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Brief Title: Iberdomide vs. Iberdomide Plus Isatuximab Maintenance Therapy Post ASCT in Newly Diagnosed Multiple Myeloma
Official Title: A Randomized Phase III Trial Assessing Iberdomide Versus Iberdomide Plus Isatuximab Maintenance Therapy Post Autologous Hematopoietic Stem-Cell Transplantation in Patients With Newly Diagnosed Multiple Myeloma
Study ID: NCT06216158
Brief Summary: The goal of this clinical trial is to compare a maintenance therapy consisting of iberdomide and isatuximab with an iberdomide-only regimen. The trial is the subsequent maintenance therapy to GMMG-HD8/DSMM XIX trial for patients with newly-diagnosed multiple myeloma. The main question it aims to answer is: ⢠Will the addition of isatuximab lead to decreased amounts of measurable myeloma cells in the bone marrow after two years?
Detailed Description: Prospective, multicentre, randomised, parallel group, open, phase III clinical trial for a maintenance therapy, for patients who underwent an induction therapy and autologous stem cell transplantation in the GMMG-HD8/DSMM XIX trial. Investigational Medicinal Product: Iberdomid (oral), isatuximab (subcutaneous administration via a wearable injector system). Randomisation will be performed centrally by GMMG/DSMM offices after verification of the eligibility of the patient. At the time of study inclusion, randomization will be performed into arm A (iberdomide) or arm B (iberdomide + isatuximab). Randomization will be stratified by centrally assessed MRD negativity status (yes vs. no vs. unknown); assessed by NGF from BMA; sensitivity of 10\^-5; independent of standard IMWG response) and number of HDM/ASCT (single vs. tandem). Patients randomized in arm A will receive 39 cycles of the drug iberdomide, a Cereblon E3 Ubiquitin Ligase Modulating Drug (CELMoDÂŽ) that shares structural similarities to the immunomodulatory compounds (IMiDs) such as thalidomide and lenalidomide. Each cycle will last for 29 days. Patients in arm B will receive the same the 39 cycles of iberdomide plus monoclonal anti-CD38 antibody isatuximab subcutaneously. In both arms, patients will receive 20 mg dexamethasone in cycle 1, on the same days as the isatuximab administration in Arm B. End of study will be after 36 months of the maintenance therapy. There is one primary objective: - Demonstration of superiority of iberdomide plus isatuximab compared to iberdomide with respect to bone marrow minimal residual disease (MRD) negativity rates (sensitivity 2x10\^-6 via next-generation flow cytometry \[NGF\]) after two years of maintenance therapy. There is one key secondary objective: - PFS, defined as time from randomization to disease progression or death from any cause, whichever occurs first. Further secondary objectives are: * Rates of sustained MRD negativity (at sensitivity levels of 10-5 and 2x10\^-6 via NGF from BMA) after 1, 2 and 3 years of maintenance therapy. * Conversion from MRD positive to negative (at sensitivity levels of 10\^-5 and 2x10\^-6 via NGF from BMA). * Rates of best overall response to treatment (BOR). * Rates of partial response (PR), very good partial response (VGPR), complete response (CR) and stringent complete response (sCR). * Time-to-next-treatment (TTNT). * PFS on subsequent line of therapy. * Overall survival (OS). * Improvement of IMWG response categories (PR, VGPR, CR, sCR). * Proportions of patients in both treatment arms maintaining BOR and CR from baseline. * Assessment of quality-of-life (QoL) via the EORTC-QLQC30, EORTC-QLQMY20, and EQ-5D-5L questionnaires.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Uniklinik RWTH Aachen, Klinik fßr Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Aachen, , Germany
