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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04270409
Registration number
NCT04270409
Ethics application status
Date submitted
13/02/2020
Date registered
17/02/2020
Titles & IDs
Public title
A Phase 3 Randomized, Open-label, Multicenter Study of Isatuximab (SAR650984) in Combination With Lenalidomide and Dexamethasone Versus Lenalidomide and Dexamethasone in Patients With High-risk Smoldering Multiple Myeloma
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Scientific title
A Phase 3 Randomized, Open Label, Multicenter Study of Isatuximab (SAR650984) in Combination With Lenalidomide and Dexamethasone Versus Lenalidomide and Dexamethasone in Patients With High-risk Smoldering Multiple Myeloma
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Secondary ID [1]
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U1111-1222-7068
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Secondary ID [2]
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EFC15992
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Plasma Cell Myeloma
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Condition category
Condition code
Cancer
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Other cancer types
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Cancer
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0
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Myeloma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Isatuximab SAR650984
Treatment: Drugs - Lenalidomide
Treatment: Drugs - Dexamethasone
Treatment: Drugs - Montelukast or equivalent
Treatment: Drugs - Acetaminophen
Treatment: Drugs - Diphenhydramine or equivalent
Treatment: Drugs - Methylprednisolone or equivalent
Experimental: Isatuximab, lenalidomide, and dexamethasone (ILd) - Participants will receive isatuximab \[intravenous (IV) administration\] in combination with lenalidomide \[per os (PO) administration\] and dexamethasone \[IV on Day 1 of Cycle 1 for participants receiving isatuximab IV only and PO otherwise for subsequent cycles\] for 24 cycles followed by isatuximab monotherapy for 12 cycles for a total duration of 36 cycles. 1 cycle = 28 days. Participants may receive other treatments as pre-medication.
Active comparator: Lenalidomide and dexamethasone (Ld) - Lenalidomide \[PO administration\] in combination with dexamethasone \[PO administration\] for 24 cycles. 1 cycle = 28 days
Treatment: Drugs: Isatuximab SAR650984
Pharmaceutical for: Solution for infusion Route of administration: Intravenous
Treatment: Drugs: Lenalidomide
Pharmaceutical form: Capsules Route of administration: Oral
Treatment: Drugs: Dexamethasone
Pharmaceutical form: Tablets and solution for injection Route of administration: Oral and intravenous
Treatment: Drugs: Montelukast or equivalent
Auxiliary Medicinal Product (AxMP)/pre-medication; ATC code: R03DC03; Pharmaceutical form: As per local commercial product; Route of administration: Oral;
Treatment: Drugs: Acetaminophen
AxMP/pre-medication ATC code: N02BE01 Pharmaceutical form: As per local commercial product; Route of administration: Oral
Treatment: Drugs: Diphenhydramine or equivalent
AxMP/pre-medication ATC code: R06AA02 Pharmaceutical form: As per local commercial product; Route of administration: Intravenous
Treatment: Drugs: Methylprednisolone or equivalent
AxMP/pre-medication; ATC code: H02AB04; Pharmaceutical form: As per local commercial product; Route of administration: Intravenous
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Safety assessment: adverse events (AEs)- Safety Run-in Part
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Assessment method [1]
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Number of participants with AEs
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Timepoint [1]
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Up to approximately 63 months
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Primary outcome [2]
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Plasma concentration of isatuximab: Cmax- Safety Run-in Part
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Assessment method [2]
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Maximum concentration observed after the first infusion (Cmax)
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Timepoint [2]
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After first infusion in Cycle 1 in safety run-in part. 1 cycle = 28 days
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Primary outcome [3]
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Receptor density/receptor occupancy Safety Run-in Part
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Assessment method [3]
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Change in CD38 receptor occupancy from baseline
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Timepoint [3]
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Baseline to Cycle 2 Day 1 (each cycle is 28 days)
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Primary outcome [4]
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Progression-free survival (PFS) Randomized Phase 3
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Assessment method [4]
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Time from randomization to MM (SLiM CRAB criteria) or other related conditions based on independent review committee assessment according to 2014 International Myeloma Working Group (IMWG) criteria or death from any cause, whichever happens first
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Timepoint [4]
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Up to approximately 114 months
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Secondary outcome [1]
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Overall response rate (ORR)- Safety Run-in Part and Randomized Phase 3
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Assessment method [1]
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Proportion of participants with best overall response recorded as partial response or better according to 2016 IMWG criteria
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Timepoint [1]
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Up to approximately 63 and 114 months for Safety Run-in Part and Randomized Phase 3, respectively
