NCT07605416

Brief Summary

This phase II trial compares standard consolidation with daratumumab, carfilzomib, lenalidomide, and dexamethasone to consolidation with teclistamab following standard induction therapy and autologous hematopoietic stem cell transplant for improving overall survival of patients with plasma cell leukemia. Consolidation therapy is treatment given after initial therapy to kill any cancer cells that may remain in the body. Daratumumab is in a class of medications called monoclonal antibodies. It binds to a protein called CD38, which is found on some types of immune cells and cancer cells, including myeloma cells. Daratumumab may block CD38 and help the immune system kill cancer cells. Carfilzomib inhibits protein complexes called proteasomes, which inhibits cancer cell growth and leads to cancer cell death. Lenalidomide may help kill cancer cells and prevents the growth of blood vessels that cancer cells need to survive. Dexamethasone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Teclistamab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Giving teclistamab as consolidation therapy after induction and autologous hematopoietic stem cell transplant may improve survival outcomes in patients with plasma cell leukemia, compared to standard consolidation with daratumumab, carfilzomib, lenalidomide, and dexamethasone.

Trial Health

65
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
74

participants targeted

Target at P50-P75 for phase_2

Timeline
77mo left

Started Jul 2026

Longer than P75 for phase_2

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 22, 2026

Completed
4 days until next milestone

First Posted

Study publicly available on registry

May 26, 2026

Completed
1 month until next milestone

Study Start

First participant enrolled

July 1, 2026

Expected
6.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 6, 2032

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 6, 2032

Last Updated

May 26, 2026

Status Verified

May 1, 2026

Enrollment Period

6.4 years

First QC Date

May 22, 2026

Last Update Submit

May 22, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • Overall survival (OS)

    The time to event outcome of overall survival will be evaluated and compared using a log-rank test to compare differences between arms. OS distributions will be evaluated graphically using the methods of Kaplan and Meier, along with estimation of the 3-year OS rates with corresponding 95% confidence intervals and other time points of interest. In a secondary manner, Cox regression models will also be used to evaluate differences in OS between treatment arms when adjusting for factors of interest as well as stratifying on the stratification factors including prior treatment status and t(11;14) status.

    From randomization to the time of death due to any cause, assessed up to 5 years

Secondary Outcomes (3)

  • Incidence of adverse events

    Up to 5 years

  • Progression free survival (PFS)

    From randomization to the time of progression and/or death due to any cause, assessed up to 5 years

  • Overall response rate

    Up to 5 years

Other Outcomes (1)

  • Minimal residual disease (MRD) negativity

    At baseline, post-induction, post-transplant, post-consolidation, and post-maintenance

Study Arms (2)

Arm 1 (induction, autoHSCT, D-KRd, maintenance)

ACTIVE COMPARATOR

See Detailed Description.

Procedure: Autologous Hematopoietic Stem Cell TransplantationProcedure: Biospecimen CollectionProcedure: Bone Marrow AspirationProcedure: Bone Marrow BiopsyDrug: CarfilzomibProcedure: Computed TomographyDrug: Daratumumab and Recombinant Human HyaluronidaseDrug: DexamethasoneOther: Fludeoxyglucose F-18Drug: LenalidomideProcedure: Magnetic Resonance ImagingDrug: MelphalanDrug: PlerixaforProcedure: Positron Emission TomographyBiological: Recombinant Granulocyte Colony-Stimulating FactorProcedure: Stem Cell IsolationProcedure: Transthoracic Echocardiography Test

Arm 2 (induction, autoHSCT, teclistamab, maintenance)

EXPERIMENTAL

See Detailed Description.

Procedure: Autologous Hematopoietic Stem Cell TransplantationProcedure: Biospecimen CollectionProcedure: Bone Marrow AspirationProcedure: Bone Marrow BiopsyDrug: CarfilzomibProcedure: Computed TomographyDrug: Daratumumab and Recombinant Human HyaluronidaseDrug: DexamethasoneOther: Fludeoxyglucose F-18Drug: LenalidomideProcedure: Magnetic Resonance ImagingDrug: MelphalanDrug: PlerixaforProcedure: Positron Emission TomographyBiological: Recombinant Granulocyte Colony-Stimulating FactorProcedure: Stem Cell IsolationDrug: TeclistamabProcedure: Transthoracic Echocardiography Test

