1590 Participants Needed

Tec-DR and Tal-DR for Multiple Myeloma

(MajesTEC-7 Trial)

Recruiting at 385 trial locations
SC
Overseen ByStudy Contact
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: Janssen Research & Development, LLC
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests new treatments for multiple myeloma, a type of blood cancer. It aims to determine if two experimental treatment combinations, Tec-DR and Tal-DR, are more effective than the existing treatment, DRd. Participants will receive one of these combinations, involving either teclistamab or talquetamab, both alongside standard drugs daratumumab and lenalidomide. This trial targets those newly diagnosed with multiple myeloma who are unsuitable for high-dose chemotherapy and stem cell transplants due to factors like advanced age or other health conditions. As a Phase 3 trial, it represents the final step before FDA approval, offering participants a chance to contribute to potentially groundbreaking treatments.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does mention that you should not have received any prior therapy for multiple myeloma or smoldering myeloma, except for a short course of corticosteroids. It's best to discuss your current medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that both investigational treatments—Talquetamab-Daratumumab-Lenalidomide (Tal-DR) and Teclistamab-Daratumumab-Lenalidomide (Tec-DR)—are generally safe, though they can cause some side effects.

For Tal-DR, studies have found that Talquetamab is well-tolerated. The FDA has approved it for treating relapsed or refractory multiple myeloma, indicating its safety for patients who have tried other treatments. However, some patients experienced side effects, such as infections.

For Tec-DR, trial data indicate that this combination also has a good safety record. In one study, 89.8% of patients experienced serious side effects, mainly infections. Despite these side effects, the treatment showed significant benefits.

Both treatments are in the final stages of testing, which suggests they have been shown to be safe in earlier studies. However, discussing potential risks and benefits with a healthcare provider is important before joining a trial.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for multiple myeloma because they bring innovative approaches to the table. Unlike standard treatments that typically involve combinations like daratumumab, lenalidomide, and dexamethasone, the new arms introduce talquetamab and teclistamab. Talquetamab targets GPRC5D, a novel antigen on myeloma cells, offering a fresh mechanism of action. Similarly, teclistamab is a bispecific antibody that directs T-cells to attack myeloma cells by targeting BCMA, a different protein on the cancer cells. These unique mechanisms could potentially enhance effectiveness and provide new hope for patients who have limited options with current therapies.

What evidence suggests that this trial's treatments could be effective for multiple myeloma?

Research has shown that combining talquetamab with daratumumab and lenalidomide (Tal-DR), one of the treatment arms in this trial, holds promise for treating multiple myeloma. Studies have found that many patients respond well, with some even experiencing a complete disappearance of their cancer. Similarly, the combination of teclistamab with daratumumab and lenalidomide (Tec-DR), another treatment arm in this trial, demonstrated a 100% response rate in certain patient groups. Many patients also reached minimal residual disease (MRD) negativity, where no cancer cells were found in their blood. These findings suggest both combinations have strong potential for effectively treating multiple myeloma.12467

Who Is on the Research Team?

JR

Janssen Research & Development, LLC Clinical Trial

Principal Investigator

Janssen Research & Development, LLC

Are You a Good Fit for This Trial?

This trial is for adults with newly diagnosed multiple myeloma who can't have high-dose chemotherapy with stem cell transplant due to age or other health issues. They should be able to perform daily activities (ECOG score 0-2) and must not plan on pregnancy or fathering children during the study.

Inclusion Criteria

I can take care of myself and am up and about more than half of my waking hours.
A participant must agree not to be pregnant, breastfeeding, or planning to become pregnant while enrolled in this study or within 6 months after the last dose of study treatment
I am newly diagnosed and not eligible for a specific intense treatment due to my age or health conditions.
See 2 more

Exclusion Criteria

I have only used a short course of steroids for my myeloma, not exceeding the specified dose.
You are allergic or have a bad reaction to the ingredients in teclistamab or talquetamab.
I am not allergic or unable to take daratumumab or lenalidomide.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Tec-DR or Tal-DR or DRd regimen, with cycles of 28 days each

Up to 196 days
Monthly visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

Up to 9 years

What Are the Treatments Tested in This Trial?