Universitätsklinikum Augsburg, Augsburg, , Germany
Helios Klinikum Bad Saarow, Bad Saarow, , Germany
CharitĂŠ Campus Benjamin Franklin, Berlin, , Germany
Vivantes Klinikum NeukÜlln, Klinik fßr Hämatologie und Onkologie, Berlin, , Germany
Helios Klinikum Berlin-Buch, Berlin, , Germany
Vivantes Klinikum Spandau, Berlin, , Germany
Studiengesellschaft Onkologie Bielefeld, Bielefeld, , Germany
Evangelisches Klinikum Bethel, Bielefeld, , Germany
Johanniter Krankenhaus, Bonn, , Germany
Universitätsklinikum Bonn, Medizinische Klinik III, Bonn, , Germany
Universitätsklinikum Bonn, Bonn, , Germany
Klinikum Chemnitz, Chemnitz, , Germany
Carl-Thiem-Klinikum Cottbus gGmbH, 2. Medizinische Klinik, Cottbus, , Germany
Klinikum Darmstadt GmbH, Medizinische Klinik V, Darmstadt, , Germany
St. Johannes Hospital Dortmund, Dortmund, , Germany
Universitätsklinikum Carl Gustav Carus Dresden, Dresden, , Germany
Helios St. Johannes Klinik Duisburg, Duisburg, , Germany
Universitätsklinikum Dßsseldorf, Dßsseldorf, , Germany
Marien Hospital Dßsseldorf GmbH, Klinik fßr Onkologie, Hämatalogie und Palliativmedizin, Dßsseldorf, , Germany
KEM I Evang. Kliniken Essen-Mitte gGmbH, Evangelisches Krankenhaus Essen-Werden gGmbH, Klinik fßr Hämatologie, Onkologie und Stammzelltransplantation, Essen, , Germany
Centrum fßr Hämatologie und Onkologie Bethanien, Frankfurt am Main, , Germany
Universitätsmedizin Greifswald, Greifswald, , Germany
Katholisches Krankenhaus Hagen, Hagen, , Germany
Universitätsmedizin Halle, Halle, , Germany
Universitätsklinikum Hamburg-Eppendorf, Zentrum fßr Onkologie, Hamburg, , Germany
Onkologische Schwerpunktpraxis Heidelberg, Heidelberg, , Germany
Universitätsklinikum Heidelberg, Medizinische Klinik V, Heidelberg, , Germany
SLK Kliniken Heilbronn, Medizinische Klinik III, Heilbronn, , Germany
Universitätsklinikum des Saarlandes, Klinik fßr Innere Medizin 1, Homburg, , Germany
Klinikum der Friedrich-Schiller-Universität Jena, Klinik fßr Innere Medizin II, Abteilung Hämatologie und internistische Onkologie, Jena, , Germany
Westpfalz-Klinikum, Kaiserslautern, , Germany
Klinikverbund Allgäu, Klinikum Kempten, Hämatologie / Onkologie, Kempten, , Germany
Oncocare, Gemeinschaftspraxis fßr Hämatologie und Onkologie, Lebach, , Germany
Universitätsklinikum Leipzig, Leipzig, , Germany
Klinikum der Stadt Ludwigshafen, Ludwigshafen, , Germany
Universitätsklinikum Schleswig-Holstein, Lßbeck, , Germany
Universitätsklinikum Magdeburg, Magdeburg, , Germany
Universitätsklinikum Mannheim, III. Medizinische Klinik, Mannheim, , Germany
Philipps-Universität Marburg Hämatologie/Onkologie, Marburg, , Germany
Klinikum Hochsauerland, Meschede, , Germany
Kliniken Ostalb, Mutlangen, , Germany
Kliniken Maria Hilf, MĂśnchengladbach, , Germany
Klinikum rechts der Isar der TU MĂźnchen, MĂźnchen, , Germany
Universitätsklinikum Mßnster, Mßnster, , Germany
Klinikum Oldenburg, Oldenburg, , Germany
Klinikum OsnabrĂźck, OsnabrĂźck, , Germany
BrĂźderkrankenhaus St. Josef, Paderborn, , Germany
Krankenhaus Barmherzige Brßder Regensburg, Klinik fßr Onkologie und Hämatologie, Regensburg, , Germany
Universitätsklinikum Regensburg, Regensburg, , Germany
Onkologische Schwerpunktpraxis Speyer, Speyer, , Germany
Klinikum der Landeshauptstadt Stuttgart - Katharinenhospital, Stuttgart, , Germany
Universitätsklinikum Tßbingen, Tßbingen, , Germany
Universitätsklinikum Ulm, Ulm, , Germany
Schwarzwald Baar Klinikum, Villingen-Schwenningen, , Germany
University of WĂźrzburg, Med. Klinik und Poliklinik II, WĂźrzburg, , Germany
Name: Hartmut Goldschmidt, Prof.
Affiliation: University Hospital Heidelberg
Role: PRINCIPAL_INVESTIGATOR