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Secondary outcome [2]
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Duration of response (DOR)-Safety Run-in Part and Randomized Phase 3
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Assessment method [2]
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Time from the date of the first response to date of progressive disease or death, whichever happens first
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Timepoint [2]
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Up to approximately 63 and 114 months for Safety Run-in Part and Randomized Phase 3, respectively
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Secondary outcome [3]
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Minimal residual disease (MRD) negativity-Safety Run-in Part and Randomized Phase 3
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Assessment method [3]
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Number of participants for whom MRD is negative
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Timepoint [3]
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Up to approximately 65 months
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Secondary outcome [4]
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Time to diagnostic (SLiM CRAB) progression or death -Safety Run-in Part and Randomized Phase 3
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Assessment method [4]
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Time from randomization to diagnosis of SLiM-CRAB or other related conditions, progression, or death from any cause
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Timepoint [4]
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Up to approximately 63 and 114 months for Safety Run-in Part and Randomized Phase 3, respectively
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Secondary outcome [5]
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Time to first-line treatment for multiple myeloma (MM)- Safety Run-in Part and Randomized Phase 3
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Assessment method [5]
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Time from randomization to first-line treatment for MM
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Timepoint [5]
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Up to approximately 63 and 114 months for Safety Run-in Part and Randomized Phase 3, respectively
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Secondary outcome [6]
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Immunogenicity: Incidence of anti-drug antibodies (ADA)- Safety Run-in Part
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Assessment method [6]
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Number of participants with anti-drug antibodies against isatuximab
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Timepoint [6]
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Up to approximately 27 months
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Secondary outcome [7]
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Sustained MRD negativity- Randomized Phase 3
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Assessment method [7]
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Number of participants with sustained MRD negativity (sample is still negative at least 1 year after the first negativity assessment)
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Timepoint [7]
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Up to approximately 65 months
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Secondary outcome [8]
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Second PFS (PFS2) Randomized Phase 3
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Assessment method [8]
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Time from randomization to date of second objective progressive disease or death from any cause
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Timepoint [8]
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Up to approximately 144 months
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Secondary outcome [9]
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Overall survival- Randomized Phase 3
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Assessment method [9]
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Time from date of randomization to death from any cause
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Timepoint [9]
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Up to approximately 144 months
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Secondary outcome [10]
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PFS and OS in participants with cytogenetic abnormalities- Safety Run-In and Randomized Part
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Assessment method [10]
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Association of cytogenetic abnormalities with survival outcomes
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Timepoint [10]
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Up to approximately 63 and 114 months for Safety Run-in Part and Randomized Phase 3, respectively
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Secondary outcome [11]
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Complete response rate - Randomized Phase 3
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Assessment method [11]
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Percentage of particpants with a CR as defined by 2016 IMWG response criteria
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Timepoint [11]
0
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Up to approximately 114 months
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Secondary outcome [12]
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Time to biochemical progression - Randomized Phase 3
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Assessment method [12]
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Time to biochemical progression is defined as the time from randomization to the date of biochemical progression based on IRC assessment.
