Study of CART-ddBMCA in Relapsed or Refractory Multiple Myeloma (iMMagine-1)


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A Phase II study of CART-ddBCMA for patients with relapsed or refractory multiple myeloma. CART-ddBCMA is a BCMA-directed CAR-T cell therapy

Targeted Conditions

Study Overview

Start Date
August 9, 2022
Completion Date
May 31, 2025
Date Posted
May 31, 2022
Accepts Healthy Volunteers?


Full Address
Honor Health
Scottsdale, Arizona 85260, United States

University of Arkansas for Medical Sciences
Little Rock, Arkansas 72205, United States

Colorado Blood Cancer Institute
Denver, Colorado 80218, United States

Moffitt Cancer Center
Tampa, Florida 33612, United States

Northside Hospital, Inc
Atlanta, Georgia 30342, United States

The University of Chicago Biological Sciences
Chicago, Illinois 60637, United States

University of Maryland School of Medicine Greenebaum Comprehensive Cancer Center
Baltimore, Maryland 21201, United States

Massachusetts General Hospital
Boston, Massachusetts 02114, United States

Dana-Farber Cancer Institute
Boston, Massachusetts 02215, United States

Barbara Ann Karmanos Cancer Hospital
Detroit, Michigan 48201, United States

John Theurer Cancer Center at Hackensack Meridian Health
Hackensack, New Jersey 07601, United States

Levine Cancer Institute at Atrium Health
Charlotte, North Carolina 28204, United States

Oregon Health & Sciences University - Knight Cancer Institute
Portland, Oregon 97239, United States

Simmons Comprehensive Cancer Center at UT Southwestern Medical Center
Dallas, Texas 75390, United States

MD Anderson Cancer Center
Houston, Texas 77030, United States

Huntsman Cancer Institute
Salt Lake City, Utah 84112, United States

UW Carbone Cancer Center
Madison, Wisconsin 53792, United States

Medical College of Wisconsin
Milwaukee, Wisconsin 53226, United States


Minimum Age (years)
Eligibility Criteria
Inclusion Criteria:

Age 18 years or older and has capacity to give informed consent

Relapsed or refractory multiple myeloma treated with at least 3 prior regimens of systemic therapy including proteasome inhibitor, immunomodulatory drugs (IMiD) and anti-CD38 antibody and are refractory to the last line of therapy. For each line, 2 consecutive cycles are required unless the best response after 1 cycle was progressive disease.

Note: IMWG criteria defines refractory disease as disease progression on or within 60 days of a therapy Note: Induction treatment with or without hematopoietic stem cell transplant and with or without maintenance is considered a single regimen

Documented measurable disease including at least one or more of the following criteria:

Serum M-protein ≥1.0 g/dL
Urine M-protein ≥200 mg/24 hours
Involved serum free light chain ≥10 mg/dL with abnormal κ/λ ratio (i.e., >4:1 or <1:2)
Eastern Cooperative Oncology Group (ECOG) performance status 0-1
Life expectancy >12 weeks

Adequate organ function defined as:

Oxygen (O2) saturation ≥92% on room air
Left Ventricular Ejection Fraction (LVEF) ≥45% by echocardiogram (ECHO) or multigated acquisition (MUGA) scan
Absolute neutrophil count (ANC) ≥1.0k/µl, platelet count (PLT) ≥50k/µl, [NOTE: Platelet transfusion not allowed within 14 days; filgrastim (or biosimilar) not allowed within 7 days, pegfilgrastim (or biosimilar) within 14 days]
Creatinine clearance ≥45 mL/min min (as determined by the Cockgroft-Gault equation) and not on dialysis
Aspartate transaminase (AST)/alanine transaminase (ALT) <3 x upper limits of normal (ULN)
Total bilirubin <1.5 x ULN (allow 3x ULN for Gilbert's syndrome)
Prothrombin time test (PTT), prothrombin time (PT)/international normalized ratio (INR) <1.5 x ULN, unless on a stable dose of anti-coagulant for a thromboembolic event (Subjects with any history of thromboembolic stroke; or history or Grade 2 (G2) or greater hemorrhage within one year are excluded)
Resolution of adverse events (AEs) from any prior systemic anticancer therapy, radiotherapy, or surgery to Grade 1 or baseline (except G2 alopecia and G2 sensory neuropathy)
Male and female participants of childbearing potential must agree to use highly effective methods of birth control through 12 months after the dose of study treatment
Willing to comply with and able to tolerate study procedures, including consent to participate in separate Long-term Safety Follow-up lasting up to 15 years per FDA guidance
Subject's leukapheresis product from non-mobilized cells is received and accepted for cell processing by manufacturing site. NOTE: Leukapheresis will be performed only after all other eligibility criteria are confirmed

Exclusion Criteria:

