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Multiple MyelomaPhase 1NCT02514239

Phase I Dose Escalation of i.v. BI 836909 Monotherapy in Last Line Multiple Myeloma Patients

A Phase 1 study testing BI 836909 in people with Multiple Myeloma, run by Boehringer Ingelheim at 5 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of this trial is to determine the maximum tolerated dose (MTD) of BI 836909 administered by continuous i.v. infusion in patients with relapsed and/or refractory multiple myeloma. If the MTD is not reached based on safety findings, a recommended dose for further development will be determined. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Multiple Myeloma
What is being tested?
BI 836909
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
43 participants
Where
5 sitesin 2 countries
Study dates
8 Jul 2015to 2 Jul 2020
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with a documented diagnosis of relapsed and/or refractory multiple myeloma who progressed after at least two prior treatment regimens, including both proteasome inhibitor as well as an immune-modulatory drug at time of screening
  • must have measurable disease, defined by one or more of following at time of screening:
  • a serum M protein > 0.5 g/dl measured by serum protein electrophoresis
  • urinary M protein excretion > 200 mg/24 hours
  • serum free light chain (FLC) measurement > 10 mg/dl, provided that the serum FLC ratio is abnormal
  • Relapse or progression of disease with an indication for therapy as per investigator´s judgement at time of screening
Show all 11Show fewer
  • ECOG Performance Status 0, 1 or 2 at time of screening
  • Age >= 18 years at time of screening
  • Written informed consent which is consistent with ICH_GCP guidelines and local legislation
  • Able to adhere to the study visit schedule e.g. ability to come to the clinic and to other protocol requirements
  • Indwelling central venous catheter or willingness to undergo intra venous central line placement.

Who cannot join

  • Plasma cell leukemia
  • Extramedullary relapse of multiple myeloma
  • Known central nervous system involvement by multiple myeloma
  • Last anticancer treatment < 2 weeks prior to visit 1
  • Last treatment with a therapeutic antibody less than 6 weeks prior to visit 1
  • Prior allogeneic stem cell transplantation or solid organ transplantation
Show all 25Show fewer
  • Autologous bone marrow transplantation < than 90 days at time of treatment start
  • Last corticosteroid < 2 weeks prior to visit 1 unless the dose is <= 10 mg/day prednisolone or equivalent
  • AST or ALT > 3 x upper limit of normal (CTCAE version 4.03 grade 2 or higher) at time of screening
  • Total conjugated bilirubin > 1.5 x upper limit of normal (CTCAE version 4.03 grade 2 or higher) at time of screening
  • Absolute neutrophil count < 1.0 x 109/L (without growth factor support) at time of screening
  • Platelets < 25 x 109/L (without transfusions) at time of screening
  • Calculated GFR < 30 mL/min (Cockcroft-Gault Formula) at time of screening
  • Clinical relevant concurrent medical disease or condition which according to the investigator's judgement would either compromise patient safety or interfere with the evaluation of the safety of the test drug, e.g. symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia requiring therapy at time of screening
  • clinically not controlled chronic or ongoing infectious disease requiring treatment at the time of enrolment or within the previous two weeks
  • Active hepatitis B or C, or laboratory evidence for a chronic infection with hepatitis B or C at time of screening; HIV infection at time of screening
  • Women of childbearing potential not using highly effective method of birth control during the trial until one year after the last dose. Highly effective methods of birth control are defined as those which result in a low failure rate (i.e. less than 1% per year)when used consistently and correctly used such as implants, injectables, combined oral contraceptives, intrauterine devises (IUDs), sexual abstinence or vasectomised partner. Barrier methods of contraception are accepted if condom or occlusive cap is used together with spermicides (e.g. foam, gel). Female patients will be considered to be of childbearing potential unless surgically sterilized by hysterectomy or bilateral tubal ligation/salpingectomy, or postmenopausal (12 months with no menses without an alternative medical cause
  • Male patients with partners of childbearing potential who are unwilling to use condoms in combination with a second medically acceptable method of contraception during the trial and for a minimum of 6 months after treatment
  • Pregnancy or breast feeding
  • Known or suspected active alcohol or drug abuse as per investigator's judgement
  • Treatment with another investigational drug within the past four weeks before start of therapy or concomitantly with this trial
  • Patients with known hypersensitivity to any component of the study drug
  • Patients with other malignancies within 5 years at time of screening (except basal cell or squamous cell carcinoma of the skin or carcinoma in situ treated with curative therapy)
  • Known autoimmune diseases requiring systemic treatment in past 5 years and interfering with evaluation of study drug
  • Pre-existing disorders of the central nervous system

Trial locations and contacts

5 sites in 2 countries.

