MagnetisMM-5: Study of Elranatamab (PF-06863135) Monotherapy and Elranatamab + Daratumumab Versus Daratumumab + Pomalidomide + Dexamethasone in Participants With Relapsed/Refractory Multiple Myeloma (MAGNETISMM-5)

Pfizer

Status and phase: Enrolling; Phase 3

Conditions: Multiple Myeloma

Treatments: Drug: Elranatamab; Drug: Pomalidomide; Drug: Dexamethasone; Drug: Daratumumab

Study type: Interventional

Funder types: Industry

Identifiers

NCT05020236

2023-509208-14-00 (Registry Identifier)

MAGNETISMM-5 (Other Identifier)

C1071005

2021-000044-22 (EudraCT Number)

Details and patient eligibility

About

The purpose of this study is to evaluate whether the BCMA-CD3 bispecific antibody elranatamab, alone and/or in combination with the anti-CD38 monoclonal antibody, daratumumab, can provide more benefit to people with multiple myeloma compared to a combination therapy including daratumumab, pomalidomide, and dexamethasone. People with multiple myeloma who have received previous treatment including lenalidomide and a proteasome inhibitor will be enrolled in the study. Part 1 of the study will assess the safety and activity of different doses of elranatamab in combination with daratumumab. People participating in Part 2 of the study will be randomly assigned to receive either elranatamab alone, elranatamab plus daratumumab, or daratumumab, pomalidomide, and dexamethasone. Part 2 will compare the safety and activity of (1) elranatamab alone compared to daratumumab, pomalidomide, and dexamethasone, and (2) elranatamab plus daratumumab compared to daratumumab, pomalidomide, and dexamethasone. Participants in all parts of the study will receive study treatment until their disease progresses, they experience unacceptable side effects, or they choose to no longer participate in the study.

Enrollment: 761 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Prior diagnosis of multiple myeloma as defined by IMWG criteria (Rajkumar et al, 2014).

• Measurable disease based on IMWG criteria as defined by at least 1 of the following:

  • Serum M-protein ≥0.5 g/dL.
  • Urinary M-protein excretion ≥200 mg/24 hours.
  • Serum immunoglobulin FLC ≥10 mg/dL (≥100 mg/L) AND abnormal serum immunoglobulin kappa to lambda FLC ratio (<0.26 or >1.65).

• Prior anti-multiple myeloma therapy including treatment with lenalidomide and a proteasome inhibitor.

• ECOG performance status ≤2.

• Resolved acute effects of any prior therapy to baseline severity or CTCAE Grade ≤1.

• Not pregnant and willing to use contraception.

Exclusion criteria

• Smoldering multiple myeloma.
• Plasma cell leukemia.
• Amyloidosis.
• POEMS Syndrome.
• Stem cell transplant within 12 weeks prior to enrolment, or active graft versus host disease.
• Active HBV, HCV, SARS-CoV2, HIV, or any active, uncontrolled bacterial, fungal, or viral infection.
• Any other active malignancy within 3 years prior to enrolment, except for adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ.
• Previous treatment with a BCMA-directed therapy.
• Anti-CD38-directed therapy within 6 months preceding the first dose of treatment in this study.
• Live attenuated vaccine within 4 weeks of the first dose of study intervention.
• Administration with an investigational product (e.g. drug or vaccine) concurrent with study intervention or within 30 days preceding the first dose of study intervention used in this study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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761 participants in 4 patient groups

Part 1 Safety Lead-In Dose Escalation: Elranatamab + Daratumumab

Experimental group

Treatment:

Drug: Daratumumab

Drug: Elranatamab

Part 2 Randomized Arm A: Elranatamab

Experimental group

Treatment:

Drug: Elranatamab

Part 2 Randomized Arm B: Elranatamab + Daratumumab

Experimental group

Treatment:

Drug: Daratumumab

Drug: Elranatamab

Part 2 Randomized Arm C: Daratumumab + Pomalidomide + Dexamethasone

Active Comparator group

Treatment:

Drug: Daratumumab

Drug: Dexamethasone

Drug: Pomalidomide