A Study to Determine the Safety and Efficacy for the Combination of Durvalumab and Daratumumab in Relapsed and Refractory Multiple Myeloma
Condition: Multiple Myeloma
MeSH terms: Multiple Myeloma; Neoplasms, Plasma Cell
Intervention: Daratumumab; Durvalumab; Pomalidomide; Dexamethasone
Intervention MeSH terms: Dexamethasone; Durvalumab; Daratumumab; Pomalidomide
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 37.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Phase 2; Open-Label; Durvalumab; Daratumumab; Multiple Myeloma; Relapsed and Refractory (RRMM); FUSION MM-003; PD-L1

Summary:

      This is an open-label, multicenter study to confirm the safety and efficacy of durvalumab +
      daratumumab (D2) in subjects with relapsed and refractory multiple myeloma. This study will
      also explore the safety and efficacy of the addition of pomalidomide + dexamethasone to
      durvalumab + daratumumab (PD3).

      On 05 Sep 2017, a Partial Clinical Hold was placed on this study by the United States (US)
      Food and Drug Administration (FDA). The decision by the FDA was based on data related to
      risks of anti-programmed cell death-1 (PD-1) antibody, pembrolizumab, in combination with
      IMiDs® immunomodulatory drugs in patients with multiple myeloma. As a result, enrollment into
      this study has been discontinued. Subjects who are receiving clinical benefit, based on the
      discretion of the investigator, may remain on study treatment after being reconsented.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Must have measurable disease as defined by m-protein or serum free light chain.

          -  Must have failed last line of treatment (refractory to last line of treatment).

          -  Must have achieved at least a minimal response (MR) to at least 1 prior anti-myeloma
             regimen before developing PD (relapsed)

          -  Has performance status of 0, 1, or 2 on the Eastern Cooperative Oncology Group (ECOG)
             Performance Scale

          -  Must be at least 18 years of age

        Exclusion Criteria:

          -  Has non-secretory multiple myeloma

          -  Has had prior anti-myeloma therapy within 2 weeks prior to study Day 1

          -  Has received prior therapy with an anti-programmed cell death 1 receptor (anti-PD-1),
             antiprogrammed death-ligand 1 (anti-PD-L1), anti-PD-L2, anti-CD137, or anti-cytotoxic
             T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab or any other
             antibody or drug specifically targeting T-cell costimulation or checkpoint pathways).

          -  Has received prior treatment with daratumumab or other anti-CD38 therapies previously

          -  Has undergone prior organ or allogeneic hematopoetic stem cell transplantation

          -  Has received autologous stem cell transplantation (ASCT) within 12 weeks before the
             date of randomization.

          -  Has received prior treatment with a monoclonal antibody within 5 half-lives of Study
             Day 1

          -  Has received investigational agents within 28 days or 5 half-lives (whichever is
             longer) of Study Day 1

          -  Has received live, attenuated vaccine within 30 days prior to Study Day 1

          -  Has chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1
             second (FEV1) 50% of predicted normal

          -  Has moderate or severe persistent asthma within the past 2 years or uncontrolled
             asthma of any classification.

          -  Is positive for human immunodeficiency virus (HIV), chronic or active hepatitis B or
             active hepatitis A or C

          -  Has a prior history of malignancies, other than MM, unless the subject has been free
             of the disease for ≥ 5 years (with the exception Basal cell carcinoma of the skin,
             Squamous cell carcinoma of the skin, Carcinoma in situ of the cervix, Carcinoma in
             situ of the breast, Incidental histologic finding of prostate cancer [T1a or T1b] or
             prostate cancer that is curative)

          -  Has clinical evidence of central nervous system (CNS) or pulmonary leukostasis,
             disseminated intravascular coagulation, or CNS multiple myeloma

          -  Has clinically significant cardiac disease

          -  Is a female who is pregnant, nursing, or breastfeeding, or who intends to become
             pregnant during the participation in the study