NCT02874742 · CITED IN SOURCE DOCUMENTS

Study Comparing Daratumumab, Lenalidomide, Bortezomib, and Dexamethasone (D-RVd) Versus Lenalidomide, Bortezomib, and Dexamethasone (RVd) in Subjects With Newly Diagnosed Multiple Myeloma

An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.

Phase: PHASE2
Status at capture: COMPLETED
Registry last update: 2025-02-04

The purpose of this study is to determine if the addition of daratumumab to lenalidomide-bortezomib-dexamethasone (RVd) will increase the proportion of participants achieving stringent complete response (sCR), as defined by the International Myeloma Working Group (IMWG) criteria, by the time of completion of post autologous stem cell transplantation (ASCT) consolidation treatment, compared with RVd alone.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

flow

Participant flow

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baseline

Baseline characteristics

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outcome · POSTED

Percentage of Participants With Stringent Complete Response (sCR)

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outcome · POSTED

Percentage of Participants With Complete Response (CR) or Better

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outcome · POSTED

Percentage of Participants With Overall Stringent Complete Response (sCR)

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outcome · POSTED

Percentage of Participants With Overall Response Rate (ORR)

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outcome · POSTED

Percentage of Participants Who Achieved Very Good Partial Response (VGPR) or Better

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outcome · POSTED

Percentage of Participants With Negative Minimal Residual Disease (MRD)

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outcome · POSTED

Duration of Complete Response or Better

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outcome · POSTED

Duration of Stringent Complete Response (sCR)

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outcome · POSTED

Time to Stringent Complete Response (sCR)

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outcome · POSTED

Time to Complete Response or Better

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outcome · POSTED

Time to Very Good Partial Response (VGPR) or Better

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outcome · POSTED

Time to Partial Response (PR) or Better

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outcome · POSTED

Progression-free Survival (PFS)

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outcome · POSTED

Overall Survival (OS)

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outcome · POSTED

Time to Progression (TTP)

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outcome · POSTED

Duration of Response

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adverse events

Adverse events

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more info

Limitations, agreements, and source contact

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Who could take part

eligibility Criteria: Inclusion Criteria: * Considered by the investigator to be eligible for high-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) according to the institution's criteria based on age, medical history, cardiac and pulmonary status, overall health and condition, co-morbid condition(s), physical examination, and laboratory studies * Has not had prior systemic therapy for multiple myeloma. An emergency course of steroids (defined as no greater than 40 milligram \[mg\] of dexamethasone, or equivalent per day for a maximum of 4 days (that is, a total of 160 mg) is permitted. In addition, radiation therapy is permitted prior to study entry, during screening, and during Cycles 1-2 of study treatment as needed for lytic bone disease * Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2 * Woman of childbearing potential must have 2 negative highly sensitive serum (beta-human chorionic gonadotropin \[b-hCG\]) during screening, the first one within 10 to 14 days prior to the first dose of any component of study treatment and the second within 24 hours prior to the first dose of any component of study treatment * A woman must agree not to donate eggs (ova, oocytes) for the purposes of assisted reproduction during the study (including during dose interruptions), and for 4 weeks following discontinuation of lenalidomide, and if receiving daratumumab, for 3 months after the last dose Exclusion Criteria: * Diagnosed or treated for malignancy other than multiple myeloma, except: a) Malignancy treated with curative intent and with no known active disease present for more than equal to (\>= )3 years before randomization; b) Adequately treated non-melanoma skin cancer, lentigo maligna or in situ malignancies (including but not limited to, cervical, breast) with no evidence of disease * Exhibiting clinical signs of or has a known history of meningeal or central nervous system involvement by multiple myeloma * Known chronic obstructive pulmonary disease with a forced expiratory volume in 1 second (FEV1) less than (\<)50 percent (%) of predicted normal * Known moderate or severe persistent asthma within the past 2 years or currently has uncontrolled asthma of any classification * Known to be seropositive for human immunodeficiency virus, known to have hepatitis B surface antigen positivity, or known to have a history of hepatitis C. Participants who completed treatment for hepatitis C at least 6 months prior to screening and have no detectable circulating hepatitis C virus (HCV) at screening, may participate in the study. Such participants will be required to undergo regular assessment for HCV reactivation during their participation in the study. Participants who test positive for HCV at any time during these assessments will be withdrawn from the study
healthy Volunteers: false
maximum Age: 70 Years
minimum Age: 18 Years
sex: ALL
std Ages: ADULT
OLDER_ADULT

