Dose Escalation Study of JNJ-54767414 (Daratumumab) in Chinese Participants With Relapsed or Refractory Multiple Myeloma Who Failed at Least 2 Prior Lines of Systemic Therapy

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the tolerability, safety and the pharmacokinetic (PK) profile of daratumumab in Chinese participants with relapsed or refractory multiple myeloma (RRMM) who failed at least 2 prior lines of systemic therapy (Part 1 and Part 2); and to evaluate the tolerability and safety of daratumumab in Chinese participants whose prior therapy included a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD) and who have demonstrated disease progression on the last therapy (Part 3).

Official Title
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A Phase 1, Open-label, Dose Escalation Study of JNJ-54767414 (Daratumumab) in Chinese Subjects With Relapsed or Refractory Multiple Myeloma Who Failed at Least 2 Prior Lines of Systemic Therapy

Conditions
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Multiple Myeloma

Intervention / Treatment
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* Drug: Daratumumab


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Part 1 and 2: Chinese participant who must be at least 20 years of age Documented multiple myeloma (MM) with measurable disease according to protocol-defined criteria Relapsed or refractory multiple myeloma after receiving at least 2 prior lines of therapy Eastern Cooperative Oncology Group performance status score of 0, 1, or 2 Adequate recovery from prior therapy Part 3: Chinese participants who must be at least 18 years of age Received both a proteasome inhibitor (PI) (greater than or equal to [>=] 2 cycles or 2 months of treatment) and an immunomodulatory drug (IMiD) (>=2 cycles or 2 months of treatment) in any order during the course of treatment (except for participants who discontinued either of these treatments due to a severe allergic reaction within the first 2 cycles/months) Documented evidence of progressive disease (PD) based on investigator's determination of response as defined by the International Myeloma Working Group (IMWG) criteria on or after their last regimen Exclusion Criteria: Part 1 and 2: Received daratumumab or other anti-CD38 therapies previously Previously received an allogenic stem cell transplant or has received an autologous stem cell transplantation within 12 weeks Exhibiting clinical signs of meningeal involvement of multiple myeloma Known chronic obstructive pulmonary disease, known moderate or severe persistent asthma within the past 2 years, or uncontrolled asthma of any classification Known clinically significant cardiac disease Known to be seropositive for human immunodeficiency virus, hepatitis B or known to have a history of hepatitis C Has plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes), or amyloidosis Abnormal laboratory values according to protocol-defined parameters at screening Part 3: - Received anti-myeloma treatment within 2 weeks before Cycle 1, Day 1

