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Multiple MyelomaPhase 2NCT05998928

A Clinical Study to Evaluate the Safety and Efficacy of BCMA-GPRC5D CAR-T in Patients With Relapsed/Refractory Multiple Myeloma Who Received Three or More Lines of Therapy

A Phase 2 study testing Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T Cells in people with Multiple Myeloma, run by Union Hospital, Tongji Medical College, Huazhong University of Science and Technology at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a single-center, open-label, single-arm study to evaluate the safety and efficacy of bispecific BCMA-GPRC5D Chimeric antigen receptor (CAR) T-cells in patients with relapsed or refractory multiple myeloma who received three or more lines of therapy. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Multiple Myeloma
What is being tested?
Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T Cells
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteChina
Study dates
27 Jul 2023to 27 Jul 2026
Phase
Phase 2
Are there results?
None posted in the registry

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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient or his or her legal guardian voluntarily participates in and signs an informed consent form;
  • Aged ≥ 18 years and ≤ 75 years;
  • Diagnosed as Multiple Myeloma (MM) according to the international standard for multiple myeloma (IMWG);
  • The presence of measurable disease at screening meets one of the following criteria:Serum M-protein ≥ 1.0 g/dL or Urine M-protein ≥ 200 mg/24h or diagnosed as Light-chain MM without measurable disease in serum and urine; Serum free light chain ≥ 10 mg/dL with an abnormal κ/λ ratio;
  • Patients must relapse or be refractory after three or more lines of therapy, which at least include: one Proteasome Inhibitor (PI), one Immunomodulatory Drug (IMiD), and one anti-CD38 monoclonal antibody;
  • diagnosed as relapsed/refractory disease or primary refractory disease;
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  • The last treatment is ineffective, or the disease progresses within 60 days after the end of the last therapy;
  • Patients must recover from the toxicity of the last therapy (< grade 2 by CTCAE criteria);
  • ECOG score 1-2 points and the expected survival period ≥ 3 months;
  • Liver, kidney and cardiopulmonary functions meet the following requirements:
  • Total bilirubin ≤ 1.5×ULN, alanine aminotransferase (ALT) ≤ 3 × ULN and aspartate aminotransferase (AST) ≤ 3 × ULN;
  • Serum creatinine ≤ 1.5×ULN, or creatinine clearance ≥ 60 mL/min;
  • Hemoglobin (Hb) ≥ 50 g/L without prior blood transfusion within 7 days;
  • Baseline peripheral oxygen saturation > 92%;
  • Corrected serum calcium ≤ 12.5 mg/dL (≤ 3.1 mmol/L) or free (ionized, ionic) calcium ≤ 6.5 mg/dL (≤ 1.6 mmol/L);
  • Left ventricular ejection fraction (LVEF) > 45%, without confirmed pericardiac effusion and abnormal electrocardiography with clinical significance;
  • Without clinically significant pleural effusion;
  • Venous access could be established; without contraindications of apheresis.

Who cannot join

  • Previous diagnosis and treatment of other malignancies within 3 years;
  • Patients received previous anti-tumor therapies before apheresis including following therapies: targeted therapies, epigenetics modulation drugs, other drugs or medical devices (invasive) of clinical trials, monoclonal antibodies, cytotoxic agents, PIs, IMiDs, radiotherapy;
  • Central Nervous System (CNS) involvement;
  • Patients with Fahrenheit macroglobulinemia, POEMS syndrome, or primary AL, amyloidosis;
  • Subjects with positive HBsAg or HBcAb positive and peripheral blood HBV DNA titer is higher than the lower limit of detection of the research institution; HCV antibody positive; HIV antibody positive; CMV DNA titer is higher than the lower limit of detection of the research institution; EBV DNA titer is higher than the lower limit of detection of the research institution;
  • Patients have a severe allergic history;
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  • Patiens have severe systemic diseases or poor cardiovascular, liver, kidney functions;
  • Acute or chronic graft versus host disease (GvHD) occurs within 6 months before the screening or needs be treated with immunosuppressive agents;
  • Active autoimmune or inflammatory diseases of the nervous system;
  • Patients develop oncology emergencies and need to be treated before screening or infusion;
  • Uncontrolled infections that need antibiotics treatment;
  • Exposure to hematopoietic growth factor of cells within 1-2 weeks before apheresis;
  • Exposure to Corticosteriods or immunosuppressive agents within 2 weeks before apheresis;
  • Patients receive a major surgical operation within 4 weeks before lymphodepletion or do not recover completely before the enrollment; or plan to receive a major surgical operation during the study period;
  • Live attenuated vaccine within 4 weeks before screening;
  • Patients with severe mental illness;
  • Patients are addcited to alcohol or drugs;
  • Pregnant or Lactating Women; Patients and his or her spouse have a fertility plan within two years after CAR-T cell infusion;
  • Other conditions considered inappropriate by the researcher.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

