RecruitingPhase 2NCT05231629

Sequential Therapy in Multiple Myeloma Guided by MRD Assessments

MRD-Guided Sequential Therapy For Deep Response in Newly Diagnosed Multiple Myeloma - MASTER-2 Trial


Sponsor

University of Alabama at Birmingham

Enrollment

300 participants

Start Date

Dec 13, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

This research study will determine the proportion of patients with lowest minimal residual disease (MRD) response obtainable after receiving 6 cycles of study treatment. Minimal residual disease is multiple myeloma cells below the level of 1 cancer cell out of 100,000 in the bone marrow. For patients who become MRD "negative" (i.e. less than 1 cancer cell out of 100,000) at the end of 6 cycles of therapy, this study will study if that good response can be maintained with 3 additional cycles of treatment instead of use of autologous hematopoietic cell transplantation (AHCT). For patients who are MRD "positive" at the end of 6 cycles of therapy, this study will answer whether more patients can become and remain MRD "negative" with AHCT plus teclistamab in combination with daratumumab when compared with patients who undergo AHCT followed by lenalidomide (an established anti-myeloma drug) plus daratumumab.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This trial is testing a treatment strategy for newly diagnosed multiple myeloma (a blood cancer of plasma cells) where therapy is guided by a sensitive test called MRD (minimal residual disease) testing — which checks whether any cancer cells remain after treatment — to decide when and how to change medications. **You may be eligible if...** - You are 18 or older - You have been newly diagnosed with multiple myeloma that requires treatment - You are in reasonably good health (ECOG performance status 0–2) - You have had limited or no prior myeloma treatment **You may NOT be eligible if...** - You have had substantial prior treatment for myeloma beyond a very limited amount of steroids or single agents - You have serious heart, kidney, or liver problems - You have active serious infections - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGDara-VRd intensification, Dara-R maintenance

Eligible patients are enrolled in arm M for induction therapy, corresponding to 6 cycles of Dara-VRd. Upon confirmation of adequate hematopoietic cell collection and result of MRD1 patients will undergo 1:1 randomization according to the MRD-assigned cohort • MRD negative cohort - Patients will be randomized between arm A (3 cycles of Dara-VRd intensification followed by 13 cycles of Dara-R maintenance) and arm B (AHCT intensification followed by 13 cycles of Dara-R maintenance) for intensification and maintenance

DRUGAHCT intensification, Dara-R maintenance

Eligible patients are enrolled in arm M for induction therapy, corresponding to 6 cycles of Dara-VRd. Upon confirmation of adequate hematopoietic cell collection and result of MRD1 patients will undergo 1:1 randomization according to the MRD-assigned cohort • MRD negative cohort - Patients will be randomized between arm A (3 cycles of Dara-VRd intensification followed by 13 cycles of Dara-R maintenance) and arm B (AHCT intensification followed by 13 cycles of Dara-R maintenance) for intensification and maintenance

DRUGAHCT intensification, Tec-Dara consolidation, Tec-Dara maintenance

Eligible patients are enrolled in arm M for induction therapy, corresponding to 6 cycles of Dara-VRd. Upon confirmation of adequate hematopoietic cell collection and result of MRD1 patients will undergo 1:1 randomization according to the MRD-assigned cohort. MRD positive cohort - Patients will be randomized between arm C (AHCT intensification, 3 cycles of Dara-Tec consolidation and 13 cycles of Dara-Tec maintenance) and arm D (AHCT intensification, 3 cycles of Dara-R consolidation and 13 cycles of Dara-R maintenance) for intensification, consolidation and maintenance.

DRUGAHCT intensification, Dara-R consolidation, Dara-R maintenance

Eligible patients are enrolled in arm M for induction therapy, corresponding to 6 cycles of Dara-VRd. Upon confirmation of adequate hematopoietic cell collection and result of MRD1 patients will undergo 1:1 randomization according to the MRD-assigned cohort. MRD positive cohort - Patients will be randomized between arm C (AHCT intensification, 3 cycles of Dara-Tec consolidation and 13 cycles of Dara-Tec maintenance) and arm D (AHCT intensification, 3 cycles of Dara-R consolidation and 13 cycles of Dara-R maintenance) for intensification, consolidation and maintenance.

DRUGDara-VRd induction

Patients undergo induction therapy with 6 cycles of daratumumab, bortezomib, lenalidomide and dexamethasone


Locations(10)

University of Alabama at Birmingham

Birmingham, Alabama, United States

Colorado Blood Cancer Institute

Denver, Colorado, United States

Columbia University

New York, New York, United States

Oregon Health and Science University

Portland, Oregon, United States

Vanderbilt University

Nashville, Tennessee, United States

University of Texas Southwestern

Dallas, Texas, United States

University of Utah

Salt Lake City, Utah, United States

University of Washington

Seattle, Washington, United States

University of Wisconsin - Carbone

Madison, Wisconsin, United States

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

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NCT05231629


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