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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT05257083
Registration number
NCT05257083
Ethics application status
Date submitted
16/02/2022
Date registered
25/02/2022
Date last updated
6/06/2024
Titles & IDs
Public title
A Study of Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Ciltacabtagene Autoleucel Versus Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Autologous Stem Cell Transplant (ASCT) in Participants With Newly Diagnosed Multiple Myeloma
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Scientific title
A Phase 3 Randomized Study Comparing Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Ciltacabtagene Autoleucel Versus Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Autologous Stem Cell Transplant (ASCT) in Participants With Newly Diagnosed Multiple Myeloma Who Are Transplant Eligible
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Secondary ID [1]
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2021-003284-10
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Secondary ID [2]
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EMN28/68284528MMY3005
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Universal Trial Number (UTN)
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Trial acronym
CARTITUDE-6
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Multiple Myeloma
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Condition category
Condition code
Cancer
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Other cancer types
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Daratumumab
Treatment: Drugs - Bortezomib
Treatment: Drugs - Lenalidomide
Treatment: Drugs - Dexamethasone
Treatment: Drugs - Cilta-cel
Treatment: Drugs - Cyclophosphamide
Treatment: Drugs - Fludarabine
Active Comparator: Arm A: DVRd + ASCT+DVRd (Standard Therapy) - Participants will receive daratumumab, bortezomib, lenalidomide and dexamethasone (DVRd) for 4 induction cycles. Followed by ASCT and 2 cycles of DVRd consolidation, and lenalidomide maintenance therapy for 2 years
Daratumumab subcutaneously (SC), 1800 mg on days 1, 8, 15 and 22 of cycle 1 and 2, on days 1 and 15 of cycle 3-6.
Bortezomib SC 1.3 mg/m^2 on days 1, 4, 8, and 11 of each cycle 1-6. Lenalidomide orally, 25 mg on days 1 to 21 of each cycle 1-6. Dexamethasone orally, 40 mg once a week on days 1, 8, 15 and 22 of each cycle 1-6.
Each cycle will consist 28 days.
Lenalidomide maintenance orally 10 to 15 mg on days 1 to 28 (continuously) until confirmed progressive disease or unacceptable toxicity or for a maximum of 2 years
Experimental: Arm B: DVRd followed by Ciltacabtagene Autoleucel - Participants will receive daratumumab, bortezomib, lenalidomide and dexamethasone (DVRd) for 6 induction cycles.
Participants will receive a conditioning regimen (cyclophosphamide 300 mg/m^2 intravenous [IV] and fludarabine 30 mg/m^2 IV daily for 3 days) and Cilta-cel infusion 0.75*10^6 chimeric antigen receptor (CAR)-positive viable T cells/kilogram (kg), followed by lenalidomide post CAR-T cell therapy for 2 years
Daratumumab subcutaneously (SC), 1800 mg on days 1, 8, 15 and 22 of cycle 1 and 2, on days 1 and 15 of cycle 3-6.
Bortezomib SC 1.3 mg/m^2 on days 1, 4, 8, and 11 of each cycle 1-6.
Lenalidomide orally, 25 mg on days 1 to 21 of each cycle 1-6.
Dexamethasone orally, 40 mg once a week on days 1, 8, 15 and 22 of each cycle 1-6.
Each cycle will consist of 28 days.
Lenalidomide maintenance orally 10 to 15 mg on days 1 to 28 (continuously) until confirmed progressive disease or unacceptable toxicity or for a maximum of 2 years
Treatment: Drugs: Daratumumab
Daratumumab will be administered SC.
Treatment: Drugs: Bortezomib
Bortezomib will be administered SC.
Treatment: Drugs: Lenalidomide
Lenalidomide will be administered orally.
Treatment: Drugs: Dexamethasone
Dexamethasone will be administered orally.
Treatment: Drugs: Cilta-cel
Cilta-cel will be administered intravenously
Treatment: Drugs: Cyclophosphamide
Cyclophosphamide will be administered intravenously.
Treatment: Drugs: Fludarabine
Fludarabine will be administered intravenously.
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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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Progression free survival (PFS)
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Assessment method [1]
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Progression free survival is defined as the time from the date of randomization to the date of first documented PD, as defined in the IMWG criteria, or death due to any cause, whichever occurs first
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Timepoint [1]
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up to 10 years ( or 300 PFS events)
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Primary outcome [2]
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Sustained MRD-negative CR
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Assessment method [2]
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Sustained MRD-negative CR is defined as being MRD negative by bone marrow aspirate, as determined by NGS with a sensitivity of at least 10-5, and meeting the IMWG criteria for CR, and with MRD-negativity status confirmed at a minimum 12 months apart and without any examination showing MRD-positive status or PD in between.
