple Myeloma Who Have Failed Prior Treatment With an Anti-CD38 Antibody
Multiple Myeloma
Bottom Line
View on ClinicalTrials.gov: NCT03525678 ↗Enrolled (actual)
221
Serious AEs
51.6%
Results posted
Apr 2020
Primary outcome: Primary: Overall Response Rate (ORR) by Independent Review Committee (IRC) (Full Analysis Population) — 31; 34; 48 Percentage of Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Belantamab mafodotin frozen liquid (Drug); Belantamab mafodotin lyophilized powder (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- Jun 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Response Rate (ORR) by Independent Review Committee (IRC) (Full Analysis Population) |
31; 34; 48 | — |
| PRIMARY Overall Response Rate by Independent Review Committee (Efficacy Population) |
30; 30 | — |
| SECONDARY Overall Response Rate by Investigator Assessment (IA) (Full Analysis Population) |
33; 32; 52 | — |
| SECONDARY Overall Response Rate by Investigator Assessment (Efficacy Population) |
33; 26 | — |
| SECONDARY Clinical Benefit Rate (CBR) by Investigator Assessment (Full Analysis Population) |
35; 38; 60 | — |
| SECONDARY Clinical Benefit Rate by Investigator Assessment (Efficacy Population) |
34; 35 | — |
| SECONDARY Clinical Benefit Rate by Independent Review Committee (Full Analysis Population) |
36; 40; 56 | — |
| SECONDARY Clinical Benefit Rate by Independent Review Committee (Efficacy Population) |
34; 38 | — |
| SECONDARY Duration of Response (DoR) by Investigator Assessment (Full Analysis Population) |
12.4; 12.6; 5.3 | — |
| SECONDARY Duration of Response by Investigator Assessment (Efficacy Population) |
6.9; 15.9 | — |
| SECONDARY Duration of Response by Independent Review Committee (Full Analysis Population) |
12.5; 6.2; 9.0 | — |
| SECONDARY Duration of Response by Independent Review Committee (Efficacy Population) |
11.0; 15.9 | — |
| SECONDARY Time to Response by Investigator Assessment (Full Analysis Population) |
1.5; 1.5; 0.9 | — |
| SECONDARY Time to Response by Investigator Assessment (Efficacy Population) |
1.4; 1.5 | — |
| SECONDARY Time to Response by Independent Review Committee (Full Analysis Population) |
1.5; 1.4; 0.9 | — |
| SECONDARY Time to Response by Independent Review Committee (Efficacy Population) |
1.5; 1.4 | — |
| SECONDARY Progression Free Survival by Investigator Assessment |
2.2; 3.2; 3.6 | — |
| SECONDARY Progression Free Survival by Independent Review Committee |
2.8; 3.9; 5.7 | — |
| SECONDARY Time to Progression by Investigator Assessment |
2.2; 3.9; 3.6 | — |
| SECONDARY Time to Progression by Independent Review Committee |
2.9; 4.9; 5.7 | — |
| SECONDARY Overall Survival |
15.3; 14.0; 24.5 | — |
| SECONDARY Number of Participants With Change From Baseline in Hematology Parameters With Respect to the Normal Range |
2; 7; 0; 87; 85; 19 | — |
| SECONDARY Number of Participants With Grade Change From Baseline in Hematology Parameters |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With Change From Baseline in Clinical Chemistry Parameters With Respect to the Normal Range |
12; 22; 4; 67; 59; 16 | — |
| SECONDARY Number of Participants With Grade Change From Baseline in Clinical Chemistry Parameters |
3; 5; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With Abnormal Findings During Physical Examination |
— | — |
| SECONDARY Number of Participants With Change From Baseline in Pulse Rate |
14; 17; 6; 57; 55; 15 | — |
| SECONDARY Number of Participants With Change From Baseline in Body Temperature |
1; 3; 0; 86; 85; 21 | — |
| SECONDARY Number of Participants With Grade Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) |
29; 41; 4; 14; 22; 8 | — |
| SECONDARY Number of Participants With Serious Adverse Events (SAEs), Common (>=5%) Non-serious Adverse Events and Adverse Events of Special Interest (AESI) |
93; 96; 24; 43; 53; 15 | — |
| SECONDARY Number of Participants With Change From Baseline in Best Corrected Visual Acuity (BCVA) Test Scores |
35; 45; 4; 11; 15; 4 | — |
| SECONDARY Number of Participants With Intraocular Pressure (IOP) >=22 mmHg Anytime Post-Baseline |
17; 16; 8; 14; 15; 7 | — |
| SECONDARY Number of Participants With Shift in Pupillary Examination Findings From Normal (Baseline) to Abnormal (Worst Post-Baseline) |
4; 12; 3 | — |
| SECONDARY Number of Participants With Shift in Extraocular Muscle Movement From Yes (Baseline) to no (Worst Post-Baseline) |
0; 4; 0; 0; 2; 0 | — |
| SECONDARY Number of Participants With Shift in Corneal Epithelium Findings From Normal (Baseline) to Abnormal (Worst Post-Baseline) for Corneal Epithelium (CE) and Corneal Stroma (CS) |