    Wuhan, Hubei, 430022

    Heng Mei, M.D., Ph.D, hmei@hust.edu.cn

    Chenggong Li, chenggongli@hust.edu.cn

    Recruiting

Other trials in China

About this study

Official title: A Clinical Study to Evaluate the Safety and Efficacy of BCMA-GPRC5D CAR-T in Patients With R/R MM Who Received Three or More Lines of Therapy

This is a single-center, open-label, single-arm study to evaluate the safety and efficacy of bispecific BCMA-GPRC5D Chimeric antigen receptor (CAR) T-cells in patients with relapsed or refractory multiple myeloma who received three or more lines of therapy.

Read the detailed description

B-cell maturation antigen (BCMA)-targeted Chimeric antigen receptor (CAR) T-cell therapy has yielded satisfactory clinical outcomes in patients with relapsed or refractory (R/R) multiple myeloma (MM). However, BCMA-targeted CAR-T cells cannot achieve a favorable response in patients with dim or negative BCMA expression on the tumor surface at baseline or relapse. G protein-coupled receptor, class C, group 5, member D (GPRC5D) is highly distributed on MM cells and proves to be a promising target for MM. In normal tissues, it is restrictedly expressed in hair follicle, rendering it a safe target for CAR-T cell therapy as well. To construct a bispecific BCMA-GPRC5D CAR structure would help mitigate the antigen escape and elevates the clinical efficacy.

This is an investigational study. The objectives are to evaluate the safety and efficacy of BCMA-GPRC5D CAR-T cells in adult patients with relapsed or refractory MM disease.

Being tested
Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T Cells
Medical subject headings
Multiple Myeloma

What participants receive

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

  • Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T CellsDrug

    fludarabine 30 mg/m2 and cyclophosphamide 300 mg/m2 both on three consecutive days during D-7 to D-3

    BCMA-GPRC5D CAR-T Cells on day 0

Study groups in NCT05998928
Study groupRoleWhat they receive
Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T CellsExperimentalPatients will receive lymphodepletion chemotherapy with fludarabine (30 mg/m2 body surface area) plus cyclophosphamide (300 mg/m2 body surface area) for 3 consecutive days during D-7 to D-3, followed by the infusion of BCMA-GPRC5D CAR-T cells at a single dose of 4.0×10^6/kg ± 50%/kg for one day.
Receives: Drug: Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T Cells

What is being measured

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

  1. Incidence of Treatment-related Adverse Events

    Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome are graded by American Society for Transplantation and Cellular Therapy (ASTCT) criteria. Other therapy-related adverse events will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0)

    Measured: within 2 years after infusion

Secondary outcomes (14)
  1. Pharmacokinetics and pharmacodynamics - Cmax

    Cmax will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  2. Pharmacokinetics and pharmacodynamics - Tmax

    Tmax will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  3. Pharmacokinetics and pharmacodynamics - AUC 0-28d

    AUC 0-28d will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  4. Pharmacokinetics and pharmacodynamics - AUC 0-90d

    AUC 0-90d will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  5. Pharmacokinetics and pharmacodynamics - AUC 0-inf

    AUC 0-inf will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  6. Pharmacokinetics and pharmacodynamics - AUC 0-t1/2

    AUC 0-t1/2 will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  7. Clinical efficacy of administering BCMA-GPRC5D CAR-T cells in Relapsed/Refractory multiple myeloma

    The rates of stringent complete response (sCRs), complete response (CR), very good partial response (VGPR), partial response (PR), minimal response (MR) will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  8. Overall response rate (ORR) of administering BCMA-GPRC5D CAR-T cells in Relapsed/Refractory multiple myeloma.

