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Active enrolling
France
ACTIVE_COMPARATOR: D-VRD induction, ASCT and D-VRD consolidation (arm A)
Standard induction therapy with 4 cycles of D-VRd, followed by HDCT (Melphalan) + ASCT, and 2 cycles of D-VRd consolidation therapy
DRUG: Lenalidomide (Revlimid®)
In association with daratumumab, bortezomib and dexamethasone (Arm A), in association with elranatamab (Arm B), in monotherapy (Arm C)DRUG: Daratumumab SC (Darzalex)
Daratumumab is given in association with bortezomib, lenalidomide and dexamethasone in induction therapy (all patients) and consolidation arm APROCEDURE: Autologous Stem Cell Transplantation
ASCT is performed in consolidation for Arm A patients after induction therapy with D-VRDDRUG: Bortezomib (Velcade®)
Bortezomib is given in associtaion with daratumumab, lenalidomide and dexamethasone in induction (all patients) and consolidation Arm ADRUG: Dexamethasone
Dexamethasone is given in association with daratumumab, bortezomib and lenalidomide in induction (all patients) and consolidation Arm AEXPERIMENTAL: D-VRD induction followed by elranatamab and lenalidomide consolidation (arm B)
Standard induction therapy with 4 cycles of D-VRd, followed by elranatamab and lenalidomide consolidation therapy.
DRUG: Elranatamab
Elranatamab is given to arm B patients in association with lenalidomide (for consolidation) and arm D patients in monotherapy (for maintenance) as experimental armsDRUG: Lenalidomide (Revlimid®)
In association with daratumumab, bortezomib and dexamethasone (Arm A), in association with elranatamab (Arm B), in monotherapy (Arm C)DRUG: Daratumumab SC (Darzalex)
Daratumumab is given in association with bortezomib, lenalidomide and dexamethasone in induction therapy (all patients) and consolidation arm ADRUG: Bortezomib (Velcade®)
Bortezomib is given in associtaion with daratumumab, lenalidomide and dexamethasone in induction (all patients) and consolidation Arm ADRUG: Dexamethasone
Dexamethasone is given in association with daratumumab, bortezomib and lenalidomide in induction (all patients) and consolidation Arm AACTIVE_COMPARATOR: lenalidomide maintenance (Arm C)
Lenalidomide monotherapy for two years (maintenance)
DRUG: Lenalidomide (Revlimid®)
In association with daratumumab, bortezomib and dexamethasone (Arm A), in association with elranatamab (Arm B), in monotherapy (Arm C)EXPERIMENTAL: elranatamab maintenance (Arm D)
Elranatamab monotherapy for two years (maintenance)
DRUG: Elranatamab
Elranatamab is given to arm B patients in association with lenalidomide (for consolidation) and arm D patients in monotherapy (for maintenance) as experimental armsPart 1 (induction/consolidation) from Randomization 1 (R1): to assess whether consolidation therapy with elranatamab and lenalidomide is superior to standard of care, in terms of Minimal Residual Disease (MRD) negativity rate
To assess whether consolidation therapy with elranatamab and lenalidomide is superior to standard of care, in terms of MRD negativity rate.
at end of consolidation, up to 36 months
Part 2 (maintenance) from Randomization 2 (R2): to assess whether maintenance therapy with elranatamab is superior to standard of care, in terms of Progression Free Survival (PFS).
To assess whether maintenance therapy with elranatamab is superior to standard of care, in terms of PFS.
from the date of second randomization to the date of confirmed PD (IMWG criteria,) or death from any cause, whichever came first, assessed up to 93 monts
Key secondary objectives: Part 1 (induction/consolidation) from R1: to assess whether consolidation therapy with elranatamab and lenalidomide is superior, in terms of PFS
To assess whether consolidation therapy with elranatamab and lenalidomide is superior, in terms of PFS
PFS defined as the time interval from the date of first randomization to the date of confirmed Progression Disease (IMWG criteria) or death from any cause, whichever occurs first., assessed up to 128 months
Key secondary objectives: Part I (induction/consolidation) from R1: to assess whether consolidation therapy with elranatamab and lenalidomide is superior to standard of care, in terms of Overal Survival (OS)
To assess whether consolidation therapy with elranatamab and lenalidomide is superior to standard of care, in terms of OS
up to 128 months
Part 1 (induction/consolidation) from R1: to assess the efficacy of consolidation therapy with elranatamab and lenalidomide compared to standard of care
To assess the efficacy of consolidation therapy with elranatamab and lenalidomide compared to standard of care: Overall response rate (ORR), Very good partial response (VGPR) rate, Complete response (CR) rate
End of consolidation phase, up to 36 months
Part 2 (maintenance) from R2: to assess the efficacy of maintenance therapy with elranatamab
To assess the efficacy of maintenance therapy with elranatamab: * Overall response rate (ORR) in maintenance * Very good partial response (VGPR) rate in maintenance * Complete response (CR) rate in maintenance
end of maintenance, up to 58 months
assess safety & Tolerability during induction, and during consolidation and maintenance therapy: Adverse events (AE), serious Adrverse events (SAE) and And adverse events of special interest (AESI) rates - Incidence of Treatment-Emergent Adverse Events
To assess safety during induction, and during consolidation and maintenance therapy: AEs, SAE and AESI rates , Incidence of Treatment-Emergent Adverse Events \[Safety and Tolerability\]
through study completion, up to 128 months
Throughout the study to evaluate the impact of treatment on health-related Quality of Life (QoL) using Rework questionnaire
To evaluate the impact of treatment on health-related QoL: Rework questionnaire
through study completion, up to 128 months
Part 2 (maintenance) from Randomization 2 (R2): to assess the efficacy of maintenance therapy with elranatamab, Progression Free Survival 2 form Randomization 2
To assess the efficacy of maintenance therapy with elranatamab: \- PFS of subsequent/next treatment line (PFS2 from R2)
up to 128 months
Part 2 (maintenance) from R2: to assess the efficacy of maintenance therapy with elranatamab, in term of Minimal Residual Disease negativity
To assess the efficacy of maintenance therapy with elranatamab: \- MRD negativity at 12 months post R2
12 months post R2, up to 71 months
Throughout the study: to evaluate the impact of treatment on health-related Quality of Life (QoL) using EQ-5D-5L
To evaluate the impact of treatment on health-related QoL: scale title :EQ-5D-5L , the minimum value is 0 and maximum value is 100 (100 corresponds to the best health that patient can imagine, 0 corresponds to the worst health that patient can imagine
Though study completion, an average of 11 years
Part 2 (maintenance) from R2: To assess the efficacy of maintenance therapy with elranatamab (OS R2)
To assess the efficacy of maintenance therapy with elranatamab: \- Overall survival from second randomization (OS R2)
up to 128 months
824
Sponsor: Intergroupe Francophone du Myelome
Collaborator: Pfizer
For more information, call or email the Pfizer Clinical Trial Contact Center:
When calling, please reference this study number: