study of carfilzomib, daratumumab and dexamethasone for patients with relapsed and/or refractory multiple myeloma.

Conditions: Relapsed Multiple Myeloma; Refractory Multiple Myeloma

Summary: compare carfizomib, dexamethasone, and daratumumab (kdd) to carfilzomib and dexamethasone (kd) in terms of progression free survival (pfs) in participants with multiple myeloma who have relapsed after 1 to 3 prior therapies.

this is a phase 3 multicenter, open-label, randomized study in participants with relapsed or refractory multiple myeloma (rrmm) who have received 1 to 3 prior therapies. participants receive the treatment determined by randomization for a maximum of approximately 5 years, up to 30 days prior to the final analysis data cutoff (dco) date or until confirmed disease progression, unacceptable toxicity, withdrawal of consent, or death (whichever occurs first). no crossover between the treatment arms is allowed. this was an open-label study. however, the assessment of response and disease progression for the primary analysis was determined by an independent review committee (irc) in a blinded manner. sensitivity analyses of response and disease progression were determined centrally by the sponsor using a validated computer algorithm (onyx response computational assessment \[orca\]) in a blinded manner. following progression or discontinuation of study drug(s), participants will have 1 follow-up visit (30 days \[+3} after last dose of all study drug\[s\]). after disease progression, data on survival status and subsequent antimyeloma therapy will be gathered at long-term follow-up (ltfu) visits every 12 weeks (+/-2 weeks) until the final analysis dco.

Eligibility criteria:
inclusion criteria: * criteria 1 relapsed or progressive multiple myeloma after last treatment * criteria 2 males or females ≥ 18 years of age * criteria 3 measurable disease with at least 1 of the following assessed within 21 days prior to randomization: * igg multiple myeloma: serum monoclonal paraprotein (m-protein) level ≥ 1.0 g/dl, * iga, igd, ige multiple myeloma: serum m-protein level ≥ 0.5 g/dl, * urine m-protein ≥ 200 mg/24 hours, * in subjects without measurable serum or urine m- protein, serum free light chain (sflc) ≥ 100 mg/l (involved light chain) and an abnormal serum kappa lambda ratio * criteria 4 received at least 1 but not more than 3 prior lines of therapy for multiple myeloma (induction therapy followed by stem cell transplant and consolidation/maintenance therapy will be considered as 1 line of therapy * criteria 5 prior therapy with carfilzomib is allowed as long as the patient had at least a partial response (pr) to most recent therapy with carfilzomib, was not removed due to toxicity, did not relapse within 60 days from discontinuation of carfilzomib, and will have at least a 6-month carfilzomib treatment-free interval from last dose received until first study treatment. (patients may receive maintenance therapy with drugs that are not proteasome inhibitors or cd38 antibodies during this 6-month carfilzomib treatment free interval) * criteria 6 prior therapy with anti-cd38 antibodies is allowed as long as the patient had at least a pr to most recent therapy with cd38 antibody, was not removed due to toxicity, did not relapse within 60 days from intensive treatment (at least every other week) of cd38 antibody therapy, and will have at least a 6 month cd38 antibody treatment-free interval from last dose received until first study treatment * other inclusion criteria may apply exclusion criteria: * criteria 1 waldenström macroglobulinemia * criteria 2 multiple myeloma of igm subtype * criteria 3 poems syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) * criteria 4 plasma cell leukemia (\> 2.0 \* 10\^9/l circulating plasma cells by standard differential) * criteria 5 myelodysplastic syndrome * criteria 6 known moderate or severe persistent asthma within the past 2 years * criteria 7 known chronic obstructive pulmonary disease (copd) with a fev1 \< 50% of predicted normal * criteria 8 active congestive heart failure (new york heart association \[nyha\] class iii to iv), symptomatic ischemia, uncontrolled arrhythmias, clinically significant electrocardiogram (ecg) abnormalities, screening ecg with corrected qt interval (qtc) of \> 470 msec, pericardial disease, or myocardial infarction within 4 months prior to randomization * other exclusion criteria may apply

Keywords: carfilzomib dexamethasone daratumumab