Treatment arms and interventions

arm Groups

description
Participants will receive lenalidomide, bortezomib, dexamethasone and daratumumab.
intervention Names
Drug: Lenalidomide
Drug: Bortezomib
Drug: Dexamethasone
Drug: Daratumumab
label
Daratumumab+Lenalidomide+Bortezomib+Dexamethasone (D-RVd)
type
EXPERIMENTAL
description
Participants will receive lenalidomide, bortezomib and dexamethasone.
intervention Names
Drug: Lenalidomide
Drug: Bortezomib
Drug: Dexamethasone
label
Lenalidomide+Bortezomib+Dexamethasone (RVd)
type
EXPERIMENTAL

interventions

arm Group Labels
Daratumumab+Lenalidomide+Bortezomib+Dexamethasone (D-RVd)
Lenalidomide+Bortezomib+Dexamethasone (RVd)
description
Cycles 1 through 6: lenalidomide 25 (milligram) mg orally on Days 1 through 14 and each cycle is of 21-days followed by maintenance treatment with lenalidomide 10 mg on days 1-21 throughout each 28-day cycle on Cycles 7 through 9. Beginning at Cycle 10, the lenalidomide dose will be increased to 15 mg unless there is a tolerability concern.
name
Lenalidomide
type
DRUG
arm Group Labels
Daratumumab+Lenalidomide+Bortezomib+Dexamethasone (D-RVd)
Lenalidomide+Bortezomib+Dexamethasone (RVd)
description
Bortezomib 1.3 mg/m\^2 subcutaneously on Days 1, 4, 8, and 11 during Cycles 1-6.
name
Bortezomib
type
DRUG
arm Group Labels
Daratumumab+Lenalidomide+Bortezomib+Dexamethasone (D-RVd)
Lenalidomide+Bortezomib+Dexamethasone (RVd)
description
Dexamethasone 40 mg orally every week (20 mg on Days 1, 2, 8, 9, 15, and 16).
name
Dexamethasone
type
DRUG
arm Group Labels
Daratumumab+Lenalidomide+Bortezomib+Dexamethasone (D-RVd)
description
Daratumumab intravenously at a dose of 16 milligram per kilogram (mg/kg) weekly during induction treatment (Days 1, 8, and 15 of Cycles 1 through 4), and every 3 weeks during consolidation treatment (Day 1 of Cycles 5 and 6), followed by maintenance treatment with daratumumab every 4 or 8 weeks.
name
Daratumumab
type
DRUG

Study design

allocation

RANDOMIZED

intervention Model

PARALLEL

masking Info

masking: NONE

primary Purpose

TREATMENT

Enrollment

count: 224
type: ACTUAL

Registered outcome plans (not posted results)

primary Outcomes

description
Percentage of participants who had achieved sCR as determined by the validated computer algorithm according to the International Myeloma Working Group (IMWG) criteria, by the end of post-autologous stem cell transplantation (post-ASCT) consolidation treatment were reported. Complete response (CR) is defined as negative immunofixation on the serum and urine, and disappearance of any soft tissue plasmacytomas, and less than (\<) 5 percent (%) PCs in bone marrow. sCR is defined as in addition to CR a normal FLC ratio, and absence of clonal plasma cells (PCs) by immunohistochemistry or immunofluorescence or 2 to 4-color flow cytometry.
measure
Percentage of Participants With Stringent Complete Response (sCR)
time Frame
From randomization to post-ASCT consolidation (after Cycle 6) before maintenance treatment (up to 10 months)

