The Multiple Myeloma Research Consortium (MMRC) Horizon Two trial is a master protocol, multi-center, phase II randomized adaptive platform trial designed to efficiently evaluate multiple investigational therapies in high-risk newly diagnosed multiple myeloma patients using an integrated and patient-centric clinical research platform that enables longitudinal learning and sharing of knowledge and investigates multiple novel therapeutic strategies within one trial platform.
The master protocol has broad scope and substantial flexibility, allowing each investigational arm within the platform to have its own design. The master protocol specifies general principles but the analysis plan for each investigational arm will be specified in its appendix. Details outlined in each investigational arm's appendix will include any co-primary endpoints (if applicable), the comparator arm, sample size and justification, inclusion of a safety run-in (if required), and any potential adaptations within the appendix. Accrual to an investigational arm will terminate in accord with its appendix. As an adaptive platform trial, MMRC Horizon Two will evaluate multiple investigational arms against common controls. It is expected that the common controls may vary over time as standard of care therapy evolves. An initial common control arm will be specified in the control arm appendix. Changes in the common controls will be made through amendments to this appendix. All patients will be randomized to an arm in the study. The default for the platform will be equal randomization to all arms that a patient is eligible. However, when there are more than two investigational arms and response adaptive randomization is deemed beneficial, it may be implemented in the trial. Participants will be on study for 5 years from the date of randomization, inclusive of treatment and follow-up periods. Specifics on treatment duration and duration of follow up will be included in the respective arm appendix.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
300
Induction, Consolidation, and Maintenance Therapy Combining Linvoseltamab and Triplet Therapy
Isatuximab-KRd with Autologous Stem Cell Transplant
Emory University
Atlanta, Georgia, United States
RECRUITINGUChicago Medicine
Chicago, Illinois, United States
RECRUITINGKarmanos Cancer Institute
Detroit, Michigan, United States
Sustained measurable residual disease (MRD) negativity
Sustained MRD negativity is defined as MRD negativity at a minimum threshold of one myeloma cell in one hundred thousand nucleated bone marrow cells at MRD assessments
Time frame: 2 years post randomization
Progression Free Survival
PFS is defined as time from randomization to disease progression or death from any cause. Participants who have not progressed or died are censored at the date last known progression-free.
Time frame: through study completion, roughly 5 years
Objective response rate (ORR)
ORR is defined as the percentage of people who have achieved a partial response (PR) or better according to the IMWG criteria within the defined period of time on trial.
Time frame: 2 years
Best overall response
Best overall response (Stringent Complete Response \[sCR\], Complete Response \[CR\], Very Good Partial Response \[VGPR\], Partial Response \[PR\], Stable Disease \[SD\], Progressive Disease \[PD\]) by International Myeloma Working Group Response Criteria.
Time frame: 2 years
Two-year progression free survival rate
Two-year progression free survival rate is defined as the proportion of participants alive and progression-free 24 months after randomization.
Time frame: 24 months after randomization
Overall survival (OS)
OS is defined as the time from randomization to death. Alive participants are censored at the date last known alive.
Time frame: through study completion, average of 5 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Mayo Clinic
Rochester, Minnesota, United States
RECRUITINGWashington University Medical Center
St Louis, Missouri, United States
RECRUITINGMemorial Sloan Kettering Cancer Center
New York, New York, United States
RECRUITINGUNC
Chapel Hill, North Carolina, United States
RECRUITINGDuration of response (DoR)
DoR is defined as time from the first observation of a confirmed response \[Stringent Complete Response (sCR), Complete Response (CR), Very Good Partial Response (VGPR), or Partial Response (PR)\] to first documentation of disease progression or death. Participants who have not progressed or died are censored at the date last known progression-free. The start date for DoR is the date the response was first observed, not the date of confirmation.
Time frame: 2 years
12-month measurable residual disease (MRD) negativity
12-month MRD negativity is defined as MRD negativity at a minimum threshold of one myeloma cell in one hundred thousand nucleated bone marrow cells at MRD assessment at disease restaging 1 (12 months±3 months from randomization). Measured using ClonoSEQ's standardized, commercial, next generation sequencing assay (preferred) or commercial multi-color flow cytometry.
Time frame: 12 months from randomization
Frequency and intensity of (serious) adverse events (S)AEs
Assessed by NCI CTCAE version 5.0, including a focus on hematologic clinical laboratory abnormalities and changes.
Time frame: through study completion, an average of 5 years