5 sites in 2 countries

France3 sites
  • HOP Claude Huriez

    Lille, 59037

  • HOP Hôtel-Dieu

    Nantes, 44000

  • INS Universitaire du Cancer

    Toulouse, 31059

Other trials in France

Germany2 sites
  • Universitätsklinikum Ulm

    Ulm, 89081

  • Universitätsklinikum Würzburg

    Würzburg, 97080

Other trials in Germany

About this study

Official title: An Open Label, Phase I, Dose Escalation Study to Characterize the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Intravenous Doses of BI 836909 in Relapsed and/or Refractory Multiple Myeloma Patients

The primary objective of this trial is to determine the maximum tolerated dose (MTD) of BI 836909 administered by continuous i.v. infusion in patients with relapsed and/or refractory multiple myeloma. If the MTD is not reached based on safety findings, a recommended dose for further development will be determined. This will depend on the safety data, pharmacokinetic/pharmacodynamics data and potentially preliminary efficacy data. Secondary objectives are to document the safety and tolerability of BI 836909, to perform pharmacokinetic and pharmacodynamic analyses and to evaluate relevant biological effects in terms of parameters of efficacy.

Being tested
BI 836909
Medical subject headings
Multiple Myeloma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BI 836909Drug

    Also called AMG 420

    Intravenous Infusion of BI 836909.

Study groups in NCT02514239
Study groupRoleWhat they receive
Intravenous Infusion of BI 836909 (0.2 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (0.4 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (0.8 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (1.6 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (3.2 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (6.5 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (13 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (25 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (50 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (100 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (200 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (400 μg/d)ExperimentalNot described
Receives: Drug: BI 836909
Intravenous Infusion of BI 836909 (800 μg/d)ExperimentalNot described
Receives: Drug: BI 836909

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Maximum Tolerated Dose (MTD) of BI 836909

    The Maximum tolerated dose (MTD) of BI 836909, which was defined as the highest dose of the dose level tested where ≤1 patient out of 6 developed a Dose-limiting toxicity (DLT). The MTD was defined based on DLTs observed during Cycle 1. However, all Adverse Events corresponding to the definition of a DLT (see below) were to be considered for confirming the MTD. A DLT was defined as any drug-related non-haematological Adverse Event of Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 Grade 3 or higher.

    Measured: Cycle 1, up to 6 weeks.

  2. The Number of Patients With Dose-limiting Toxicities (DLTs)

    The number of patients with Dose-limiting toxicities (DLTs) in cycle 1. A Dose-limiting toxicity was defined as any drug-related non-haematological Adverse Event of Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 Grade 3 or higher.

    Measured: Cycle 1, up to 6 weeks.

Secondary outcomes (9)
  1. Number of Participants With an Objective Response

    Objective responses: Stringent complete response (sCR): CR + normal Free light chain (FLC) ratio and no clonal cells in bone marrow by immunohistochemistry or immunofluorescence. CR: negative immunofixation on serum and urine, disappearance of soft tissue plasmacytomas, and <5% plasma cells in bone marrow. Very good partial response (VGPR): serum and urine M protein detectable by immunofixation but not on electrophoresis or >90% reduction in serum M protein plus urine M protein level <100 mg/24h. PR: >50% reduction of serum and 24 h urinary M protein by >90% or to <200mg/24h. If unmeasurable, a >50% decrease in difference between involved and uninvolved FLC levels instead of M protein criteria. if FLC assay was not measurable, a >50% reduction in plasma cells was required instead of M protein, provided baseline bone marrow plasma cell was >30%. In addition to the listed criteria, a >50% reduction in the size of soft tissue plasmacytomas was also required, if present at baseline.

    Measured: On-treatment: From start of treatment till end of trial (EOT) visit, up to 61 weeks. Extended follow-up: From start of treatment till the last extended follow-up visit which was scheduled at 12 months after end of treatment, up to 113 weeks.

  2. Duration of Objective Response - on Treatment

    For patients with objective response, the duration of response was calculated from the time of first recorded achievement of a response (sCR, CR, PR, or VGPR) until documented progression or death. The Kaplan-Meier method was used to calculate the estimates.

    Measured: From start of treatment till end of trial (EOT) visit, up to 61 weeks.

  3. Duration of Objective Response - Including Extended Follow up Visits

    For patients with objective response, the duration of response was calculated from the time of first recorded achievement of a response (sCR, CR, PR, or VGPR) until documented progression or death. The Kaplan-Meier method was used to calculate the estimates.

    Measured: From start of treatment till the last extended follow-up visit which is scheduled at 12 months after end of treatment, up to 113 weeks.

  4. Number of Participants With a Minimal Residual Disease (MRD) Response

    Minimal residual disease (MRD) response was defined as <1 tumour cell within 10000 normal cells in bone marrow. MRD was determined using Fluorescence-activated cell sorting (FACS) analysis.

