Clinical trial NCT04000282: First-in-human Single Agent Study of SAR442085 in Relapsed or Refractory Multiple Myeloma
Official title: An Open-label, First-in-human, Single Agent, Dose-escalation and Expansion Study for the Evaluation of Safety, Pharmacokinetics, Pharmacodynamics and Anti-tumor Activity of SAR442085 in Patients With Relapsed or Refractory Multiple Myeloma (RRMM)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Plasma Cell Myeloma
Lead sponsor: Sanofi
Sponsor class: INDUSTRY
First posted: 2019-06-27
Enrollment: 37
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: TREATMENT

Brief summary: Primary Objectives:

* Dose Escalation Part A: To determine the maximum tolerated dose (MTD) of SAR442085 administered as a single agent in patients with relapsed or refractory multiple myeloma (RRMM), and determine the recommended Phase 2 dose (RP2D) for the subsequent Expansion Part B
* Dose Expansion Part B: To assess the antitumor activity of single agent of SAR442085 at the RP2D in patients with RRMM

Secondary Objectives:

* To characterize the safety profile of SAR442085
* To characterize the pharmacokinetics (PK) profile of SAR442085 when administered as a single agent
* To evaluate the potential immunogenicity of SAR442085
* To assess preliminary evidence of antitumor activity in the Dose Escalation Part A

Detailed description: Patient will continue to receive study medication until disease progression, unacceptable toxicity, withdrawal of informed consent, or other reason why investigator considers it appropriate to discontinue study medication. Once permanently discontinued, study medication cannot be restarted at later timepoint.

Eligibility criteria: Inclusion criteria :

* Participant must be at least 18 years of age or of the country's legal age of majority if the legal age is \>18 years old, at the time of signing the informed consent.
* Participant has given voluntary written informed consent.
* Participant has been previousy diagnosed with multiple myeloma based on standard criteria.
* Part A: (1) participant has received at least 3 prior lines of therapy for multiple myeloma, or at least 2 prior lines of therapy if at least 1 of those lines consisted of 2 or more multi-agent regimens (eg, multi-agent induction regimen with autologous stem cell transplantation, followed by maintenance regimen). (2) Prior therapy for multiple myeloma has included at least 1 proteasome inhibitor (bortezomib, carfilzomib, ixazomib), at least 1 immunomodulatory agent (lenalidomide, thalidomide, pomalidomide), at least 1 anti-CD38 monoclonal antibody and at least 1 steroid. Applicable countries in EU and Asia can enroll anti-CD38 naive RRMM patients from DL4 and onwards. (3) Participant had at least a minimal response (MR) to the anti-CD38 antibody containing regimen and had last dose of anti-CD38 monoclonal antibody at least 9 months prior to study entry. Applicable countries in EU and Asia can enroll anti-CD38 naive RRMM patients from DL4 and onwards.
* Part B and the last cohort(s) of Part A: (1) participant has received at least 3 prior lines of therapy for multiple myeloma, or at least 2 prior line of therapy if at least 1 of those lines consisted of 2 or more multi-agent regimens (eg, multi-agent induction regimen with autologous stem cell transplantation, followed by maintenance regimen). (2) Prior therapy for multiple myeloma has included at least 1 proteasome inhibitor (bortezomib, carfilzomib, ixazomib), at least 1 immunomodulatory agent (lenalidomide, thalidomide, pomalidomide) and at least 1 steroid. (3) Prior therapy has not included an anti-CD38 monoclonal antibody.
* Participant has myeloma disease progression on or after last therapy.
* Participant must have measurable disease as defined as at least one of the following:

  * Serum M protein ≥0.5 g/dL (≥5 g/L)
  * Urine M protein ≥200 mg/24 hours
  * Serum FLC assay: Involved FLC assay ≥10 mg/dL (≥100 mg/L) and an abnormal serum
  * FLC ratio (\<0.26 or \>1.65).
* A male participant must agree to use contraception during the intervention period and for at least 150 days after the last dose of study drug and refrain from donating sperm during this period.
* A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:

  * Not a woman of childbearing potential (WOCBP)
  * A WOCBP who agrees to follow the contraceptive guidance during the intervention period and for at least 150 days after the last dose of study intervention.

