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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04973137
Registration number
NCT04973137
Ethics application status
Date submitted
1/07/2021
Date registered
22/07/2021
Titles & IDs
Public title
A Study to Evaluate the Efficacy and Safety of Birtamimab in Mayo Stage IV Patients With AL Amyloidosis
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Scientific title
A Phase 3, Randomized, Multicenter, Double-Blind, Placebo-Controlled, Efficacy and Safety Study of Birtamimab Plus Standard of Care vs. Placebo Plus Standard of Care in Mayo Stage IV Subjects With Light Chain (AL) Amyloidosis
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Secondary ID [1]
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NEOD001-301
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Universal Trial Number (UTN)
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Trial acronym
AFFIRM-AL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Light Chain (AL) Amyloidosis
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0
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Condition category
Condition code
Metabolic and Endocrine
0
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0
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Metabolic disorders
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Metabolic and Endocrine
0
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0
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Other metabolic disorders
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Human Genetics and Inherited Disorders
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Birtamimab
Other interventions - Placebo
Treatment: Drugs - Standard of Care Chemotherapy
Experimental: Birtamimab plus Standard of Care Chemotherapy- For Double-blind Phase and OLE Phase of study - Intravenous administration of 24 mg/kg birtamimab every 28 days.
Drug: Standard of Care Chemotherapy. Bortezomib-containing chemotherapy regimen (e.g. cyclophosphamide, bortezomib, and dexamethasone (CyBorD)) according to the institutional standard of care.
The initiation of daratumumab treatment at randomization is allowed at the discretion of the Investigator; initiation at any other time during the Double-blind Phase is prohibited. For subjects who did not initiate daratumumab at randomization during the Double-blind Phase, daratumumab may be initiated at any time during the OLE Phase at the Investigator's discretion.
Placebo comparator: Placebo plus Standard of Care Chemotherapy- For Double-blind Phase of study - Intravenous 0.9% Saline administration as a placebo every 28 days.
Drug: Standard of Care Chemotherapy. Bortezomib-containing chemotherapy regimen (e.g. cyclophosphamide, bortezomib, and dexamethasone (CyBorD)) according to the institutional standard of care. Initiation of daratumumab at randomization allowed at the discretion of the investigator.
Treatment: Drugs: Birtamimab
Intravenous administration of 24 mg/kg birtamimab every 28 days
Other interventions: Placebo
Intravenous 0.9% Saline administration as a placebo every 28 days
Treatment: Drugs: Standard of Care Chemotherapy
Bortezomib-containing chemotherapy regimen (e.g. cyclophosphamide, bortezomib, and dexamethasone (CyBorD)) according to the institutional standard of care
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Other interventions
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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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Time to all-cause mortality for the Double Blind Phase
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Assessment method [1]
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Comparison of time to all-cause mortality for birtamimab and placebo control.
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Timepoint [1]
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Time from the first dose of study drug until the pre-defined number of events (all-cause mortality) have been reached.
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Secondary outcome [1]
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6MWT distance for the Double Blind Phase
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Assessment method [1]
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Change from baseline to Month 9 in the 6-Minute Walk Test (6MWT) distance
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Timepoint [1]
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Month 9
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Secondary outcome [2]
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Physical Component Summary score of the Short Form-36, version 2 for the Double Blind Phase
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Assessment method [2]
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The Short Form-36, version 2 is a 36-item self-administered quality-of-life questionnaire that measures health on functional status, well-being, and overall evaluation of health. The Physical Component Summary score ranges from 0 to 100 with higher scores indicating higher health-related quality of life. The Physical Component Summary is derived primarily from questions regarding physical functioning, physical problems, bodily pain, and general health questions.