    ORR will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  9. Clinical benefit rate

    Clinical benefit rate refers to ORR plus MR rate.

    Measured: within 2 years after infusion

  10. Duration of Response (DoR) of administering BCMA-GPRC5D CAR-T cells in Relapsed/Refractory multiple myeloma.

    DOR will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  11. Progress-free survival (PFS) of administering BCMA-GPRC5D CAR-T cells in Relapsed/Refractory multiple myeloma.

    PFS will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  12. Overall survival (OS) of administering BCMA-GPRC5D CAR-T cells in Relapsed/Refractory multiple myeloma.

    OS will be assessed from CAR T cell infusion to death or last follow-up (censored).

    Measured: within 2 years after infusion

  13. Minimal Residual Disease (MRD)

    MRD status will be continuously monitored to assess the negative rate of MRD.

    Measured: within 2 years after infusion

  14. Antigen expression in tumor cells at different time points

    Changes in proportion of antigen-positive tumor cells after CAR T cell infusion

    Measured: within 2 years after infusion

Timeline

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

  1. First posted21 Aug 2023
  2. Study start27 Jul 2023
  3. Primary completion27 Jul 2025 (estimated)
  4. Study completion27 Jul 2026 (estimated)

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05998928
Sponsor's protocol ID
BCMA-GPRC5D CAR-T-cells
Status last verified
Nov 2023
First submitted
28 Jul 2023
Last updated
13 Nov 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mailankody S, Devlin SM, Landa J, Nath K, Diamonte C, Carstens EJ, Russo D, Auclair R, Fitzgerald L, Cadzin B, Wang X, Sikder D, Senechal B, Bermudez VP, Purdon TJ, Hosszu K, McAvoy DP, Farzana T, Mead E, Wilcox JA, Santomasso BD, Shah GL, Shah UA, Korde N, Lesokhin A, Tan CR, Hultcrantz M, Hassoun H, Roshal M, Sen F, Dogan A, Landgren O, Giralt SA, Park JH, Usmani SZ, Riviere I, Brentjens RJ, Smith EL. GPRC5D-Targeted CAR T Cells for Myeloma. N Engl J Med. 2022 Sep 29;387(13):1196-1206. doi: 10.1056/NEJMoa2209900.

    PubMed 36170501
  • Fernandez de Larrea C, Staehr M, Lopez AV, Ng KY, Chen Y, Godfrey WD, Purdon TJ, Ponomarev V, Wendel HG, Brentjens RJ, Smith EL. Defining an Optimal Dual-Targeted CAR T-cell Therapy Approach Simultaneously Targeting BCMA and GPRC5D to Prevent BCMA Escape-Driven Relapse in Multiple Myeloma. Blood Cancer Discov. 2020 Sep;1(2):146-154. doi: 10.1158/2643-3230.BCD-20-0020.

    PubMed 33089218

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Fludarabine + Cyclophosphamide + BCMA-GPRC5D CAR-T Cells in people with Multiple Myeloma, run by Union Hospital, Tongji Medical College, Huazhong University of Science and Technology at 1 site in China.

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 18 inclusion and 19 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: status not confirmed, as of the sponsor's last update on 13 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

Results are not available in the source record.

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

Contact Heng Mei (027-8572600, hmei@hust.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Treatment-related Adverse Events (time frame: within 2 years after infusion). 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 NCT05998928, which also lists 2 linked publications.

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 13 Nov 2023.

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