Exclusion criteria:

* Participant is diagnosed or treated for another malignancy within 3 years prior to enrollment, with the exception of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, superficial bladder carcinoma or low risk prostate cancer.
* Participant has an Eastern Cooperative Oncology Group (ECOG) performance status score \>2.
* Participant has a history of Chronic obstructive pulmonary disease (COPD) or asthma.
* Participant has not recovered from adverse reactions to prior myeloma treatment or procedures (chemotherapy, immunotherapy, radiation therapy) to NCI CTCAE Grade ≤1 or baseline (exception: alopecia).
* Participant has congestive heart failure (New York Heart Association) Grade ≥II; cardiac myopathy, active ischemia, or any other uncontrolled cardiac condition such as angina pectoris, clinically significant arrhythmia requiring therapy including anticoagulants, or clinically significant uncontrolled hypertension, QT interval corrected by the Fridericia method \>480 msec (Grade ≥2).
* Participant has had acute myocardial infarction within 6 months before first dose of study medication.
* Participant has ongoing sensory or motor neuropathy of National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Grade ≥3.
* Participant has active autoimmune disease including autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, inflammatory bowel syndrome, pneumonitis or any chronic condition requiring a higher corticosteroid systemic equivalent than prednisone 10 mg daily.
* Known acquired immunodeficiency syndrome (AIDS) or related illnesses or human immunodeficiency virus (HIV) disease requiring antiretroviral treatment, or to have active hepatitis A, B (defined as a known positive hepatitis B surface antigen (HBsAg) result or positive HepB DNA), or C (defined as a known quantitative hepatitis C \[HCV\] ribonucleic acid RNA results greater than the lower limits of detection of the assay or positive HCV antigen) infection.
* Participant has positive Coombs test at baseline.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Primary outcomes:
measure: The maximum tolerated dose (MTD) of SAR442085 (Part A)
timeFrame: At the end of Cycle 1 (each cycle is approximately 28 days)
measure: Recommended Phase 2 dose (RP2D) (Part A)
timeFrame: At the end of Cycle 1 (each cycle is approximately 28 days)
measure: Overall response rate (Part B)
timeFrame: approximately 6 months after the last patient has started treatment in Part B (approx. 2 years)
Secondary outcomes:
measure: Treatment-emergent adverse events (AEs)/serious adverse events (SAE) (Both Part A and B)
timeFrame: From baseline to end of treatment + 30 days (approx. 2 years)
measure: PK parameters of SAR442085: Cmax (Both Part A and B)
timeFrame: Cycle 1 Day 1 to Day 28
measure: PK parameters of SAR442085: Tmax (Both Part A and B)
timeFrame: Cycle 1 Day 1 to Day 28
measure: PK parameters of SAR442085: AUC (Both Part A and B)
timeFrame: Cycle 1 Day 1 to Day 28
measure: Anti-drug antibody (ADA) against SAR442085 (Both Part A and B)
timeFrame: Cycle 1, 2, 3, 6 and 9 (each cycle is approximately 28 days)
measure: Progression-free survival (Part B)
timeFrame: approximately 12 months after the last patient has started treatment in Part B (approx. 2 years)
measure: Duration of response (Part B)
timeFrame: approximately 12 months after the last patient has started treatment in Part B (approx. 2 years)
Other outcomes:
Locations:
city: Duarte
country: United States
facility: City of Hope Site Number : 8400002
state: California
city: Boston
country: United States
facility: Dana Farber Cancer Institute Site Number : 8400003
state: Massachusetts
city: Rochester
country: United States
facility: Mayo Clinic of Rochester Site Number : 8400005
state: Minnesota
city: Chapel Hill
country: United States
facility: UNC Chapel Hill Site Number : 8400006
state: North Carolina
city: Milwaukee
country: United States
facility: Froedtert Hospital & Medical College of Wisconsin Site Number : 8400004
state: Wisconsin
city: Brno
country: Czechia
facility: Investigational Site Number : 2030002
city: Ostrava - Poruba
country: Czechia
facility: Investigational Site Number : 2030003
city: Praha 2
country: Czechia
facility: Investigational Site Number : 2030001
city: TOULOUSE Cedex 9
country: France
facility: Investigational Site Number : 2500001
city: Athens
country: Greece
facility: Investigational Site Number : 3000001
city: Salamanca
country: Spain
facility: Investigational Site Number : 7240001
city: Taipei
country: Taiwan
facility: Investigational Site Number : 1580001
Study officials:
affiliation: Sanofi
name: Clinical Sciences & Operations
role: STUDY_DIRECTOR
References:
citation: Kapoor P, Nathwani N, Jelinek T, Pour L, Perrot A, Dimopoulos MA, Huang SY, Spicka I, Chhabra S, Lichtman E, Mateos MV, Kanagavel D, Zhao L, Guillemin-Paveau H, Mace S, van de Velde H, Richardson PG. An open-label, first-in-human, single agent, dose escalation study for the evaluation of safety and efficacy of SAR442085 in patients with relapsed or refractory multiple myeloma. Eur J Haematol. 2024 Nov;113(5):593-605. doi: 10.1111/ejh.14270. Epub 2024 Jul 12.