Primary Objectives: * VCDI cohort: * To determine the maximum tolerated dose (MTD) and recommended dose (RD) of SAR650984 isatuximab when administered in combination with bortezomib (Velcade®) , cyclophosphamide, and dexamethasone (VCDI) based on the dose-limiting toxicity(ies) (DLTs) observed in patients with newly diagnosed multiple myeloma non-eligible for transplantation * To evaluate safety and preliminary efficacy (overall response rate and complete response rate) of isatuximab administered at the selected dose in combination with bortezomib based regimin VCDI according to IMWG criteria. * VRDI Part A cohort and Part B cohort: * To evaluate the preliminary efficacy (complete response \[CR\] rate) of isatuximab administered at the selected dose in combination with bortezomib based regimen: VRDI, (bortezomib, lenalidomide, dexamethasone) according to IMWG criteria in adult patients with newly diagnosed MM non eligible for transplantation or no intent for immediate transplantation. Secondary Objectives: * VCDI cohort: * To characterize the overall safety profile of SAR650984 in combination with VCD regimen, including cumulative toxicities. * To characterize the pharmacokinetic (PK) profile of SAR650984/isatuximab and each combination drug in VCDI regimen. * To evaluate the immunogenicity of SAR650984 in combination treatments. * To evaluate the preliminary efficacy of VCDI regimen in terms of duration of response and progression-free survival. * To assess the relationship between clinical effects (adverse event \[AE\] and/or tumor response) and CD38 receptor density. * VRDI Part A cohort and Part B cohort: * To characterize the overall safety profile of isatuximab in combination with VRD regimen. * To evaluate the infusion duration (only applicable for VRDI Part B cohort) * To characterize the PK profile of isatuximab and each combination drug in VRDI regimen. * To evaluate the immunogenicity of isatuximab in combination treatments. * To evaluate the preliminary efficacy of VRDI regimen in terms of ORR, DOR, and PFS. * To evaluate the impact of M protein measurement without isatuximab interference (via the SEBIA HYDRASHIFT 2/4 isatuximab IFE test) on CR and BOR assessment. * To assess the relationship between clinical effects (AE and/or tumor response) and CD38 receptor density (only applicable for VRDI Part A cohort). * To assess MRD negativity rate in patients achieving a CR or VGPR and explore correlation with clinical outcome.
The duration of the study for an individual patient will include: * A period to assess eligibility (screening or baseline period) of up to 3 weeks for VCDI cohort, up to 28 days for VRDI cohort; * for patients in the VCDI cohort: a treatment period including up to 12 induction treatment cycles (50-week duration). * for patients in the VRDI cohort: a treatment period including up to 4 induction cycles (24 week duration). * Following induction, both cohorts have maintenance periods consisting of 4 week cycles until progression, unacceptable AE, or patient willingness to discontinue and an end-of-treatment visit at least 30 days following the last administration of treatment. * Patients that discontinue therapy for reasons other than progression will have follow-up visits until progression or until the patient receives another anticancer therapy, whichever is earlier.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
90
Pharmaceutical form: tablet Route of administration: oral
Pharmaceutical form: lyophilized powder for subcutaneous injection Route of administration: subcutaneous
Pharmaceutical form: tablet Route of administration: oral
Pharmaceutical form: tablet or solution for infusion Route of administration: oral or intravenous
Pharmaceutical form: solution for infusion Route of administration: intravenous
Investigational Site Number : 250002
Nantes, France
Investigational Site Number : 250003
Pierre-Bénite, France
Investigational Site Number : 250001
Toulouse, France
Investigational Site Number : 276003
Berlin, Germany
Investigational Site Number : 276002
Leipzig, Germany
Investigational Site Number : 380003
Milan, Italy
Investigational Site Number : 380002
Roma, Italy
Investigational Site Number : 380001
Torino, Italy
Investigational Site Number : 724004
Santander, Cantabria, Spain
Investigational Site Number : 724001
Pamplona, Navarre, Spain
...and 2 more locations
Assessment of dose-limiting toxicities (DLTs) in VCDI cohort
Time frame: Up to 6 weeks per treated patient
Overall response rate (VCDI)
Time frame: Up to 34 weeks of treatment (induction phase)
Complete response rate (VCDI)
Time frame: Up to 34 weeks of treatment (induction phase)
Complete response rate (VRDI)
Time frame: Up to 104 weeks of treatment (induction and maintenance phase) in VRDI part A and part B cohorts
Number of patients with adverse events (AEs), clinically significant changes in laboratory tests and vital signs according to the National Cancer Institute - Common Toxicity Criteria (NCI-CTC) version 4.03 grade scaling
Time frame: VCDI: Up to approximately 106 weeks, VRDI Part A and Part B: Up to approximately 104 weeks
Overall response rate (VRDI)
Time frame: Up to 104 weeks of treatment (induction and maintenance phase) in VRDI part A and part B cohorts
Infusion duration
Time frame: VRDI Part B: Up to 104 weeks of treatment
Assessment of PK parameter: Partial area under the serum concentration time curve (AUC)
Time frame: VCDI: Up to approximately 42 weeks, VRDI: Up to approximately 48 weeks
Assessment of PK parameter: Maximum observed concentration (Cmax)
Time frame: VCDI: Up to approximately 42 weeks, VRDI: Up to approximately 48 weeks
Levels of human antidrug antibodies (ADA)
Time frame: VCDI: Up to approximately 42 weeks, VRDI: Up to approximately 48 weeks
Duration of response - time
Time frame: VCDI and VRDI: Until treatment discontinuation by the last patient
Progression-free survival for VCDI
Time frame: VCDI: 30 months after LPI
Progression-free survival for VRDI
Time frame: VRDI Part A and Part B: 24 months after LPI
MRD negativity rate
Time frame: Up to 3 years of treatment (induction and maintenance phase) in VRDI part A and part B cohorts
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