About this trial
This phase II trial tests alternate doses and dosing schedules of belantamab mafodotin in treating patients with triple-class multiple myeloma that has come back (after a period of improvement) (recurrent) and/or does not respond to treatment (or that has not responded to previous treatment) (refractory). Belantamab mafodotin is a monoclonal antibody, belantamab, linked to a chemotherapy drug, mafodotin. Belantamab is a form of targeted therapy because it attaches to specific molecules (receptors) on the surface of cancer cells, known as BCMA receptors, and delivers mafodotin to kill them. This trial may help researchers determine if alternate doses and dosing schedules work better in preventing certain side effects, such as eye toxicity, and treating patients with recurrent or refractory multiple myeloma.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age >= 18 years
Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, 2
If patients have undergone stem cell transplantation (SCT), day 0 of SCT must be > 100 days prior to registration to be eligible for the study
Has had disease progression after >= 3 prior lines of anti-myeloma treatments including one proteasome inhibitor (eg. bortezomib, carfilzomib or ixazomib), one immunomodulatory agent (eg.thalidomide, lenalidomide or pomalidomide) and one anti-CD38 monoclonal antibody (eg.daratumumab or isatuximab)
Disqualifiers
Active plasma cell leukemia at the time of screening. Symptomatic amyloidosis, active POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasmaproliferative disorder, myeloma protein, and skin changes), Waldenstrom Macroglobulinemia
Prior belantamab mafodotin therapy. However, patients with prior exposure to another non-belantamab mafodotin anti-BCMA agent such as an anti-BCMA CAR-T or anti-BCMA bispecific antibody will be allowed to participate in the study
Systemic active infection requiring treatment
Any unresolved toxicity >= grade 2 from previous treatment except for alopecia, or peripheral neuropathy up to grade 2
Trial design
Parallel
Treatments tested in this trial
Belantamab Mafodotin
Biological/VaccineGiven IV
Biospecimen Collection
Procedure/SurgeryUndergo collection of blood samples
Bone Marrow Aspirate
Procedure/SurgeryUndergo bone marrow aspirate
Bone Marrow Biopsy
Procedure/SurgeryUndergo biopsy
Computed Tomography
Procedure/SurgeryUndergo CT scan
Magnetic Resonance Imaging
Procedure/SurgeryUndergo MRI scan
Positron Emission Tomography
Procedure/SurgeryUndergo PET/CT scan
Treatment groups
Trial outcomes
Primary outcomes
Grade 3/4 keratopathy-free rate
The proportion of successes will be estimated by the number of successes (proportion of patients free of grade 3/4 keratopathy at the time of dose #4) divided by the total number of evaluable patients. 95% confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner. If both arms prove to meet the primary endpoint, they will be evaluated indirectly in relation to each other similar, to a Bayesian pick the winner, approach if only one can be brought forward for further testing
Secondary outcomes
Overall response rate
Will be estimated by the total number of patients who achieve a complete response (CR), very good partial response, or partial response divided by the total number of evaluable patients. All evaluable patients will be used for this analysis. Exact binomial 95% confidence intervals for the true overall response rate will be calculated.
Incidence of adverse events (AEs)
The maximum grade for each type of AE will be recorded for each patient, and frequency tables will be reviewed to determine patterns. Additionally, the relationship of the AEs to the study treatment will be taken into consideration.
Time to progression
The distribution of time will be estimated using the method of Kaplan-Meier.
Progression free survival (PFS)
The distribution of PFS will be estimated using the method of Kaplan-Meier.
Sponsors and contacts
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