secondary Outcomes

description
CR or better rate is defined as the percentage of participants who achieve CR or sCR, according to the IMWG criteria. CR is negative immunofixation on the serum and urine, and disappearance of any soft tissue plasmacytomas, and \< 5% PCs in bone marrow. sCR is defined as in addition to CR a normal FLC ratio, and absence of clonal plasma cells (PCs) by immunohistochemistry or immunofluorescence or 2 to 4-color flow cytometry. For 2 participants (1 in each randomized treatment group), data were updated by the study sites which resulted in their inclusion to the response-evaluable analysis set after the primary analysis.
measure
Percentage of Participants With Complete Response (CR) or Better
time Frame
From randomization to end of following: induction treatment, ASCT, post-ASCT consolidation (after Cycle 6) and at the end of maintenance period of 24 months (overall duration up to 34 months)
description
Overall sCR rate is defined as the percentage of participants who achieved sCR, according to the IMWG criteria. CR is defined as negative immunofixation on the serum and urine, and disappearance of any soft tissue plasmacytomas, and \< 5 % PCs in bone marrow. sCR is defined as in addition to CR a normal FLC ratio, and absence of clonal PCs by immunohistochemistry or immunofluorescence or 2 to 4-color flow cytometry.
measure
Percentage of Participants With Overall Stringent Complete Response (sCR)
time Frame
From randomization to end of following: induction treatment, ASCT, post-ASCT consolidation (after Cycle 6) and at the end of maintenance treatment of 24 months (overall duration up to 34 months)
description
ORR- percentage of participants who achieved partial response (PR) or better (PR, Very Good Partial Response \[VGPR\], CR or sCR) based on computerized algorithm as per IMWG criteria. PR -greater than or equal to (\>=) 50% reduction of serum M-protein and reduction in 24-hour urinary M-protein by \>=90% or to \<200 mg//24 hours. If serum and urine M-protein are not measurable, a decrease of \>=50% in the difference between involved and uninvolved FLC levels is required. A \>=50% reduction in the size of soft tissue plasmacytomas is also required; VGPR-serum and urine M-component detectable by immunofixation but not on electrophoresis, or \>= 90% reduction in serum M-protein plus urine M-protein \<100 mg/24 hours; CR-negative immunofixation on the serum and urine, and disappearance of any soft tissue plasmacytomas, and \<5% PCs in bone marrow. sCR- in addition to CR a normal FLC ratio, and absence of clonal PCs by immunohistochemistry or immunofluorescence or 2 to 4-color flow cytometry.
measure
Percentage of Participants With Overall Response Rate (ORR)
time Frame
From randomization to end of following: induction treatment, ASCT, post-ASCT consolidation (after Cycle 6) and at the end of maintenance treatment of 24 months (overall duration up to 34 months)
description
VGPR or better rate is defined as the percentage of participants who achieved VGPR or better, according to the IMWG criteria. VGPR is defined as serum and urine M-component detectable by immunofixation but not on electrophoresis, or \>= 90% reduction in serum M-protein plus urine M-protein \<100 mg/24 hours.
measure
Percentage of Participants Who Achieved Very Good Partial Response (VGPR) or Better
time Frame
From randomization to end of following: induction treatment, ASCT, post-ASCT consolidation (after Cycle 6) and at the end of maintenance period of 24 months (overall duration up to 34 months)
description
Minimal residual disease negative rate is defined as the percentage of participants who achieve MRD negative status by the respective time point. Minimal residual disease was evaluated in participants who achieved CR or sCR (including participants with VGPR or better and suspected daratumumab interference) using next-generation sequencing which utilizes multiple myeloma cell DNA from bone marrow aspirates at a threshold of less than (\<) 10\^5.
measure
Percentage of Participants With Negative Minimal Residual Disease (MRD)
time Frame
From randomization to end of following: induction treatment, post-ASCT consolidation (after Cycle 6) (up to 4.5 months), and at the end of maintenance period of 24 months (overall duration up to 34 months)
description
Duration of CR or better is the duration from the date of initial documentation of a CR or sCR response, according to the IMWG criteria, to the date of first documented evidence of progressive disease (PR), or relapse from CR. PD is defined as an increase of 25 % from the lowest response value in one of the following: serum and urine M-component (absolute increase must be greater than or equal to \[\>=\] 0.5 gram per deciliter \[g/dL\] and \>=200 milligrams \[mg\]/24 hours respectively); Only in participants without measurable serum and urine M-protein levels the difference between involved and uninvolved FLC levels (absolute increase must be \> 10 mg/dL); Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas; Development of hypercalcemia (corrected serum calcium \>11.5 mg/dL) that can be attributed solely to plasma cells (PCs) proliferative disorder.
