INOBRODIB

A new clinical trial is investigating the effectiveness of Inobrodib, when combined with Pomalidomide and Dexamethasone, for patients with multiple myeloma that has returned after treatment or no longer responds to available therapies. This Phase II study aims to evaluate how well this drug combination works against relapsed or refractory multiple myeloma and to further understand potential side effects. The trial is particularly focused on patients who have already tried several other treatments including proteosome inhibitors, anti-CD38 monoclonal antibodies, and targeted immunotherapies, but whose cancer continues to progress.

Table of Contents

What is Inobrodib?

Inobrodib (also known as CS1477) is an investigational medicine being studied for the treatment of multiple myeloma that has either come back after previous treatment (relapsed) or no longer responds to available therapies (refractory)[1]. Multiple myeloma is a type of blood cancer that affects plasma cells, which are white blood cells that produce antibodies to fight infections.

This drug is currently being evaluated in clinical trials to determine its effectiveness and safety when used in combination with other medications. It is not yet approved for general use and is only available through clinical trials[1].

Inobrodib Combination Therapy

In the ongoing clinical trial, Inobrodib is not being used alone but as part of a three-drug combination therapy[1]:

  • Inobrodib – The investigational drug being studied
  • Pomalidomide (also known as Pomalyst or Imnovid) – An established medication for multiple myeloma
  • Dexamethasone – A corticosteroid that is commonly used in cancer treatment

This combination is referred to as “InoPd” in the clinical trial documentation. The researchers want to determine if adding Inobrodib to the established combination of pomalidomide and dexamethasone can improve outcomes for patients whose multiple myeloma has stopped responding to other treatments[1].

Who is Eligible for This Treatment?

The treatment is being studied specifically for patients who meet the following criteria[1]:

  • Adults aged 18 years or older
  • Diagnosed with multiple myeloma that has relapsed (come back) and become refractory (no longer responds) to previous treatments
  • Their cancer must be refractory to at least one proteasome inhibitor (a type of cancer medication that blocks the action of proteasomes, which are cellular complexes that break down proteins)
  • Their cancer must be refractory to at least one anti-CD38 monoclonal antibody (a type of targeted therapy that binds to CD38 proteins on myeloma cells)
  • Their cancer must be refractory to pomalidomide, even though pomalidomide is included in the study treatment
  • They must have previously received an approved targeted immunotherapy such as:
    • BCMA therapy (B-cell maturation antigen targeted treatment)
    • CAR-T therapy (Chimeric Antigen Receptor T-cell therapy, where a patient’s own immune cells are modified to fight cancer)
    • GPRC5D therapy (G Protein-Coupled Receptor Class C Group 5 Member D targeted treatment)
    • T-cell engagers (TCEs, which help direct T cells to cancer cells)
    • Antibody-drug conjugates (ADCs, which combine antibodies with cancer-killing drugs)

These eligibility criteria indicate that Inobrodib is being studied for patients with advanced multiple myeloma who have already tried and not responded adequately to several other treatment options[1].

How is the Treatment Administered?

The clinical trial uses a specific dosing schedule for each medication in the combination[1]:

  1. Inobrodib: 40 mg taken orally (by mouth) twice daily, following a schedule of 4 days on and 3 days off, within each 28-day treatment cycle.
  2. Pomalidomide: 4 mg taken orally once daily on days 1 through 21 of each 28-day cycle.
  3. Dexamethasone: 40 mg taken orally once daily on days 1, 8, 15, and 22 of each 28-day cycle.

Patients continue receiving this treatment until one of the following occurs[1]:

  • Their disease progresses (gets worse)
  • They start a different anti-cancer therapy
  • They experience unacceptable side effects
  • They meet other criteria for withdrawal from the study

Treatment Goals and Effectiveness Measures

The main goal of the treatment is to achieve an objective response in patients with relapsed or refractory multiple myeloma. The trial measures several outcomes to determine how well the treatment works[1]:

  • Objective Response Rate (ORR): The percentage of patients whose cancer shrinks or disappears after treatment. The researchers are looking for patients to achieve at least a partial response (PR), which means the cancer has decreased by a certain amount.
  • Duration of Response (DoR): How long the positive response to treatment lasts.
  • Time to Response (TTR): How quickly patients respond to the treatment.
  • Very Good Partial Response (VGPR) rate: The percentage of patients who achieve a deeper level of response than just PR.
  • Complete Response (CR) rate: The percentage of patients whose cancer becomes undetectable after treatment.
  • Progression-Free Survival (PFS): How long patients live without their cancer getting worse.
  • Overall Survival (OS): How long patients live after starting the treatment, regardless of whether their cancer responds.

These measurements will be assessed both by the study investigators and by an independent review committee to ensure accuracy and objectivity[1].

Safety Monitoring

An important aspect of the clinical trial is monitoring the safety of Inobrodib when combined with pomalidomide and dexamethasone. The researchers are tracking[1]:

  • Treatment-emergent adverse events (TEAEs): Any new medical problems or worsening of existing conditions that occur after starting treatment.
  • Vital signs: Basic health measurements like blood pressure, heart rate, and temperature.
  • Laboratory abnormalities: Changes in blood tests that might indicate side effects of treatment.