39; 40; 16; 39; 44; 14 | — |
| SECONDARY Number of Participants With Shift in Corneal Epithelium Findings From no (Baseline) to Yes (Worst Post-Baseline) |
3; 5; 1; 4; 4; 1 | — |
| SECONDARY Number of Participants With Shift in Tear Break-up Time From >10 Seconds (Baseline) to <=5 Seconds (Worst Post-Baseline) |
14; 12; 2; 11; 12; 1 | — |
| SECONDARY Area Under the Concentration-time Curve From Time Zero Extrapolated to Infinite Time (AUC[0-infinity]) of GSK2857916 Following IV Dose in Participants With RRMM |
5644; 6495; 6962; 7848; 9199; 9694 | — |
| SECONDARY Area Under the Concentration-time Curve Over the Dosing Interval (AUC[0-tau]) of GSK2857916 Following IV Dose in Participants With RRMM |
4666; 5678; 5946; 6399; 6941; 7593 | — |
| SECONDARY Area Under the Concentration-time Curve From Zero to Time of Last Quantifiable Concentration (AUC[0-tlast]) of GSK2857916 Following IV Dose in Participants With RRMM |
4607; 5567; 6293; 6033; 6084; 8388 | — |
| SECONDARY Maximum Observed Concentration (Cmax) of GSK2857916 Following IV Dose in Participants With RRMM |
42.51; 52.03; 51.32; 42.35; 45.5; 48.06 | — |
| SECONDARY Time to Reach Maximum Observed Concentration (Tmax) of GSK2857916 Following IV Dose in Participants With RRMM |
0.780; 0.700; 0.750; 0.580; 0.715; 0.870 | — |
| SECONDARY Terminal Half-life (t1/2) of GSK2857916 Following IV Dose in Participants With RRMM |
164.4; 165.8; 196.2; 193.7; 214.4; 279.5 | — |
| SECONDARY AUC(0-infinity) of GSK2857916 Total Antibody Following IV Dose in Participants With RRMM |
10268; 10209; 10170; 20526; 18637; 22782 | — |
| SECONDARY AUC(0-tau) of GSK2857916 Total Antibody Following IV Dose in Participants With RRMM |
7305; 9566; 9029; 11243; 11646; 15311 | — |
| SECONDARY AUC(0-tlast) of GSK2857916 Total Antibody Following IV Dose in Participants With RRMM |
7417; 9628; 9017; 10725; 11295; 17715 | — |
| SECONDARY Cmax of GSK2857916 Total Antibody Following IV Dose in Participants With RRMM |
48.94; 61.06; 60.08; 49.34; 55.60; 65.07 | — |
| SECONDARY Tmax of GSK2857916 Total Antibody Following IV Dose in Participants With RRMM |
1.750; 1.870; 0.650; 0.830; 1.150; 1.750 | — |
| SECONDARY t1/2 of GSK2857916 Total Antibody Following IV Dose in Participants With RRMM |
241.8; 250.8; 299.8; 352.4; 372.0; 557.3 | — |
| SECONDARY AUC(0-infinity) of Cysteine-maleimidocaproyl Monomethyl Auristatin F (Cys-mcMMAF) Following IV Dose of GSK2857916 in Participants With RRMM |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY AUC(0-tau) of Cys-mcMMAF Following IV Dose of GSK2857916 in Participants With RRMM |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY AUC(0-tlast) of Cysteine-maleimidocaproyl Monomethyl Auristatin F (Cys-mcMMAF) Following IV Dose of GSK2857916 in Participants With RRMM |
79.26; 113.57; 100.35; 70.84; 74.04; 69.83 | — |
| SECONDARY Cmax of Cys-mcMMAF Following IV Dose of GSK2857916 in Participants With RRMM |
0.903; 1.148; 1.017; 0.660; 0.749; 0.656 | — |
| SECONDARY Tmax of Cys-mcMMAF Following IV Dose of GSK2857916 in Participants With RRMM |
22.830; 23.835; 24.080; 23.235; 22.570; 22.780 | — |
| SECONDARY t1/2 of Cys-mcMMAF Following IV Dose of GSK2857916 in Participants With RRMM |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Number of Participants With at Least One Confirmed Positive Post-Baseline Anti-drug Antibody (ADA) Result |
2; 0; 0 | — |
| SECONDARY Titers of Anti-drug Antibodies Against GSK2857916 |
125.0; 100.0 | — |
| SECONDARY Number of Participants With Symptomatic AEs Measured by Patient-reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) |
59; 67; 19; 39; 36; 12 | — |
| SECONDARY Worst Change From Baseline in National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) Overall Composite Score |
-20.0; -19.6; -23.1 | — |
| SECONDARY Worst Change From Baseline in Ocular Surface Disease Index (OSDI) Total Score |
26.9; 28.2; 35.0 | — |
| SECONDARY Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30-item Core Module (EORTC QLQ-C30) Score |
-0.7; -4.1; 1.5; -3.2; 6.0; 1.0 | — |
| SECONDARY Change From Baseline in EORTC QLQ 20-item Multiple Myeloma Module (MY20) Score |
2.8; 4.2; 8.3; -2.0; 8.3; -2.2 | — |
Summary