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Timepoint [12]
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Up to approximately 114 months
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Secondary outcome [13]
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Safety assessment: adverse events (AEs)- Randomized Phase 3
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Assessment method [13]
0
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Number of participants with AEs
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Timepoint [13]
0
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Up to approximately 144 months
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Secondary outcome [14]
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Plasma concentration of isatuximab- Randomized Phase 3
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Assessment method [14]
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Concentration observed just before treatment administration during repeated dosing (Ctrough) after IV administration
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Timepoint [14]
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At predose of Cycle 2 Day 1 and Cycle 6 Day 1
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Secondary outcome [15]
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European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30-Randomized Phase 3
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Assessment method [15]
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Mean change from baseline scores will be assessed, with responses ranging from 1=not at all to 4=very much or 1=very poor to 7=excellent; higher scores represent a better level of physical functioning
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Timepoint [15]
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Baseline to follow-up (up to approximately 7 years)
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Secondary outcome [16]
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EORTC QLQ-MY20 - Randomized Phase 3
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Assessment method [16]
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Mean change from baseline in scores will be assessed using a 4-point scale, with responses ranging from 1=not at all to 4=very much; higher scores represent better perspectives of the future and higher level of symptomatology
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Timepoint [16]
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Baseline to follow-up (up to approximately 7 years)
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Secondary outcome [17]
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EQ-5D-5L Randomized Phase 3
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Assessment method [17]
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Mean change from baseline scores will be assessed from 5 items, with responses ranging from 'no' to 'extreme problems'; health state utility values (HSUVs) are generated by multiplying the item scores by country specific value sets; health status is assessed via a VAS; higher scores = higher HSUV/health status
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Timepoint [17]
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Baseline to follow-up (up to approximately 7 years)
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Secondary outcome [18]
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Randomized Phase 3: HRUPQ - Randomized Phase 3
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Assessment method [18]
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Mean change from baseline in Health resource utilization and productivity questionnaire (HRUPQ) scores. HRUPQ will assess health care resource utilization of HRSM and the impact of HRSM on employment/work higher scores = greater impact on work/productivity, resources
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Timepoint [18]
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Baseline to follow-up (up to approximately 7 years)
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Secondary outcome [19]
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Patient's Qualitative Assessment of Treatment Version 2 (PQAT-v2) Randomized Phase 3
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Assessment method [19]
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Patient's qualitative assessment of treatment will be assessed using a 10 point visual analogue/numeric rating scale with response anchors of 'not beneficial at all' to 'extremely beneficial'; higher scores represent greater patient-perceived benefits of treatment
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Timepoint [19]
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End of treatment (up to approximately 5 years)
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Eligibility
Key inclusion criteria
Inclusion criteria:
* Participants who are diagnosed within 5 years with SMM (per International Myeloma Working Group [IMWG] criteria), defined as serum M-protein =30 g/L or urinary M-protein =500 mg per 24 hour or both, and/or clonal bone marrow plasma cells (BMPCs) 10% to <60%, and absence of myeloma defining events or other related conditions and with high-risk SMM
* Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1 or 2
* Capable of giving voluntary written informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria:
* Evidence of any of the following calcium, renal failure, anemia, bone lesions (CRAB) criteria or Myeloma Defining Events (SLiM CRAB) detailed below (attributable to the participants SMM involvement):
* Increased calcium levels: Corrected serum calcium >1 mg/dL above the ULN or >11 mg/dL
* Renal insufficiency: Determined by glomerular filtration rate (GFR) <40 mL/min/1.73 m² (Modification of Diet in Renal Disease [MDRD] Formula) or serum creatinine >2 mg/dL
* Anemia (hemoglobin 2 g/dL below lower limit of normal or <10 g/dL or both) transfusion support or concurrent treatment with erythropoietin stimulating agents is not permitted
* = 1 bone lytic lesion
* BMPCs =60%
* Serum involved/uninvolved FLC ratio =100 and an involved FLC =100mg/L
* Whole body magnetic resonance imaging (WB-MRI) or positron emission tomography-computed tomography (PET-CT) with more than 1 bone focal lesion (=5 mm in diameter by MRI)
* Primary systemic amyloid light-chain (AL) amyloidosis, monoclonal gammopathy of undetermined significance (MGUS), standard risk smoldering myeloma, soft tissue plasmacytoma, symptomatic myeloma
* Uncontrolled infection within 28 days prior to randomization in Phase 3 or first study intervention administration in safety run-in
* Clinically significant cardiac disease, including:
* Myocardial infarction within 6 months with left ventricular dysfunction or uncontrolled ischemic cardiac disease before Cycle 1 Day 1, or unstable or uncontrolled disease/condition related to or affecting cardiac function (eg, unstable angina, congestive heart failure, New York Heart Association Class III-IV)
* Uncontrolled cardiac arrhythmia (Grade 2 or higher by NCI-CTCAE Version 5.0) or clinically significant electrocardiogram (ECG) abnormalities
* Known acquired immunodeficiency syndrome (AIDS)-related illness or known human immunodeficiency virus (HIV) disease requiring antiviral treatment or active hepatitis A (defined as positive hepatitis A antigen or positive IgM). HIV serology at screening will be tested for German participants and any other country where required as per local regulations and serology hepatitis B and C at screening will be tested for all participants
* Uncontrolled or active HBV infection: Patients with positive HBsAg and/or HBV DNA
Of note:
Patient can be eligible if anti-HBc IgG positive (with or without positive anti-HBs) but HBsAg and HBV DNA are negative. If anti-HBV therapy in relation with prior infection was started before initiation of IMP, the anti-HBV therapy and monitoring should continue throughout the study treatment period.