Interventions

Undergo autoHSCT

Also known as: AHSCT, Autologous, Autologous Hematopoietic Cell Transplantation, Autologous Stem Cell Transplant, Autologous Stem Cell Transplantation, Stem Cell Transplantation, Autologous
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo collection of blood samples

Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo bone marrow aspiration

Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo bone marrow biopsy

Also known as: Biopsy of Bone Marrow, Biopsy, Bone Marrow
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given IV

Also known as: Carfilnat, CFZ, Kyprolis, PR 171, PR-171, PR171
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo PET/CT and/or CT

Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, Computerized Tomography (CT) scan, CT, CT Scan, Diagnostic CAT Scan, Diagnostic CAT Scan Service Type, tomography
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given SC

Also known as: DARA Co-formulated with rHuPH20, DARA/rHuPH20, Daratumumab + rHuPH20, Daratumumab and Hyaluronidase, Daratumumab and Hyaluronidase-fihj, Daratumumab and vorhyaluronidase, Daratumumab and Vorhyaluronidase Alfa, Daratumumab with rHuPH20, Daratumumab-rHuPH20, Daratumumab/Hyaluronidase-fihj, Daratumumab/rHuPH20 Co-formulation, Darzalex Faspro, Darzalex/rHuPH20, Darzquro, HuMax-CD38-rHuPH20, Recombinant Human Hyaluronidase Mixed with Daratumumab
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given PO

Also known as: Aacidexam, Adexone, Aknichthol Dexa, Alba-Dex, Alin, Alin Depot, Alin Oftalmico, Amplidermis, Anemul mono, Auricularum, Auxiloson, Baycadron, Baycuten, Baycuten N, Cortidexason, Cortisumman, Decacort, Decadrol, Decadron, Decadron DP, Decalix, Decameth, Decasone R.p., Dectancyl, Dekacort, Deltafluorene, Deronil, Desamethasone, Desameton, Dexa-Mamallet, Dexa-Rhinosan, Dexa-Scheroson, Dexa-sine, Dexacortal, Dexacortin, Dexafarma, Dexafluorene, Dexalocal, Dexamecortin, Dexameth, Dexamethasone Intensol, Dexamethasonum, Dexamonozon, Dexapos, Dexinoral, Dexone, Dinormon, Dxevo, Fluorodelta, Fortecortin, Gammacorten, Hemady, Hexadecadrol, Hexadrol, LenaDex, Lokalison-F, Loverine, Methylfluorprednisolone, Millicorten, Mymethasone, Orgadrone, Spersadex, TaperDex, Visumetazone, ZoDex
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo FDG PET/CT

Also known as: 18FDG, FDG, Fludeoxyglucose (18F), fludeoxyglucose F 18, Fludeoxyglucose F18, Fluorine-18 2-Fluoro-2-deoxy-D-Glucose, Fluorodeoxyglucose F18
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given PO

Also known as: CC 5013, CC-5013, CC5013, CDC 501, Revlimid
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo MRI

Also known as: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, MRIs, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging, sMRI, Structural MRI
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given IV

Also known as: Alanine Nitrogen Mustard, CB-3025, L-PAM, L-Phenylalanine Mustard, L-Sarcolysin, L-Sarcolysin Phenylalanine mustard, L-Sarcolysine, Melphalan for Injection-Hepatic Delivery System, Melphalanum, Phenylalanine Mustard, Phenylalanine Nitrogen Mustard, Sarcoclorin, Sarkolysin, WR-19813
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given SC

Also known as: AMD 3100, AMD-3100, AMD3100, JM-3100, Mozobil, SDZ SID 791
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo PET/CT

Also known as: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure), Positron Emission Tomography Scan, Positron-Emission Tomography, PT
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given SC

Also known as: Recombinant Colony-Stimulating Factor 3, rhG-CSF
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo stem cell collection

Also known as: Isolation, Stem Cell, Stem Cell Collection, Stem Cell Recovery
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Given SC

Also known as: JNJ 64007957, JNJ-64007957, JNJ64007957, Teclistamab-cqyv, Tecvayli
Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Undergo TTE

Also known as: TRANSTHORACIC ECHOCARDIOGRAPHY, TTE
Arm 1 (induction, autoHSCT, D-KRd, maintenance)Arm 2 (induction, autoHSCT, teclistamab, maintenance)