measure
Duration of Complete Response or Better
time Frame
From randomization to the date of first documented evidence of progressive disease or relapse from CR (up to 5 years)
description
Duration of sCR is the duration from the date of initial documentation of a sCR response, according to the IMWG criteria, to the date of first documented evidence of progressive disease, or relapse from sCR. PD is defined as an increase of 25 % from the lowest response value in one of the following: serum and urine M component (absolute increase must be \>= 0.5 g/dL and \>=200 mg/24 hours respectively); Only in participants without measurable serum and urine M-protein levels the difference between involved and uninvolved FLC levels (absolute increase must be \> 10 mg/dL); Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas; Development of hypercalcemia (corrected serum calcium \>11.5 mg/dL) that can be attributed solely to PC proliferative disorder.
measure
Duration of Stringent Complete Response (sCR)
time Frame
From randomization to the date of first documented evidence of progressive disease or relapse from sCR (up to 5 years)
description
Time to sCR is the duration from the date of randomization to the date of initial documentation of sCR, which was confirmed by a repeated measurement as required by the IMWG criteria.
measure
Time to Stringent Complete Response (sCR)
time Frame
From randomization to the date of initial documentation of sCR (up to 5 years)
description
Time to CR or better is the duration from the date of randomization to the date of initial documentation of CR or better, which was confirmed by a repeated measurement as required by the IMWG criteria.
measure
Time to Complete Response or Better
time Frame
From randomization to the date of initial documentation of CR (up to 5 years)
description
Time to VGPR or better is the duration from the date of randomization to the date of initial documentation of VGPR or better, which was confirmed by a repeated measurement as required by the IMWG criteria.
measure
Time to Very Good Partial Response (VGPR) or Better
time Frame
From randomization to the date of initial documentation of VGPR or better (up to 5 years)
description
Time to PR or better is the duration from the date of randomization to the date of initial documentation of PR or better, which was confirmed by a repeated measurement as required by the IMWG criteria.
measure
Time to Partial Response (PR) or Better
time Frame
From randomization to the date of initial documentation of PR or better (up to 5 years)
description
PFS is defined as the duration from the date of randomization to the date of first documented evidence of progressive disease or death, whichever comes first. PD is defined as an increase of 25 % from the lowest response value in one of the following: serum and urine M-component (absolute increase must be \>= 0.5 g/dL and \>=200 mg/24 hours respectively); Only in participants without measurable serum and urine M-protein levels the difference between involved and uninvolved FLC levels (absolute increase must be \> 10 mg/dL); Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas; Development of hypercalcemia (corrected serum calcium \>11.5 mg/dL) that can be attributed solely to PC proliferative disorder.
measure
Progression-free Survival (PFS)
time Frame
From randomization to the date of first documented evidence of progressive disease or death (up to 5 years)

Full study description

brief Summary: The purpose of this study is to determine if the addition of daratumumab to lenalidomide-bortezomib-dexamethasone (RVd) will increase the proportion of participants achieving stringent complete response (sCR), as defined by the International Myeloma Working Group (IMWG) criteria, by the time of completion of post autologous stem cell transplantation (ASCT) consolidation treatment, compared with RVd alone.

Source references

references

citation
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Source notices and limitations

Discovery and provenance

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penia, which occurred in 62% of patients who received D-VRd and 51% of patients who received VRd.</li></ul></div></li><li>The phase II <a href="/clinicaltrials/NCT02874742">GRIFFIN</a> trial (NCT02874742) enrolled 207 patients with newly diagnosed transplant-eligible multiple myeloma. Patients were randomly assigned to receive in
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patients who received D-VRd and 51% of patients who received VRd.</li></ul></div></li><li>The phase II <a href="/clinicaltrials/NCT02874742">GRIFFIN</a> trial (NCT02874742) enrolled 207 patients with newly diagnosed transplant-eligible multiple myeloma. Patients were randomly assigned to receive induction therapy with either D-VR
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Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Health Professional Version
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Preserved source evidence · Not medical advice