A Study to Evaluate the Efficacy and Safety of Daratumumab in Combination With Cyclophosphamide, Bortezomib and Dexamethasone (CyBorD) Compared to CyBorD Alone in Newly Diagnosed Systemic Amyloid Light-chain (AL) Amyloidosis



Status:Recruiting
Conditions:Hematology
Therapuetic Areas:Hematology
Healthy:No
Age Range:18 - Any
Updated:4/6/2019
Start Date:October 5, 2017
End Date:October 30, 2025
Contact:Study Contact
Email:JNJ.CT@sylogent.com
Phone:844-434-4210

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A Randomized Phase 3 Study to Evaluate the Efficacy and Safety of Daratumumab in Combination With Cyclophosphamide, Bortezomib and Dexamethasone (CyBorD) Compared to CyBorD Alone in Newly Diagnosed Systemic AL Amyloidosis

The purpose of this study is to evaluate the efficacy and safety of daratumumab plus
cyclophosphamide, bortezomib and dexamethasone (CyBorD) compared with CyBorD alone in
treatment of newly diagnosed amyloid light chain (AL) amyloidosis participants.

Participant involved in study for approx. 8 years duration includes Screening Phase (complete
clinical evaluation will be done), Treatment Phase (monitoring of adverse events (AEs),
laboratory abnormalities and clinical response), Post-Treatment Observation Phase (disease
evaluations will be done) and a Long-term Follow-up Phase (Subsequent anticancer treatment,
response to subsequent treatment, date of progression and survival status will be obtained
every 16 weeks).The primary hypothesis is that daratumumab in combination with CyBorD will
improve the overall complete hematological response rate compared to CyBorD alone in AL
amyloidosis participants. Safety will be assessed by AEs, laboratory test results,
electrocardiogram, vital sign measurements, physical examination, and Eastern Cooperative
Oncology Group (ECOG) performance status.

Inclusion Criteria:

- Histopathological diagnosis of amyloidosis based on detection by immunohistochemistry
and polarizing light microscopy of green bi-refringent material in congo red stained
tissue specimens (in an organ other than bone marrow) or characteristic electron
microscopy appearance

- Measurable disease of amyloid light-chain (AL) amyloidosis as defined by at least one
of the following:

1. serum monoclonal (M)-protein greater than or equal (>=) 0.5 grams/deciliter
(g/dL) by protein electrophoresis (routine serum protein electrophoresis and
immunofixation [IFE] performed at a central laboratory)

2. serum free light chain greater than or equal to (>=) 50 milligram/Liter (mg/L)
with an abnormal kappa:lambda ratio or the difference between involved and
uninvolved free light chains (dFLC) >= 50 mg/L

- One or more organs impacted by AL amyloidosis according to consensus guidelines

- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0, 1 or 2

Exclusion Criteria:

- Prior therapy for AL amyloidosis or multiple myeloma including medications that target
CD38, with the exception of 160 mg dexamethasone (or equivalent corticosteroid)
maximum exposure prior to randomization

- Previous or current diagnosis of symptomatic multiple myeloma, including the presence
of lytic bone disease, plasmacytomas, >= 60 percent (%) plasma cells in the bone
marrow, or hypercalcemia

- Evidence of significant cardiovascular conditions as specified below:

1. NT-ProBNP > 8500 nanogram per liter (ng/L)

2. New York Heart Association (NYHA) classification IIIB or IV heart failure

3. Heart failure that in the opinion of the investigator is on the basis of ischemic
heart disease (eg, prior myocardial infarction with documented history of cardiac
enzyme elevation and electrocardiogram [ECG] changes) or uncorrected valvular
disease and not primarily due to AL amyloid cardiomyopathy

4. Inpatient admission to a hospital for unstable angina or myocardial infarction
within the last 6 months prior to first dose or percutaneous cardiac intervention
with recent stent within 6 months or coronary artery bypass grafting within 6
months

5. For participants with congestive heart failure, cardiovascular-related
hospitalizations within 4 weeks prior to randomization

6. Participants with a history of sustained ventricular tachycardia or aborted
ventricular fibrillation or with a history of atrioventricular (AV) nodal or
sinoatrial (SA) nodal dysfunction for which a pacemaker/implantable
cardioverter-defibrillators [ICD] is indicated but not placed (participants who
do have a pacemaker/ICD are allowed on study)

7. Screening 12-lead ECG showing a baseline QT interval as corrected by Fridericia's
formula (QTcF) > 500 milliseconds (msec). Participants who have a pacemaker may
be included regardless of calculated QTc interval

8. Supine systolic blood pressure < 90 millimeter of mercury (mmHg), or symptomatic
orthostatic hypotension, defined as a decrease in systolic blood pressure upon
standing of > 20 mmHg despite medical management (eg, midodrine,
fludrocortisones) in the absence of volume depletion

- Planned stem cell transplant during the first 6 cycles of protocol therapy are
excluded. Stem cell collection during the first 6 cycles of protocol therapy is
permitted

- Known to be seropositive for human immunodeficiency virus (HIV)

- Any one of the following:

1. Seropositive for hepatitis B (defined by a positive test for hepatitis B surface
antigen [HBsAg]). Participants with resolved infection (ie, participants who are
HBsAg negative but positive for antibodies to hepatitis B core antigen [anti-HBc]
and/or antibodies to hepatitis B surface antigen [anti-HBs]) must be screened
using real-time polymerase chain reaction (PCR) measurement of hepatitis B virus
(HBV) deoxyribonucleic acid (DNA) levels. Those who are PCR positive will be
excluded

2. Known to be seropositive for hepatitis C (except in the setting of a sustained
virologic response [SVR], defined as aviremia at least 12 weeks after completion
of antiviral therapy)

- Grade 2 sensory or Grade 1 painful peripheral neuropathy
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