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Documented diagnosis of primary plasma cell leukemia according to IMWG criteria defined as 5% or greater circulating plasma cells at the time of initial diagnosis
  • Measurable disease at the time of initial diagnosis of at least one of the following as defined by IMWG criteria:
  • Serum monoclonal protein ≥ 0.5 g/dL or
  • Urine monoclonal protein ≥ 200 mg/24 hours (h) or
  • Serum free light chain (FLC) assay: Serum free light chain ≥ 100 mg/L and abnormal serum free light chain ratio
  • Age 18 - 80 years
  • Prior treatment:
  • ≤ 1 cycle of induction treatment based on physician/investigator discretion
  • No history of severe allergic reaction (including erythema nodosum) to lenalidomide or other prior immunomodulatory imide drug (IMiD) therapy
  • No history of clinically significant cardiopulmonary disease resulting from prior proteosome inhibitor therapy
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn, before study entry, the following criteria must be met
  • Female of childbearing potential (FCBP) is a female who: 1) has achieved menarche (first menstrual cycle) at some point, 2) has not undergone a hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of both ovaries), or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time during the preceding 24 consecutive months). \* Female of childbearing potential (FCBP):
  • Must use a contraceptive method that is highly effective (with a failure rate of \< 1% per year), preferably with low user dependency during the intervention and agrees to not donate eggs (ova, oocytes) for the purpose of reproduction during this period. The investigator should evaluate the effectiveness of the contraceptive method in relationship to the first dose of study intervention
  • Given the risk of teratogenicity with immunomodulatory drugs (IMiD), females of child-bearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 25 mIU/mL within 10-14 days prior to, and again within 24 hours of starting lenalidomide, and must either commit to continued abstinence from heterosexual intercourse or being two acceptable methods of birth control, one highly effective method and one additional effective method at the same time, at least 28 days before she starts taking lenalidomide. Examples of highly effective methods are intrauterine device, hormonal contraceptives, tubal ligation, or partner's vasectomy. Examples of barrier method are male condom, diaphragm, or cervical cap. FCBP must also agree to ongoing pregnancy testing. Men must agree to use latex condom during sexual contract with a FCBP even if they have had a successful vasectomy. All patients must be counseled at a minimum frequency of 28 days about pregnancy precautions and risk of fetal exposure
  • +31 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Leukemia, Plasma Cell

Interventions

Stem Cell TransplantationSpecimen HandlingBiopsycarfilzomibdaratumumabHyaluronoglucosaminidaseDexamethasoneCalcium Dobesilateauricularumdexamethasone acetatedexamethasone 21-phosphateFluorodeoxyglucose F18LenalidomideMagnetic Resonance SpectroscopyMelphalanplerixaforferric pyrophosphatepegylated granulocyte colony-stimulating factor

Condition Hierarchy (Ancestors)

LeukemiaNeoplasms by Histologic TypeNeoplasmsMultiple MyelomaNeoplasms, Plasma CellHematologic DiseasesHemic and Lymphatic DiseasesLymphoproliferative DisordersImmunoproliferative DisordersImmune System Diseases

Intervention Hierarchy (Ancestors)

Cell TransplantationCell- and Tissue-Based TherapyBiological TherapyTherapeuticsTransplantationSurgical Procedures, OperativeClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisInvestigative TechniquesCytodiagnosisCytological TechniquesDiagnostic Techniques, SurgicalGlycoside HydrolasesHydrolasesEnzymesEnzymes and CoenzymesPolysaccharide-LyasesCarbon-Oxygen LyasesLyasesPregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsSteroids, FluorinatedBenzenesulfonatesBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsArylsulfonatesArylsulfonic AcidsSulfonic AcidsSulfur AcidsSulfur CompoundsDeoxyglucoseDeoxy SugarsCarbohydratesPhthalimidesPhthalic AcidsAcids, CarbocyclicCarboxylic AcidsPiperidonesPiperidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsIsoindolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingSpectrum AnalysisChemistry Techniques, AnalyticalNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedPhenylalanineAmino Acids, AromaticAmino Acids, CyclicAmino AcidsAmino Acids, Peptides, and Proteins

Study Officials

  • Douglas W Sborov

    Alliance for Clinical Trials in Oncology

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 22, 2026

First Posted

May 26, 2026

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

November 6, 2032

Study Completion (Estimated)

November 6, 2032

Last Updated

May 26, 2026

Record last verified: 2026-05

Data Sharing

IPD Sharing
Will share

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

More information