The goal of this phase 2 clinical trial is to learn if patients with Multiple Myeloma who are minimal residual disease positive after initial therapy (including an autologous stem cell transplant \[ASCT\]) will benefit from maintenance therapy with Iberdomide and subcutaneous (SC) Daratumumab. The main questions it aims to answer are: * Assess if giving Iberdomide and the SC Daratumumab in the maintenance setting is an effective treatment and warrants further investigation in patients with residual disease * Is giving Iberdomide and SC Daratumumab maintenance post ASCT a safe option Participants will: * provide informed consent and complete screening assessments for eligibility within 28 days of starting treatment * Screening assessments include specific laboratory tests, a medical history assessment and a physical examination (including temperature, pulse, blood pressure, respirations, height and weight), an assessment of your heart function, a breathing test, cancer imaging, a bone marrow biopsy, minimal residual disease testing (MRD) and a questionnaire * If eligible, patients will start treatment with Iberdomide (1.0 mg on day 1-21 of each 28 day cycle, with an increase to 1.3 mg on Cycle 4 if the 1.0 mg dose was tolerated, to a maximum of 26 cycles or progressive disease, whichever is first) and SC Daratumumab (1800 mg SC on days 1, 8, 15 and 22 of cycle 1 and 2, then 1800 mg SC on Day 1 and 15 of cycle 3-6 and 1800 mg SC on Day 1 for cycles 7-26 to a maximum of 26 cycles or progressive disease, whichever is first) * while receiving treatment on study, physical exams (including temperature, pulse, blood pressure, respirations, height and weight), toxicity assessments, laboratory assessments and questionnaires will be done at various times over the course of the 26 cycles * an MRD assessment is required at 6, 12 and 24 months after starting treatment * End of treatment will occur once 26 cycles are completed, or cancer has progressed whichever comes first. At that time, specific laboratory tests, a physical examination (including temperature, pulse, blood pressure, respirations, height and weight), cancer imaging, a bone marrow biopsy and minimal residual disease testing (MRD) will occur.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Iberdomide 1.0mg daily for days 1-21 of a 28-day cycle, an increase to 1.3 mg daily on Day 1-21 of a 28-day cycle is allowed at cycle 4 or higher if the 1.0 mg dose was well tolerated.
Daratumumab/rHuPH20 will be dosed as follows: * Daratumumab/rHuPH20 1800 mg SC days 1, 8, 15, 22 (28-day cycle; cycles 1-2) * Daratumumab/rHuPH20 1800 mg SC days 1, 15 (28-day cycle; cycles 3-6) * Daratumumab/rHuPH20 1800 mg SC day 1 (28-day cycle; cycles 7-26)
Karmanos Cancer Institute
Detroit, Michigan, United States
RECRUITINGKCI at McLaren Greater Lansing
Lansing, Michigan, United States
RECRUITINGRate of MRD (-) at 12 months
Summarized by a binomial response rate and its associated 2-sided 90% confidence interval (CI) using Pearson-Klopper method.
Time frame: 12 months
Rate of Sustained MRD (-)
The rate at which IMWG (International Myeloma Working Group) response category improves by at least one grade during maintenance and the rate of treatment interruptions and dosage adjustments during maintenance will be summarized by a binomial response rate and 2-sided 95% CI using Pearson-Klopper method. Two or more consecutive negative measurements during therapy which are at least 6 months apart.
Time frame: 24 months
Progression-Free Survival
Duration from the start date of treatment until the date of progression (as defined by IMWG criteria) or death from any cause.
Time frame: 12 months
Progression Free Survival
Duration from the start date of treatment until the date of progression (as defined by IMWG criteria) or death from any cause.
Time frame: 24 months
Overall Survival
Duration from the start date of treatment until the date of death from any cause
Time frame: 12 months
Overall Survival
Duration from the start date of treatment until the date of death from any cause
Time frame: 24 months
Rate on Improvement in IMWG response category
Rate at which IMWG response category improves by at least 1 grade
Time frame: 24 months
Frequency of treatment interruptions and dosage adjustments during maintenance
Frequency of treatment interruptions and dosage adjustments during maintenance.
Time frame: 24 months
Patient reported Quality of Life (QoL) per EORTC QLQ-C30
The 30 question European Organization for Research and Treatment, Quality of Life Questionnaire for cancer patients (EORTC QLQ-C30) is a 30-item subject self-reported questionnaire composed of both multi-item and single scales. The EORTC QLQ-C30 questionnaire is scored using a four-point Likert scale. The scores are then transformed to a scale of 0 to 100, where higher scores indicate better quality of life. The questionnaire includes five functions, nine symptoms, and a global health status.
Time frame: At baseline and day 1 of each treatment cycle until end of treatment
Patient reported Quality of Life (QoL) per EQ-5D-5L
The European Organization for Research and Treatment EuroQol (EORTC EQ-5D-5L) questionnaire is a patient reported health-related quality of life questionnaire that consists of two parts: The first part is the EQ-5D descriptive system that measures the respondent's health status in five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Items are rated 1=No problem, 2=Slight Problem, 3=Moderate Problem, 4=Severe Problem and 5=Extreme Problem or inability. Part 2 is the EQ visual analogue scale (EQ VAS) records the respondent's overall current health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'.
Time frame: At baseline and day 1 of each treatment cycle until end of treatment
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