Safety assessments continue from the start of treatment until 28 days after the end of treatment. This information will help determine whether the benefits of adding Inobrodib to the treatment regimen outweigh any potential risks[1].

Study Type Phase II, open-label, multicenter clinical trial
Condition Relapsed or Refractory Multiple Myeloma
Treatment Combination Inobrodib + Pomalidomide + Dexamethasone (InoPd)
Inobrodib Dosing 40 mg orally twice daily, 4 days on/3 days off for each 28-day cycle
Pomalidomide Dosing 4 mg orally once daily on Days 1-21 of each 28-day cycle
Dexamethasone Dosing 40 mg orally once daily on Days 1, 8, 15, and 22 of each 28-day cycle
Participant Eligibility 18+ years old; refractory to proteosome inhibitor, anti-CD38 antibody, and pomalidomide; previously treated with targeted immunotherapy
Number of Participants Approximately 100 patients
Primary Outcome Objective Response Rate (ORR) based on IMWG criteria
Treatment Duration Until disease progression, new anticancer therapy, unacceptable toxicity, or withdrawal criteria met
Study Duration Up to 48 months

Ongoing Clinical Trials on INOBRODIB

  • Study on the Safety and Effects of Inobrodib, Betamethasone Sodium Phosphate, and Dimethyl Fumarate in Patients with Advanced Blood and Bone Marrow Cancers

    Recruiting

    1 1 1
    Spain

Glossary

  • Multiple Myeloma: A type of blood cancer that forms in plasma cells (a type of white blood cell) in the bone marrow. These cancerous cells multiply and can cause damage to bones, immune system, kidneys, and red blood cell count.
  • Relapsed Multiple Myeloma: When multiple myeloma returns after a period of remission or response to treatment.
  • Refractory Multiple Myeloma: Multiple myeloma that does not respond to treatment or stops responding to treatment.
  • Inobrodib (CS1477): An investigational anti-cancer drug being studied for the treatment of multiple myeloma.
  • Pomalidomide (Pomalyst, Imnovid): An immunomodulatory drug used to treat multiple myeloma, which works by enhancing the immune system's ability to kill cancer cells and by preventing the growth of new blood vessels that feed tumors.
  • Dexamethasone: A corticosteroid medication that reduces inflammation and suppresses the immune system. In multiple myeloma treatment, it helps to reduce side effects and can also kill myeloma cells.
  • Phase II Clinical Trial: A stage of clinical research that tests a drug's effectiveness and further evaluates its safety in a larger group of patients with the specific disease being studied.
  • Open-label Study: A type of clinical trial where both the researchers and participants know which treatment is being administered.
  • Proteosome Inhibitor (PI): A type of drug that blocks the action of proteasomes, cellular structures that break down proteins. This can cause cancer cells to die.
  • Anti-CD38 Monoclonal Antibody (mAb): A type of targeted therapy that attaches to the CD38 protein found on myeloma cells, helping the immune system identify and destroy these cancer cells.
  • B-cell Maturation Antigen (BCMA): A protein found on the surface of myeloma cells that serves as a target for certain immunotherapies.
  • Chimeric Antigen Receptor Therapy (CAR-T): A type of treatment in which a patient's T cells (a type of immune cell) are changed in the laboratory to attack cancer cells.
  • T-cell Engagers (TCEs): A type of immunotherapy that helps the body's T cells recognize and attack cancer cells.
  • Antibody Drug Conjugate (ADC): A highly targeted type of treatment that combines an antibody that targets a specific protein on cancer cells with a cytotoxic (cell-killing) drug.
  • Objective Response Rate (ORR): The percentage of patients whose cancer shrinks or disappears after treatment. In this study, it refers to patients achieving a partial response or better.
  • International Myeloma Working Group (IMWG) criteria: Standardized guidelines used to evaluate response to treatment in multiple myeloma patients.
  • Independent Review Committee (IRC): A group of experts who review clinical trial data independently to minimize bias in evaluating treatment outcomes.
  • Partial Response (PR): A decrease in the amount of cancer in the body in response to treatment. Usually defined as at least a 50% reduction in measurable tumor or cancer markers.
  • Very Good Partial Response (VGPR): A treatment response that is better than a partial response but not a complete response, typically meaning a 90% or greater reduction in measurable disease.
  • Complete Response (CR): The disappearance of all signs of cancer in response to treatment.
  • Duration of Response (DoR): The length of time that a tumor continues to respond to treatment without growing or spreading.
  • Time to Response (TTR): How long it takes from the start of treatment until a patient shows a response to treatment.
  • Progression Free Survival (PFS): The length of time during and after treatment that a patient lives with the disease without it worsening.
  • Overall Survival (OS): The length of time from either diagnosis or the start of treatment that patients are still alive.
  • Treatment-emergent Adverse Events (TEAEs): Side effects or medical problems that begin or worsen after starting a medical treatment.

References

  1. https://clinicaltrials.gov/study/NCT07096778