The purpose of this study is to characterize cardiac safety of Daratumumab, Cyclophosphamide, Bortezomib, and Dexamethasone (D-VCd) treatment regimens (Arm A: daratumumab + immediate VCd treatment and Arm B: daratumumab + deferred VCd) in newly diagnosed systemic amyloid light chain (AL) amyloidosis with cardiac involvement and to identify potential mitigation strategies for cardiac toxicity (cohort 1); to characterize the pharmacokinetics of subcutaneous (SC) daratumumab, among racial and ethnic minorities, including Black or African American, with newly diagnosed AL amyloidosis treated with D-VCd (cohort 2).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
151
Daratumumab will be administered subcutaneously.
Cyclophosphamide will be administered either orally or IV.
Bortezomib will be administered by SC injection or IV.
Dexamethasone will be administered orally or IV.
City of Hope
Duarte, California, United States
Yale
New Haven, Connecticut, United States
Moffitt Cancer Center
Tampa, Florida, United States
Winship Cancer Institute Emory University
Atlanta, Georgia, United States
Tufts Medical Center
Boston, Massachusetts, United States
Boston University Medical Center
Number of Participants with Cardiac Events of Any Toxicity Grade
Number of participants with cardiac events of any toxicity grade will be reported.
Time frame: Up to 12 months
Observed Concentration Immediately Prior to the Next Study Treatment Administration (Ctrough) of Daratumumab
Ctrough is defined as the observed concentration immediately prior to the next study treatment administration.
Time frame: Cycle 3 Day 1 predose (each cycle is of 28 days)
Overall Complete Hematologic Response (HemCR) Rate
Overall HemCR rate is defined as percentage of participants who achieve HemCR during or after the study treatment.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
HemCR Rate
HemCR rate at 6 month is defined as percentage of participants who achieve HemCR at 6 month during or after the study treatment.
Time frame: At 6 months
Very Good Partial Response (VGPR) or Better Rate
Hematologic greater than or equal to (\>=) VGPR rate is defined as percentage of participants who achieve hematologic response of VGPR or better.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Time to HemCR or (VGPR or Better)
For participants who achieve HemCR (or \>=VGPR), time to HemCR (or \>=VGPR) is defined as the time between the date of first study treatment and the first efficacy evaluation at which the participant has met all criteria for hematologic complete response (CR) (or \>=VGPR).
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Duration of Response (HemCR and VGPR or Better)
For participants who achieve HemCR (or \>=VGPR), duration of HemCR (or \>=VGPR) is defined as the time between the date of initial documentation of HemCR (or \>=VGPR) to the date of first documented evidence of hematologic progressive disease or death, whichever comes first.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Organ Response Rate (OrRR)
Organ response rate is defined as the percentage of participants who achieve organ response in each corresponding organ (kidney, heart, liver).
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Overall Survival (OS)
OS is measured from the date of first study treatment to the date of the participant's death.
Time frame: Until Cycle 12 or Month 12 (whichever occurs later)
Time to Subsequent Therapy
Time to subsequent therapy for amyloid light chain (AL) amyloidosis is defined as the time from the date of first study treatment to the start date of subsequent AL amyloidosis (non-protocol) treatment.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Number of Participants with Adverse Events (AEs) by Severity
Number of participants with AEs by severity will be reported. An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/ biological agent under study.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Serum Concentration of Daratumumab
Serum samples will be analyzed to determine concentrations of daratumumab.
Time frame: Up to 3 years
Number of Participants with Antibodies to Daratumumab
Number of participants with antibodies to daratumumab will be reported.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Number of Participants with Antibodies to Recombinant Human Hyaluronidase PH20 Enzyme (rHuPH20)
Number of participants with antibodies to rHuPH20 will be reported.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
Change from Baseline in Clinical Signs and Symptoms Score of Cardiac AL Amyloidosis
Change from baseline in clinical signs and symptoms score of cardiac AL amyloidosis will be reported.
Time frame: Up to Cycle 12 or Month 12 (whichever occurs later)
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