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Timepoint [2]
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up to 24 months
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Secondary outcome [1]
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Overall Response (OR)
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Assessment method [1]
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OR is defined as participants who achieve a partial response (PR) or better according to the IMWG criteria.
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Timepoint [1]
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up to 17 years
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Secondary outcome [2]
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Complete Response (CR) or better status
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Assessment method [2]
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CR or better is defined as percentage of participants who achieve a CR response or Stringent Complete Response (sCR) response according to the IMWG criteria.
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Timepoint [2]
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up to 17 years
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Secondary outcome [3]
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Overall Minimal Residual Disease (MRD) -negative CR
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Assessment method [3]
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achieving MRD-negative CR, as determined by NGS at any time after the date of randomization before initiation of subsequent antimyeloma therapy.
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Timepoint [3]
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up to 17 years
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Secondary outcome [4]
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Time to subsequent antimyeloma therapy
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Assessment method [4]
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Time to subsequent anti-myeloma therapy is defined as the time from randomization to the start of subsequent anti-myeloma therapy.
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Timepoint [4]
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up to 17 years
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Secondary outcome [5]
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Progression Free Survival on Next-line Therapy (PFS2)
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Assessment method [5]
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the time from the date of randomization to the date of event, defined as PD as assessed by investigator that starts after the next line of subsequent therapy, or death due to any cause, whichever occurs first.
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Timepoint [5]
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up to 17 years
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Secondary outcome [6]
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Overall Survival (OS)
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Assessment method [6]
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Overall survival is measured from the date of randomization to the date of the participant's death.
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Timepoint [6]
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up to 17 years
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Secondary outcome [7]
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Change from Baseline in Health-Related Quality of Life (HRQoL) as Assessed by European Organization for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC-QLQ-C30) Scale Score
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Assessment method [7]
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The EORTC QLQ-C30 includes 30 items in 5 functional scales (physical, role, emotional, cognitive, and social), 1 global health status scale, 3 symptom scales (pain, fatigue, nausea/vomiting), and 6 single symptom items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The responses are reported using a verbal rating scale. The item and scale scores are transformed to a 0 to 100 scale. A higher score represents greater HRQoL, better functioning, and more (worse) symptoms.
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Timepoint [7]
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up to 17 years
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Secondary outcome [8]
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Change from Baseline in Health-Related Quality of Life as Assessed by MySIm-Q Scale Score
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Assessment method [8]
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The MySIm-Q is a disease-specific PRO assessment complementary to the EORTC-QLQ-C30. It includes 17 items with recall period of "7 days" and responses are reported on a 5-point verbal rating scale. Item responses are scored from 0 to 4. Higher scores indicate greater severity/impact.
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Timepoint [8]
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up to 17 years
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Secondary outcome [9]
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Change from Baseline in Health-Related Quality of Life as Assessed by European Quality of Life - 5 Dimensions-5 Levels (EQ-5D-5L) Scale Scor
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Assessment method [9]
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The EQ-5D-5L is a generic measure of health status. The EQ-5D-5L is a 5-item questionnaire that assesses 5 domains including mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each of the 5 dimensions is divided into 5 levels of perceived problems, where Level 1: no problem, Level 2: slight problems, Level 3: moderate problems, Level 4: severe problems and Level 5: extreme problems, plus a visual analog scale rating "health today" with anchors ranging from 0 (worst imaginable health state) to 100 (best imaginable health state).
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Timepoint [9]
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up to 17 years
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Secondary outcome [10]
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Change from Baseline in Health-Related Quality of Life as Assessed by Patient Global Impression of Symptom Severity (PGIS) Scale Score
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Assessment method [10]
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The PGIS uses 2 items to assess the participant's perception of the severity of their disease symptoms and impact using a 5-point verbal rating scale. Score ranges from 1 (None) to 5 (Very Severe).
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Timepoint [10]
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up to 17 years
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Secondary outcome [11]
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Patient-reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)
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Assessment method [11]
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The National Cancer Institute's PRO-CTCAE is an item library of common adverse events experienced by people with cancer that are appropriate for self-reporting. Each symptom selected for inclusion can be rated by up to 3 attributes characterizing the presence/frequency, severity, and/or interference that ranges from 0 to 4 with higher scores indicating higher frequency or greater severity/impact.
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Timepoint [11]
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up to 280 days
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Eligibility
Key inclusion criteria
- Participants with documented NDMM according to IMWG diagnostic criteria, for whom
high-dose therapy and ASCT are part of the intended initial treatment plan.