Plasma cell leukemia or history of plasma cell leukemia

Treatment with the following therapies as specified below

Any prior systemic treatment for multiple myeloma within the 14 days prior to scheduled leukapheresis
Receiving high-dose (e.g., >10 mg prednisone or equivalent) systemic steroid therapy or any other form of immunosuppressive therapy within 14 days prior to leukapheresis
Prior treatment with any gene therapy or gene-modified cellular immune-therapy
Prior B-cell maturation antigen (BCMA) directed therapy
Autologous stem cell transplantation within 3 months prior to leukapheresis, or any prior allogeneic stem cell transplantation
Subjects with solitary plasmacytomas without evidence of other measurable disease are excluded
History of allergy or hypersensitivity to study drug components. Subjects with a history of severe hypersensitivity reaction to dimethyl sulphoxide (DMSO) are excluded
Contraindication to fludarabine or cyclophosphamide

Severe or uncontrolled intercurrent illness or laboratory abnormalities including

Active bacterial, viral, or fungal infection requiring systemic treatment (isolated fever may not constitute active infection in and of itself, (e.g., related to disease)
Symptomatic congestive heart failure (i.e., New York Heart Association stage III or IV)
Unstable angina, arrhythmia, or myocardial infarction (MI) within 6 months prior to Screening
Significant pulmonary dysfunction
Uncontrolled thromboembolic events or recent severe hemorrhage (i.e., within one year)
Any history of pulmonary embolism (PE) in the past 12 months or deep vein thrombosis (DVT) within three months of enrollment. Therapeutic dosing of anticoagulants (e.g., warfarin, low molecular weight heparin, Factor Xa inhibitors) is allowed for history of PE/DVT if greater than twelve and three months, respectively, from time of enrollment, and should be at a stable maintenance dose.
Auto-immune disease requiring immunosuppressive therapy within the last 24 months

Seropositive for and with evidence of active hepatitis B or C infection at time of Screening, or HIV seropositive

Subjects with a history of hepatitis B but have received antiviral therapy and have non-detectable viral DNA are eligible
Subjects seropositive because of hepatitis B virus vaccine with no signs or active infection are eligible
Subjects who had hepatitis C but have received antiviral therapy and show no detectable hepatitis C virus (HCV) viral RNA are eligible
Active central nervous system (CNS) involvement by malignancy
Any sign of active or prior CNS pathology including but not limited to history of epilepsy, seizure, paresis, aphasia, stroke, subarachnoid hemorrhage or CNS bleed, severe brain injury, dementia, cerebellar disease, Parkinson's disease, organic brain syndrome or psychosis
Active malignancy not related to myeloma that has required therapy in the last 3 years or is not in complete remission. Exceptions to this criterion include successfully treated non-metastatic basal cell or squamous cell skin carcinoma, or prostate cancer that does not require therapy.
Females who are pregnant or breastfeeding or females of childbearing potential not using an effective method of birth control
Subjects with any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in study (or full access to medical records) as written including follow up, the interpretation of data or place the subject at unacceptable risk
Any vaccine ≤ 6 weeks before leukapheresis and/or anticipation of the need for such a vaccine during the subject's participation in the study
Concurrent enrollment on another study using an investigational therapy for the treatment of RRMM

Study Contact Info

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Clinical Information
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Study Contact Phone

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Other Details

FDA Regulated Drug?
FDA Regulated Device?
Detailed Description
This is a Phase II open-label study of CART-ddBCMA* in patients with relapsed or refractory multiple myeloma (MM). The study will have the following sequential phases: screening, enrollment, pre-treatment with lymphodepleting chemotherapy, treatment with CART-ddBCMA, and follow-up. If necessary, bridging therapy is allowed to control growth of MM disease while CART-ddBCMA is being manufactured.

Following a single infusion of CART-ddBCMA both safety and efficacy data will be assessed. Efficacy will be assessed monthly for the first 6 months, then quarterly up to 2 years, or upon patient relapse. The primary analysis will be conducted approximately 13 months after the final patient is dosed. This will allow approximately 12 months follow up from the time of the last observed response on study.

Long-term safety data will be collected under a separate long-term follow up study for up to 15 years per health authority guidelines.

*CART-ddBCMA drug product consists of autologous T cells that have been genetically modified ex vivo to express a D-domain Chimeric Antigen Receptor (CAR), followed by a cluster of differentiation 8 (CD8) hinge and transmembrane region that is fused to the intracellular signaling domains for 4-1BB and CD3ξ, that specifically recognizes B-cell maturation antigen (BCMA). The active substance of CART-ddBCMA is CAR+ CD3+ T cells that have undergone ex vivo T-cell activation, gene transfer by replication-deficient lentiviral vector, and expansion.
NCTid (if applicable)