Patients with negative HBsAg and positive HBV DNA observed during screening period will be evaluated by a specialist for start of anti-viral treatment: study treatment could be proposed if HBV DNA becomes negative and all the other study criteria are still met.
Active HCV infection: positive HCV RNA and negative anti-HCV
Of note:
Patients with antiviral therapy for HCV started before initiation of IMP and positive HCV antibodies are eligible. The antiviral therapy for HCV should continue throughout the treatment period until seroconversion.
Patients with positive anti-HCV and undetectable HCV RNA without antiviral therapy for HCV are eligible
* Malabsorption syndrome or any condition that can significantly impact the absorption of lenalidomide
* Any of the following within 3 months prior to randomization (or first study intervention administration in safety run-in cohort): treatment resistant peptic ulcer disease, erosive esophagitis or gastritis, infectious or inflammatory bowel disease, diverticulitis, pulmonary embolism, or other uncontrolled thromboembolic event
* Received treatment (eg surgery, radiotherapy, medication) for a malignancy within 3 years of randomization (or first study intervention administration in safety run-in cohort)
* Prior exposure to approved or investigational treatments for SMM or MM (including but not limited to conventional chemotherapies, immunomodulatory imid drugs, or Proteasome inhibitors); concurrent use of bisphosphonates or receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitor denosumab is not permitted; however, prior bisphosphonates or once-a-year intravenous bisphosphonate given for the treatment of osteoporosis is permitted
* Ongoing treatment with corticosteroids with a dose >10 mg prednisone or equivalent per day at the time of randomization (or first study intervention administration in safety run-in cohort)
* Women of childbearing potential or male participant with women of childbearing potential who do not agree to use a highly effective method of birth control
* Vaccination with a live vaccine 4 weeks before the start of the study drug. Seasonal flu vaccines that do not contain live virus are permitted
The above information is not intended to contain all considerations relevant to a potential participation in a clinical trial.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/06/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
10/10/2033
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Actual
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Sample size
Target
337
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,WA
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Recruitment hospital [1]
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Investigational Site Number :0360008 - Liverpool
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Recruitment hospital [2]
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Investigational Site Number :0360005 - Waratah
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Recruitment hospital [3]
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Investigational Site Number :0360001 - Wollongong
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Recruitment hospital [4]
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Investigational Site Number :0360002 - Fitzroy
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Recruitment hospital [5]
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Investigational Site Number :0360007 - Heidelberg West
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Recruitment hospital [6]
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Investigational Site Number :0360004 - Richmond
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Recruitment hospital [7]
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Investigational Site Number :0360006 - Nedlands
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Recruitment postcode(s) [1]
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2170 - Liverpool
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Recruitment postcode(s) [2]
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2298 - Waratah
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Recruitment postcode(s) [3]
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2500 - Wollongong
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Recruitment postcode(s) [4]
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3065 - Fitzroy
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Recruitment postcode(s) [5]
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3081 - Heidelberg West
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Recruitment postcode(s) [6]
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3121 - Richmond
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Recruitment postcode(s) [7]
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6009 - Nedlands
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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United States of America
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Colorado
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United States of America
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Florida
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United States of America
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Massachusetts
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United States of America
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North Carolina
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United States of America
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Tennessee
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United States of America
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Texas
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0
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Brazil
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State/province [8]
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São Paulo
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0
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Canada
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State/province [9]
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Alberta
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Country [10]
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Canada
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State/province [10]
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New Brunswick
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Canada
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State/province [11]
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Quebec
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Country [12]
0
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China
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State/province [12]
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Hangzhou
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0
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China
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Nanchang
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China
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Shanghai
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China
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Shenyang
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China
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Tianjin
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Czechia
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Brno
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Czechia
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Hradec Kralove
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Czechia
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Olomouc
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Czechia
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Ostrava - Poruba
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Czechia
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State/province [21]
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Praha 2
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Denmark
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State/province [22]
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Aalborg
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Denmark
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Aarhus N
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Denmark
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Copenhagen
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Denmark
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Roskilde
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France
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Ars-Laquenexy
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France
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Bayonne
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France
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GRENOBLE Cedex 9
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France
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La Roche sur Yon
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France
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Lille
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France
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Paris
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France
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Poitiers Cedex