Multiple myeloma (MM) is an incurable malignancy and accounts for 1 percentage (%) of all cancers and for 10% of all hematologic malignancies. Participants with relapsed/refractory multiple myeloma (RRMM) will be included in this study, to evaluate the efficacy and safety of belantamab mafodotin (GSK2857916) monotherapy. Participants will be treated with belantamab mafodotin monotherapy until disease progression (PD) or unacceptable toxicity and will be followed for Progression Free Survival and Overall survival. The participants will be randomized to receive either frozen belantamab mafodotin at the dose of 2.5 milligram per kilogram (mg/kg) or 3.4 mg/kg administered Intravenously (IV). There will be an independent cohort of participants who will receive a lyophilized configuration of belantamab mafodotin. For participants who discontinued from the study other than Progressive disease (PD), disease evaluation will continue to be performed at 3-week intervals until confirmed PD, death, start of a new anticancer treatment, withdrawal of consent, or end of the study whichever occurs first.
Eligibility Criteria
Inclusion Criteria
- Participants who provided signed written informed consent, which includes compliance with the requirements and restrictions listed in the consent form.
- Male or female, 18 years or older.
- Participants with Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
- Participants with histologically or cytologically confirmed diagnosis of MM as defined in IMWG, 2014 criteria, and participant has undergone stem cell transplant or is considered transplant ineligible and has failed at least 3 prior lines of anti-myeloma treatments, including an anti-CD38 antibody (example [e.g.], daratumumab) alone or in combination, and is refractory to an Immunomodulatory drug (IMiD) (that is [i.e.], lenalidomide or pomalidomide), and to a proteasome inhibitor (e.g., bortezomib, ixazomib or carfilzomib).
- The participant has measurable disease with at least one of the following: Serum M-protein >=0.5 grams per deciliter (g/dL) (>=5 grams per Liter [g/L]); Urine M-protein >=200 milligram per 24 hours (mg/24h); Serum Free light chain (FLC) assay: Involved FLC level >=10 mg/dL (>=100 mg/Liter) and an abnormal serum FLC ratio ( 1.65).
- Participants with a history of autologous stem cell transplant are eligible for study participation provided the following eligibility criteria are met: transplant was >100 days prior to study enrollment; no active infection(s); participants meet the remainder of the eligibility criteria outlined in the protocol.
- Participants with adequate organ system functions as defined follows: Absolute neutrophil count (ANC) >=1.0 X 10^9/L; Hemoglobin >=8.0 g/dL; Platelets>= 50 X 10^9/L; Total bilirubin =1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin =30 milliliter per minute per 1.73 meter square (mL/min/m^2); Spot urine (albumin/creatinine ratios [spot urine]) =45 percent.
- Female participants: Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. A female participant is eligible to participate if she is not pregnant or breastfeeding, and not a woman of childbearing potential (WOCBP) or is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of =60 mg prednisone daily for >=4 days) within the past 14 days if administered to treat MM or non-MM disease.
- Symptomatic amyloidosis, active 'polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes' (POEMS) syndrome, active plasma cell leukemia at the time of screening.
- Prior allogeneic stem cell transplant.
- Current corneal epithelial disease except mild punctate keratopathy.
- Use of an investigational drug within 14 days or five half-lives, whichever is shorter, preceding the first dose of study drug. Prior treatment with a monoclonal antibody within 30 days of receiving the first dose of study drugs. Prior B-cell maturation antigen (BCMA) targeted therapy.
- Evidence of active mucosal or internal bleeding.
- Any major surgery within the last four weeks.
- Presence of active renal condition (infection, requirement for dialysis or any other condition that could affect participant's safety). Participants with isolated proteinuria resulting from MM are eligible.
- Any serious and/or unstable pre-existing medical, psychiatric disorder or other conditions (including lab abnormalities) that could interfere with participant's safety, obtaining informed consent or compliance to the study procedures.
- Current unstable liver or biliary disease per investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis.
- Malignancies other than disease under study are excluded, except for any other malignancy from which the participant has been disease-free for more than 2 years and, in the opinion of the principal investigators and GlaxoSmithKline Medical Monito
Data sourced from ClinicalTrials.gov (NCT03525678). 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.