First In Human (FIH) Study of REGN5459 in Patients With Relapsed or Refractory Multiple Myeloma (MM)

Overview

About this study

The purpose of this study is to assess the safety, tolerability, and dose-limiting toxicities (DLTs) and to determine a recommended phase 2 dose regimen (RP2DR) (defined as either a maximum tolerated dose regimen [MTDR] or biologically effective dose regimen [BEDR]) of REGN5459 as monotherapy in patients with relapsed or refractory multiple myeloma (MM) who have exhausted all therapeutic options that are expected to provide meaningful clinical benefit. 

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Key Inclusion Criteria:

- Eastern Cooperative Oncology Group (ECOG) performance status ≤1

- Patients must have myeloma that is response-evaluable according to the 2016
International Myeloma Working Group (IMWG) response criteria

- Measurable disease is defined as 1 or more of the following:

1. Serum M-protein ≥1 g/dL,

2. Urine M-protein ≥200 mg/24-hour, and/or

3. Free light chain (FLC) assay with involved FLC level ≥10 mg/dL with an abnormal
serum FLC ratio

- A patient with Immunoglobulin A (IgA) myeloma but without measurable M-protein may be
enrolled if quantitative IgA levels are ≥400 mg/dL and can be followed longitudinally

- A patient with non-secretory MM may be considered for enrollment after discussion with
the sponsor that includes the feasibility of an individualized plan for response
assessment

- Patients with MM who have exhausted all therapeutic options that are expected to
provide meaningful clinical benefit, either through disease relapse, treatment
refractory disease, or intolerance of the therapy, and including either:

1. Progression on or after at least 3 lines of therapy, or intolerance of therapy,
including a proteasome inhibitor, an Immunomodulatory imide drug (IMiD), and an
anti-CD38 antibody, OR

2. Progression on or after an anti-CD38 antibody and having disease that is "double
refractory" to a proteasome inhibitor and an IMiD, or intolerance of therapy. The
anti-CD38 antibody may have been administered alone or in combination with
another agent such as a proteasome inhibitor. Refractory disease is defined as
lack of response or relapse within 60 days of last treatment.

- Adequate hematologic function as measured by:

1. Platelet count > 50 x 109/L. A patient may not have received a platelet
transfusion within 7 days to meet this platelet eligibility requirement.

2. ANC > 1.0 x 109/L. A patient may not have received granulocyte colony stimulating
factor (G-CSF) within 2 days to meet this absolute neutrophil count eligibility
requirement.

3. Hemoglobin > 8.0 g/dL

- Adequate hepatic function, defined as:

1. Total bilirubin ≤1.5 x ULN

2. Transaminase (ALT, AST) ≤2.5 x ULN

3. Alkaline phosphatase ≤2.5 x ULN

- Patients with Gilbert syndrome do not need to meet this total bilirubin requirement
provided that the total bilirubin is unchanged from the baseline value.

d. Serum creatinine clearance by Cockcroft-Gault >30 mL/min

- A patient with a creatinine clearance by Cockcroft-Gault who does not meet eligibility
criteria may be considered for enrollment if a measured creatinine clearance (based on
24-hour urine collection or other reliable method) is >30 mL/min

- Life expectancy of at least 6 months

Key Exclusion Criteria:

- Patients with known MM brain lesions or meningeal involvement

- History of neurodegenerative condition or central nervous system (CNS) movement
disorder, or patients with a history of seizure within 12 months before study
enrollment are excluded

- Cardiac ejection fraction <40% by echocardiogram or multi-gated acquisition scan
(MUGA)

- Prior treatment with any anti-BCMA antibody (including antibody-drug conjugate or
bispecific antibody) or BCMA-directed CAR T therapy

- Uncontrolled infection with human immunodeficiency virus (HIV), hepatitis B virus
(HBV) or hepatitis C virus (HCV) infection; or other uncontrolled infection

1. Patients with HIV who have controlled infection (undetectable viral load and CD4
count above 350 cells/microliter either spontaneously or on a stable antiviral
regimen) are permitted.

2. Patients with hepatitis B (Hepatitis B Surface Antigen Test positive [HepBsAg+])
who have controlled infection (serum HBV DNA polymerase chain reaction [PCR] that
is below the limit of detection AND receiving anti-viral therapy for hepatitis B)
are permitted.

3. Patients who are HCV antibody-positive (HCV Ab+) who have controlled infection
(undetectable HCV RNA by polymerase chain reaction (PCR) either spontaneously or
in response to a successful prior course of anti-HCV therapy) are permitted.

- History of allogeneic stem cell transplantation at any time, or autologous stem cell
transplantation within 12 weeks of the start of study treatment

NOTE: Other protocol defined Inclusion/Exclusion Criteria apply.

 

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Eligibility last updated 3/20/23. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Prashant Kapoor, M.D.

Closed for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

More information

Publications

Publications are currently not available

Additional contact information

Cancer-related trials contact form

Phone: 855-776-0015 (toll-free)

International patient clinical studies questions