RecruitingInterventionalPhase 2

Use of Isatuximab, Dexamethasone and Lenalidomide in a Go-Slow Fashion for Ultra-Frail Patients With Multiple Myeloma: A Phase 2 Multicenter Study

NCT ID: NCT06517017Sponsor: University of UtahLast updated: 2025-11-28

Summary

Historically, the frailest patients with multiple myeloma are under-represented in clinical trials, and have very high rates of treatment discontinuation, and early treatment mortality. The investigators hypothesize that a go-slow gentle approach to starting treatment in such patients, starting with just Isatuximab and dexamethasone with a gentle introduction to lenalidomide third cycle onwards, may improve treatment adherence and quality of life. The goal of this clinical trial is to learn if a go-slow approach to treating MM in ultra-frail patients may improve the ability to adhere to treatment and improve quality of life.

Arms & interventions

DrugIsatuximab
Subcutaneous isatuximab will be administered weekly on a 28-day cycle during the first two cycles, and every two weeks of a 28-day cycle thereafter. Dexamethasone will be administered on the days of isatuximab administration and can be discontinued after two cycles of therapy, or continued at discretion of investigator. Lenalidomide, will be added after two cycles of therapy have been completed.

Outcome measures

Primary

Completion rate of 9 cycles of treatment
Assess the feasibility of approach incorporating the use of isatuximab and dexamethasone with the subsequent addition of lenalidomide from the third cycle onwards in ultra-frail patients with myeloma
Time frame: At the end of 9 cycles of treatment (each cycle is 28 days)

Secondary

Change in quality of life as per the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 domain
Time frame: At the end of 4 cycles of treatment (each cycle is 28 days)
Frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by type
Time frame: At study completion. Participants will be enrolled in study for about 3 years.
Frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by severity (as defined by the NIH CTCAE, version 5.0)
Time frame: At study completion. Participants will be enrolled in study for about 3 years.
Frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by seriousness
Time frame: At study completion. Participants will be enrolled in study for about 3 years.
Frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by duration
Time frame: At study completion. Participants will be enrolled in study for about 3 years.
Frequency of adverse events (AEs) and serious adverse events (SAEs) characterized by relationship to study treatment
Time frame: At study completion. Participants will be enrolled in study for about 3 years.
Overall survival (OS)
Time frame: Time from registration until 3 years from start of therapy or death from any cause.

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No

Inclusion Criteria: * Male or female subject aged ≥ 18 years. * Histologically confirmed myeloma and/or Plasma Cell Leukemia who are newly diagnosed and having completed ≤ 1 prior cycle of myeloma treatment. * For female subjects of childbearing potential: Negative pregnancy test or evidence of post-menopausal status or evidence of permanent surgical sterilization (bilateral oophorectomy or hysterectomy). The post-menopausal status will be defined as having been amenorrheic for 24 months without an alternative medical cause. * Subjects must be willing to follow contraception requirements listed in the protocol, agree to participate in the Lenalidomide REMS program, and have signed the Patient-Physician Agreement Form. * Male subjects must agree to use a latex condom during intercourse for the duration of study therapy as described in the protocol, even if he has undergone a successful vasectomy. * Recovery to baseline or ≤ Grade 1 CTCAE v5 from toxicities related to any prior treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive therapy per the treating investigator. * Able to provide informed consent and willing to sign an approved consent form that conforms to federal and institutional guidelines. * IMWG defined frailty score ≥ 3. IMWG definition available here: http://www.myelomafrailtyscorecalculator.net Exclusion Criteria: * Receiving other investigational agents. * Any condition that would, in the Investigator's judgment, compromise the subject's ability to understand the subject information, give informed consent, and/or contraindicate the subject's participation in the clinical study due to safety concerns or compliance with clinical study procedures (e.g., infection/inflammation, intestinal obstruction, unable to swallow medication, \[subjects may not receive the drug through a feeding tube\], social/ psychological issues, etc.) * Known prior severe hypersensitivity (NCI CTCAE v5.0 Grade ≥ 3) to investigational product (IP) or any component in its formulations. This includes hypersensitivity or history of intolerance to steroids, mannitol, pregelatinized starch, sodium stearyl fumarate, histidine (as base and hydrochloride salt), arginine hydrochloride, poloxamer 188, sucrose or any of the other components of study intervention that are not amenable to premedication with steroids and H2 blockers or would prohibit further treatment with these agents. * Subjects currently taking prohibited medications as described in the protocol.

Study locations (1)

Huntsman Cancer Institute at the University of Utah

Salt Lake City, Utah, 84112

Recruiting

Rachel Kingsford · Contact

801-585-0115 rachel.kingsford@hci.utah.edu