The Multiple Myeloma Research Foundation (MMRF) announced an initiative designed to accelerate the evaluation of new investigational therapies for multiple myeloma (MM). The MMRF, in collaboration with the U.S. Food and Drug Administration (FDA), the National Cancer Institute (NCI), pharmaceutical, biotech and diagnostic industry members, academic center leaders and patients, initiated the formal development of a Master Protocol to allow patients to participate in clinical trials evaluating several investigational therapies at once.
A workshop to advance the MM Master Protocol, attended by more than 80 participants, was held in Washington, D.C. During the meeting, attendees from the FDA, NCI, industry, academia and the patient community endorsed a plan to move forward with the development of the complete master study protocol.
“We have made real progress in the battle against multiple myeloma, but there is still more work to do to bring new, effective, personalized treatments to patients,” said Walter M. Capone, President and Chief Executive Officer of MMRF. “The development of a Multiple Myeloma Master Protocol offers a promising solution to accelerate the development of critical targeted therapies to patients through a novel research model.”
Complementing the pursuit of novel drug classes and immunotherapies in MM drug development is the promise of identifying new targeted therapies for patients with specific genetic alterations. The MM Master Protocol would enable several Phase 2 clinical trials to take place in parallel within a single study design. Patients would be assigned to an appropriate experimental therapy based on an analysis of their genetic alterations. This novel approach – which has recently been applied in other cancers – allows multiple new therapies to be evaluated more rapidly than with a traditional trial design. Decisions to advance an investigational drug to Phase 3 testing in a specific genetic subgroup, or to test a different drug in this subgroup, can be expedited – with the goal of getting new drugs to patients faster than ever before.
“Myeloma is an incredibly complex, heterogeneous disease. There is an acute need for new therapies, particularly for patients whose cancer has relapsed,” said Shaji Kumar, M.D., Mayo Clinic College of Medicine. “The evidence suggests that this is the right approach to accelerate the development of targeted treatments. When finalized, this Master Protocol will be a major landmark for the multiple myeloma community.”
In addition to discussing protocol design, meeting participants addressed the application of minimal residual disease (MRD) measurements as surrogate endpoints for MM clinical trials. Multiple reports suggest that MRD is a strong predictor of long-term progression free survival (PFS) in multiple myeloma.
“It is critical that we build the Master Protocol with all stakeholders in partnership,” said Dr. Kumar. “MRD measurement, in the context of an innovative trial design like the Master Protocol, is an important tool that can ultimately make drug trials more efficient and less costly, thus speeding the delivery of better care to patients.”
The MM Master Protocol is a biomarker-driven, clinical trial that matches patients with relapsed disease with targeted therapies based on the genomic profile of their tumor. This approach builds on the work of MMRF’s Multiple Myeloma Genomics Initiative (MMGI), which established novel connections between the disease and important biomarkers and molecular targets. A key example of this is MMGI’s discovery, confirmed by other researchers, that the BRAF gene plays a role in a subset of myeloma cases. This type of genomics research has accelerated the ability of scientists to identify specific disease subtypes and design therapies to treat them successfully, particularly in cases where existing therapies are no longer effective.
“The workshop accelerated the development of a Master Protocol and is enabling stakeholders to collaborate and to leverage cutting edge science to bring the right treatments to patients as quickly as possible,” said Mr. Capone. “We are honored to work with partners across the spectrum of patient care to drive this concerted effort and work together toward a cure.”
Date: November 5, 2014