    Measured: On-treatment: From start of treatment till end of trial (EOT) visit, up to 61 weeks. Follow-up: From start of treatment till the last extended follow-up visit which was scheduled at 12 months after end of treatment, up to 113 weeks.

  5. Duration of Minimal Residual Disease (MRD) Response - on Treatment

    Duration of MRD response was calculated from the time of first recorded achievement of a MRD response to documented progression or death. The Kaplan-Meier method was used to calculate the estimates.

    Measured: From start of treatment till end of trial (EOT) visit, up to 61 weeks.

  6. Duration of Minimal Residual Disease (MRD) Response - Including Extended Follow up Visits

    Duration of MRD response was calculated from the time of first recorded achievement of a MRD response to documented progression or death. The Kaplan-Meier method was used to calculate the estimates.

    Measured: From start of treatment till the last extended follow-up visit which was scheduled at 12 months after end of treatment, up to 113 weeks.

  7. Progression-free Survival (PFS) - on Treatment

    PFS was defined as time from first treatment with BI 836909 till disease progression or death. Progression was defined according to International Myeloma Working Group (IMWG 2006) response criteria as an increase >25% from lowest response value in any of the following parameters: -Serum M protein (absolute increase had to be >0.5 gram/ deciliters (dL)) -Urine M protein (absolute increase had to be >200 milligram (mg)/24 hour) -Only in patients without measurable serum and urine M protein levels The difference between involved and uninvolved FLC levels. Absolute increase had to be >10 mg/dL -Bone marrow plasma cell percentage; absolute percentage had to be >10% -Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas -Development of hypercalcaemia (corrected serum calcium >11.5 mg/dL or 2.65 Millimole/Liter) that was attributed solely to the plasma cell proliferative disorder.

    Measured: From start of treatment till end of trial (EOT) visit, up to 61 weeks.

  8. Progression-free Survival (PFS) - Including Extended Follow up Visits

    PFS was defined as time from first treatment with BI 836909 till disease progression or death. Progression was defined according to International Myeloma Working Group (IMWG 2006) response criteria as an increase >25% from lowest response value in any of the following parameters: -Serum M protein (absolute increase had to be >0.5 gram/ deciliters (dL)) -Urine M protein (absolute increase had to be >200 milligram (mg)/24 hour) -Only in patients without measurable serum and urine M protein levels The difference between involved and uninvolved FLC levels. Absolute increase had to be >10 mg/dL -Bone marrow plasma cell percentage; absolute percentage had to be >10% -Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas -Development of hypercalcaemia (corrected serum calcium >11.5 mg/dL or 2.65 Millimole/Liter) that was attributed solely to the plasma cell proliferative disorder

    Measured: From start of treatment till the last extended follow-up visit which was scheduled at 12 months after end of treatment, up to 113 weeks.

  9. Serum Concentration at Steady State of BI 836909 (Css)

    Serum concentration at steady state of BI 836909 (Css).

    Measured: Pharmacokinetic samples were collected at 48:00 hours (h):minutes (min), 168:00, 336:00, 504:00 and 671:50 h after the start of infusion of BI 836909 of the first cycle.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Aug 2015 (estimated)
  2. Study start8 Jul 2015
  3. Primary completion17 Jul 2018
  4. Study completion2 Jul 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
43 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02514239
Sponsor's protocol ID
1351.1
Other IDs
2014-004896-22, 2014
Status last verified
Feb 2022
First submitted
21 May 2015
Last updated
24 Feb 2022
Individual data sharing
No: Clinical studies sponsored by Boehringer Ingelheim, phases I to IV, interventional and non-interventional, are in scope for sharing of the raw clinical study data and clinical study documents. Exceptions might apply, e.g. studies in products where Boehringer Ingelheim is not the license holder; studies regarding pharmaceutical formulations and associated analytical methods, and studies pertinent to pharmacokinetics using human biomaterials; studies conducted in a single center or targeting rare diseases (in case of low number of patients and therefore limitations with anonymization). For more details refer to: https://www.mystudywindow.com/msw/datatransparency

Publications

  • Topp MS, Duell J, Zugmaier G, Attal M, Moreau P, Langer C, Kronke J, Facon T, Salnikov AV, Lesley R, Beutner K, Kalabus J, Rasmussen E, Riemann K, Minella AC, Munzert G, Einsele H. Anti-B-Cell Maturation Antigen BiTE Molecule AMG 420 Induces Responses in Multiple Myeloma. J Clin Oncol. 2020 Mar 10;38(8):775-783. doi: 10.1200/JCO.19.02657. Epub 2020 Jan 2.

    PubMed 31895611

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing BI 836909 in people with Multiple Myeloma, run by Boehringer Ingelheim at 5 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 25 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in France, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 22 Jul 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Maximum Tolerated Dose (MTD) of BI 836909 (time frame: Cycle 1, up to 6 weeks.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02514239, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Feb 2022.

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