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Part 1: Dose Escalation Part<br>Participants will receive single dose of daratumumab from Week 1 till Week 3 (Period 1 - single dosing period) followed by 6 weekly doses of daratumumab until Week 9 (Period 2 - weekly dosing period) and every 2 weeks for 8 infusions and then once every 4 weeks from Week 26 until disease progression, intolerability, or other reasons for treatment discontinuation (Period 3 - less intense dosing period). A dose of 8 milligram per kilogram (mg/kg) will be chosen as the starting dose and will be escalated to 16 mg/kg if the 8 mg/kg is determined safe and tolerated by study evaluation team (SET). | Drug: Daratumumab<br>* Intravenous (IV) infusion of 8 mg/kg or 16 mg/kg daratumumab.<br>* Other names: JNJ-54767414;|
| Experimental: Part 2: Pharmacokinetic (PK) Expansion Part<br>Participants will receive daratumumab at 16 mg/kg in 3 periods as given in the Part 1. | Drug: Daratumumab<br>* Intravenous (IV) infusion of 8 mg/kg or 16 mg/kg daratumumab.<br>* Other names: JNJ-54767414;|
| Experimental: Part 3: Safety Expansion Part<br>Participants will receive daratumumab 16 mg/kg every week for 8 weeks followed by every 2 weeks for an additional 16 weeks, and then every 4 weeks thereafter. Participants will be treated with daratumumab until disease progression, intolerability, or any other reasons for treatment discontinuation. | Drug: Daratumumab<br>* Intravenous (IV) infusion of 8 mg/kg or 16 mg/kg daratumumab.<br>* Other names: JNJ-54767414;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Adverse Events (AEs) as a Measure of Safety and Tolerability (Part 1,2 and 3) |  | From the time of signing of informed consent form (ICF) until 30 days after the last study drug dose (approximately 2 years) | 
| Maximum Observed Plasma Concentration (Cmax) (Part 1 and 2) | The Cmax is the maximum observed plasma concentration. | Until Cycle 14, Day 1 (each cycle of 21 days till Cycle 3 and 28 days Cycle 4 onward) | 
| Trough Analyte Concentration (Ctrough) (Part 1 and 2) | The (Ctrough) is the concentration before dosing just prior to the beginning of a doing interval. | Until Cycle 14, Day 1 (each cycle of 21 days till Cycle 3 and 28 days Cycle 4 onward) | 
| Area Under the Plasma Concentration-Time Curve (AUC) (Part 1 and 2) | AUC is defined as area under the plasma concentration-time curve. | Until Cycle 14, Day 1 (each cycle of 21 days till Cycle 3 and 28 days Cycle 4 onward) | 
| Systemic Clearance (CL) (Part 1 and 2) | Systemic Clearance (CL) is a quantitative measure of the rate at which a drug substance is removed from the body. The total systemic clearance after intravenous dose was estimated by dividing the total administered dose by the plasma Area Under the Plasma Concentration-Time Curve From Time Zero to Infinite Time (AUC [0-infinity]). | Until Cycle 14, Day 1 (each cycle of 21 days till Cycle 3 and 28 days Cycle 4 onward) | 
| Elimination Half-Life (t1/2) (Part 1 and 2) | Elimination half-life (t[1/2]) is associated with the terminal slope (lambda [z]) of the semi-logarithmic drug concentration-time curve, calculated as 0.693/lambda(z). | Until Cycle 14, Day 1 (each cycle of 21 days till Cycle 3 and 28 days Cycle 4 onward) | 
| Volume of Distribution (Vd) (Part 1 and 2) | The Vd is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired blood concentration of a drug. | Until Cycle 14, Day 1 (each cycle of 21 days till Cycle 3 and 28 days Cycle 4 onward) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall Response Rate (ORR) | ORR is defined as the proportion of participants who achieve complete response [CR] (including sCR) according to the IMWG criteria, during or after the study treatment. IMWG criteria CR: Negative immunofixation on the serum and urine, disappearance of any soft tissue plasmacytomas and less than (<)5 % plasma cells (PCs) in bone marrow; sCR: CR along with normal free light chain (FLC) ratio and absence of clonal PCs by immunohistochemistry, immunofluorescence or 2 to 4 color flow cytometry. Partial Response (PR): more than equal to (>=) 50percent (%) reduction of serum M-protein and reduction in 24-hour urinary M-protein by >=90% or to <200 mg/24 hours; VGPR: Serum and urine M-component detectable by immunofixation but not on electrophoresis, or >= 90 % reduction in serum M-protein plus urine M-protein less than (<)100 mg/24 hours. | From the date of first dose of daratumumab to the date of initial documentation of progressive disease (approximately 2 years) | 
| Time to Response | Time to response is defined as the time between the date of first dosing and the first efficacy evaluation that the participant has met all criteria for PR (including VGPR) or CR (including sCR). | From the date of first dose of daratumumab to the date of initial documentation of a response (approximately 2 years) | 
| Duration of Response | Duration of Response will be calculated from date of initial documentation of a response (CR/PR) to date of first documented evidence of PD. IMWG criteria for PD- Increase of 25% from lowest response value in any one of following: Serum M-component (absolute increase must be >=0.5 gram per deciliter [g/dL]), urine M-component (absolute increase must be >=200 mg/24 hours), only in participants without measurable serum and urine M-protein levels: difference between involved and uninvolved FLC levels (absolute increase must be >10 mg/dL), only in participants without measurable serum and urine M-protein levels and without measurable disease by FLC levels, bone marrow PC percentage (absolute percentage must be >=10%). Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in size of existing bone lesions or soft tissue plasmacytomas. Development of hypercalcemia (corrected serum calcium >11.5 mg/dL) that can be attributed to PC proliferative disorder. | From the date of initial documentation of a response to the date of first documented evidence of progressive disease (approximately 2 years) | 
| Progression-Free Survival (PFS) | PFS is defined as the time from the date of first dose of daratumumab to the date of first documented Progressive disease (PD), as per International Myeloma Working Group (IMWG) criteria, or death due to any cause, whichever occurs first. | From the date of first dose of daratumumab to the date of first documented progressive disease (approximately 2 years) | 
| Overall Survival (OS) | Overall survival (OS) is measured from the date of first dose of daratumumab to the date of the participant's death. | From the date of first dose of daratumumab to the date of the participant's death (approximately 2 years) | 
| Number of Participants With Incidence of Antibodies to Daratumumab |  | Up to Follow-up Phase-Week 8 |