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France
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State/province [33]
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RENNES Cedex 09
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0
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Germany
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Hamburg
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Germany
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Heidelberg
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Greece
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State/province [36]
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Athens
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Greece
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State/province [37]
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Thessaloniki
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Hungary
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Budapest
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Hungary
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State/province [39]
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Debrecen
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Hungary
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State/province [40]
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Kaposvár
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Ireland
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Dublin
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Israel
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Ashdod
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Israel
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Jerusalem
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Israel
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Petah-Tikva
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0
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Israel
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Ramat Gan
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0
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Israel
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Tel Aviv
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Italy
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Forlì-Cesena
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0
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Italy
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0
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Milano
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0
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Italy
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State/province [49]
0
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Ancona
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0
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Italy
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Bologna
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0
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Italy
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0
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Terni
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0
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Japan
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0
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Aichi
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0
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Japan
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0
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Chiba
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0
0
Japan
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0
0
Gunma
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Country [55]
0
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Japan
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Ibaraki
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Japan
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Okayama
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Japan
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Shizuoka
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Japan
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Tokyo
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Korea, Republic of
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Seoul-teukbyeolsi
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Korea, Republic of
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Seoul
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Lithuania
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Vilnius
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New Zealand
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Canterbury
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New Zealand
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Waikato
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Norway
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Bergen
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Norway
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Oslo
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Poland
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Kujawsko-pomorskie
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Poland
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Lódzkie
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Poland
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Pomorskie
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Poland
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Slaskie
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Spain
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Barcelona [Barcelona]
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Spain
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Navarra
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Spain
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Valenciana, Comunidad
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Spain
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Madrid
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Spain
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Salamanca
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Spain
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Zaragoza
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Sweden
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Göteborg
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Sweden
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Helsingborg
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Turkey
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Ankara
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Turkey
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Istanbul
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Turkey
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Izmir
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United Kingdom
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Hampshire
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United Kingdom
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London, City Of
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United Kingdom
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Leicester
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United Kingdom
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Southampton
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Sanofi
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
Primary Objectives: * Safety run-in: To confirm the recommended dose of isatuximab when combined with lenalidomide and dexamethasone in participants with high-risk smoldering multiple myeloma (SMM) * Randomized Phase 3: To demonstrate the clinical benefit of isatuximab in combination with lenalidomide and dexamethasone in the prolongation of progression-free survival when compared to lenalidomide and dexamethasone in subjects with high-risk SMM Secondary Objectives: Safety run-in * To assess overall response rate (ORR) * To assess duration of response (DOR) * To assess minimal residual disease (MRD) negativity in participants achieving very good partial response (VGPR) or complete response (CR) * To assess time to diagnostic (SLiM CRAB) progression or death * To assess time to first-line treatment for multiple myeloma (MM) * To assess the potential immunogenicity of isatuximab * Impact of abnormal cytogenetic subtype on participant outcome Randomized Phase 3 - Key Secondary Objectives: To compare between the arms * MRD negativity * Sustained MRD negativity * Second progression-free survival (PFS2) * Overall survival Other Secondary Objectives: To evaluate in both arms * CR rate * ORR * DOR * Time to diagnostic (SLiM CRAB) progression * Time to biochemical progression * Time to first-line treatment for MM * Safety and tolerability * Pharmacokinetics (PK) * Potential of isatuximab immunogenicity * Clinical outcome assessments (COAs)
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Trial website
https://clinicaltrials.gov/study/NCT04270409
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Public notes
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Contacts
Principal investigator
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Clinical Sciences & Operations
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Sanofi
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04270409