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Timepoint [2]
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Month 9
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Eligibility
Key inclusion criteria
Key Inclusion Criteria for Double-blind Phase:
* Aged =18 years and legal age of consent according to local regulations
* Newly diagnosed and AL amyloidosis treatment-naïve with cardiac involvement
* Confirmed diagnosis of AL amyloidosis
* Confirmed Mayo Stage IV AL Amyloidosis as defined by NT-proBNP =1800 pg/mL and Troponin-T =0.025 ng/mL or high sensitivity cardiac troponin T=40ng/L and dFLC =18 mg/dL
* Planned first-line chemotherapy contains bortezomib administered subcutaneously weekly
Inclusion Criteria for Open-label (OLE) Phase:
* Must not have discontinued treatment in Double-blind Phase
* WOCBP must have a negative pregnancy test and must agree to use highly effective contraception through 90 days following last study drug administration
* Male subjects must be surgically sterile or agree to use highly effective contraception through 90 days following last study drug administration
* Ability to understand and willingness to sign an ICF prior to initiating the OLE Phase
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Minimum age
18
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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?
No
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Key exclusion criteria
Exclusion Criteria for Double-blind Phase:
* Non-AL amyloidosis
* NT-proBNP >8500 pg/mL
* Meets the International Myeloma Working Group (IMWG) definition of multiple myeloma except for malignancy biomarker of involved/uninvolved serum free light chain ratio =100
* Subject is eligible for and plans to undergo ASCT or organ transplant during the study
* Myocardial infarction, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or ECG evidence of acute ischemia, within 6 months prior to the Month 1-Day 1 Visit
* Severe valvular stenosis (e.g., aortic or mitral stenosis with a valve area <1.0 cm2) or severe congenital heart disease
* ECG evidence of acute ischemia or active conduction system abnormalities
* Prior treatment with hematopoietic growth factors, transfusions of blood or blood products within 1 week of Month 1-Day 1
* Prior radiotherapy within 4 weeks of Month 1-Day 1
* Prior treatment with plasma cell-directed chemotherapy, birtamimab, daratumumab, 11- 1F4, anti-serum amyloid P antibody, doxycycline for amyloid, or other investigational treatment directed at amyloid
* Waldenström's macroglobulinemia and/or immunoglobulin M monoclonal gammopathy
Exclusion Criteria for OLE Phase:
* Any medical condition or clinically significant abnormality on physical, neurological, laboratory, vital signs, or ECG examination that precludes treatment with birtamimab or participation in the study, in the medical judgment of the Investigator
* Symptomatic orthostatic hypotension that in the medical judgment of the Investigator would interfere with subject's ability to safely receive treatment or complete study assessments
* History of Grade =3 infusion-related AEs during the Double-blind Phase or hypersensitivity to birtamimab
* Unable or unwilling to adhere to the study-specified procedures and restrictions
* Planning to use any other investigational treatment during the study
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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 receiving the treatment/s
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Intervention assignment
Parallel
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Phase
Phase 3
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Recruitment
Recruitment status
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
30/08/2021
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Date of last data collection
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1/06/2027
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Actual
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Sample size
Target
220
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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SESLHD: St George Hospital - Kogarah
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Icon Cancer Centre - Wesley - Auchenflower
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Icon Cancer Center - South Brisbane
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Royal Adelaide Hospital - Adelaide
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Box Hill Hospital - Box Hill
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2217 - Kogarah
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4066 - Auchenflower
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4101 - South Brisbane
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5000 - Adelaide
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3128 - Box Hill
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6000 - Perth
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Funding & Sponsors
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Name
Prothena Biosciences Ltd.
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Ethics approval
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Summary
Brief summary
A Phase 3 study to evaluate the efficacy and safety of birtamimab plus standard of care compared to placebo plus standard of care in Mayo Stage IV patients with AL amyloidosis.
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Trial website
https://clinicaltrials.gov/study/NCT04973137
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Contacts
Principal investigator
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Contact person for public queries
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Sonia Romero
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650-837-8550
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[email protected]
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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)?
No
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No/undecided IPD sharing reason/comment
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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/NCT04973137