- Measurable disease, as assessed by central laboratory, at screening as defined by any
of the following:
1. Serum monoclonal paraprotein (M-protein) level =1.0 g/dL or urine M-protein level
=200 mg/24 hours; or
2. Light chain MM without measurable disease in serum or urine: serum Ig free-light
chain (FLC) =10 mg/dL and abnormal serum Ig kappa lambda FLC ratio.
- ECOG performance status of grade 0 or 1
- Clinical laboratory values within prespecified range.
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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?
No
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Key exclusion criteria
- Prior treatment with CAR-T therapy directed at any target.
- Any prior BCMA target therapy.
- Any prior therapy for MM or smoldering myeloma other than a short course of
corticosteroids
- Received a strong cytochrome P450 (CYP)3A4 inducer within 5 half-lives prior to
randomization
- Received or plans to receive any live, attenuated vaccine (except for COVID-19
vaccines) within 4 weeks prior to randomization.
- Known active, or prior history of central nervous system (CNS) involvement or clinical
signs of meningeal involvement of MM
- Stroke or seizure within 6 months of signing Informed Consent Form (ICF)
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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
Open (masking not used)
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Who is / are masked / blinded?
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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
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
10/10/2023
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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
1/08/2040
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Actual
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Sample size
Target
750
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Royal Adelaide Hospital - Adelaide
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Princess Alexandra Hospital - Brisbane
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Royal Prince Alfred Hospital - Camperdown
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Royal Brisbane and Womens Hospital - Herston
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Alfred Health - Melbourne
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Austin Hospital - Melbourne
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment hospital [8]
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St. Vincent's Hospital - Melbourne
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Recruitment hospital [9]
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [10]
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Calvary Mater Newcastle Hospital - Waratah
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Recruitment hospital [11]
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Westmead Hospital - Westmead
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Recruitment postcode(s) [1]
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- Adelaide
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Recruitment postcode(s) [2]
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- Brisbane
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Recruitment postcode(s) [3]
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- Camperdown
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Recruitment postcode(s) [4]
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- Herston
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Recruitment postcode(s) [5]
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- Melbourne
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Recruitment postcode(s) [6]
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- Murdoch
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Recruitment postcode(s) [7]
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- Waratah
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Recruitment postcode(s) [8]
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- Westmead
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Recruitment outside Australia
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United States of America
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Arkansas
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California
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Florida
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Georgia
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Illinois
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Kansas
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Ramat Gan
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Bunkyo-Ku
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Kanazawa
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Nagoya
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Okayama
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Osaka
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Tohoku
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Netherlands
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Amsterdam
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Groningen
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Nijmegen
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Oslo
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Badalona
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Spain
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Barcelona
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Madrid
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Spain
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Pamplona
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Spain
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Salamanca
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Spain
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Santiago De Compostela
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Country [84]
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0
Spain
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State/province [84]
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Sevilla
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Country [85]
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Spain
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State/province [85]
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Valencia
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Country [86]
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Sweden
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State/province [86]
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Göteborg
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Country [87]
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Sweden
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State/province [87]
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Linköping
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Country [88]
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Sweden
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State/province [88]
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Lund
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Country [89]
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Sweden
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State/province [89]
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Uppsala
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Country [90]
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Switzerland
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State/province [90]
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Basel
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Country [91]
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Switzerland
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State/province [91]
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Bern
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Country [92]
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Switzerland
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State/province [92]
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Lausanne
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Country [93]
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Switzerland
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State/province [93]
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Zürich
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Country [94]
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United Kingdom
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State/province [94]
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Birmingham
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Country [95]
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United Kingdom
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State/province [95]
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Cardiff
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Country [96]
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United Kingdom
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State/province [96]
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Leeds
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Funding & Sponsors
Primary sponsor type
Other
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Name
Stichting European Myeloma Network
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Address
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Other collaborator category [1]
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Commercial sector/Industry
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Name [1]
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Janssen Research & Development, LLC
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to compare the efficacy of Daratumumab, Bortezomib, Lenalidomide
and Dexamethasone (DVRd) followed by Ciltacabtagene Autoleucel versus Daratumumab,
Bortezomib, Lenalidomide and Dexamethasone (DVRd) followed by Autologous Stem Cell Transplant
(ASCT) in newly diagnosed multiple myeloma patients.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT05257083
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Public notes
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Contacts
Principal investigator
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Sarah Lonergan
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Address
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Phone
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+31 107033123
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT05257083
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