Interventions

  • Daratumumab
  • Dexamethasone
  • Lenalidomide
  • Teclistamab
Trial Overview The study compares two treatments: Teclistamab combined with Daratumumab and Lenalidomide (Tec-DR), versus Talquetamab with the same combination (Tal-DR). The goal is to see which treatment works better compared to a standard therapy of Daratumumab, Lenalidomide, and Dexamethasone.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: Teclistamab, Daratumumab SC, and Lenalidomide (Tec-DR)Experimental Treatment3 Interventions
Group II: Talquetamab, Daratumumab SC, and Lenalidomide (Tal-DR)Experimental Treatment3 Interventions
Group III: Daratumumab SC, Lenalidomide, and Dexamethasone (DRd)Active Control3 Interventions

Daratumumab is already approved in European Union, United States for the following indications:

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Approved in European Union as Darzalex for:
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Approved in United States as Darzalex for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Janssen Research & Development, LLC

Lead Sponsor

Trials
1,022
Recruited
6,408,000+
Joaquin Duato profile image

Joaquin Duato

Janssen Research & Development, LLC

Chief Executive Officer since 2022

MBA from ESADE, Master of International Management from Thunderbird School of Global Management

Dr. Jijo James, MD profile image

Dr. Jijo James, MD

Janssen Research & Development, LLC

Chief Medical Officer since 2014

MD from St. Johns Medical College, MPH from Columbia University

Published Research Related to This Trial

In a study of 737 patients with newly diagnosed multiple myeloma, the addition of daratumumab to lenalidomide and dexamethasone significantly reduced the risk of disease progression or death, with a hazard ratio of 0.56, indicating a 44% lower risk compared to the control group.
Patients receiving daratumumab had a higher rate of complete response (47.6% vs. 24.9%) and a greater percentage achieving minimal residual disease status (24.2% vs. 7.3%), although they also experienced more severe side effects like neutropenia and pneumonia.
Daratumumab plus Lenalidomide and Dexamethasone for Untreated Myeloma.Facon, T., Kumar, S., Plesner, T., et al.[2023]
Daratumumab combined with lenalidomide and dexamethasone showed an impressive overall response rate of 81% in patients with relapsed/refractory multiple myeloma, indicating its efficacy in this challenging patient population.
The treatment was well tolerated, with no dose-limiting toxicities observed and manageable infusion-related reactions, suggesting a favorable safety profile consistent with previous treatments.
Phase 1/2 study of daratumumab, lenalidomide, and dexamethasone for relapsed multiple myeloma.Plesner, T., Arkenau, HT., Gimsing, P., et al.[2022]
Intravenous daratumumab, when combined with bortezomib, thalidomide, and dexamethasone, significantly improves treatment outcomes for adults with newly diagnosed multiple myeloma, leading to higher rates of stringent complete response and prolonged progression-free survival, as shown in the phase III CASSIOPEIA trial.
The addition of daratumumab has a minimal impact on overall toxicity, with the most common serious side effects being blood-related issues, indicating it is a relatively safe option for patients undergoing treatment for multiple myeloma.
Daratumumab: A Review in Combination Therapy for Transplant-Eligible Newly Diagnosed Multiple Myeloma.Lamb, YN.[2021]

Citations

Talquetamab, a GPRC5D×CD3 Bispecific Antibody, in ...Results: As of July 11, 2024, 32 pts were enrolled. Median follow-up was 10.5 months in the Q2W cohort (n=8) and 3.5 months in the Q4W cohort (n=24).
Talquetamab, a GPRC5D×CD3 Bispecific Antibody, in ...This novel, fully immune combination regimen of tal-DR showed high ORR and rapid responses in pts with NDMM with 3.5-10.5 months of follow-up.
Talquetamab in Multiple Myeloma: Efficacy, Safety, and Future ...Administered following a step‐up dosing phase to manage cytokine release syndrome (CRS), talquetamab demonstrated a high overall response rate ( ...
Ongoing Analyses and Recent Data for Talvey in Multiple ...MonumenTAL-1 (NCT03399799/NCT04634552) was a phase 1/2 study that had shown a 73% overall response rate (ORR) in 100 patients receiving a 0.4-mg ...
TALVEY®▼ (talquetamab) and DARZALEX® ...Updated data show 100 percent overall response rate, with 56 percent of patients achieving complete response or better with weekly dosing, supporting the ...
Safety and activity of talquetamab in patients with relapsed ...Talquetamab continued to demonstrate high overall response rates in heavily pretreated patients with relapsed or refractory multiple myeloma ...
Talquetamab, a GPRC5D×CD3 Bispecific AntibodyTalquetamab (Tal) is the first approved GPRC5D-targeting bispecific antibody for the treatment of patients with relapsed/refractory MM1-3.
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