ClinicalTrials.gg
CompletedNCT05804032Updated Feb 18, 2026

Lenalidomide, Bortezomib and Dexamethasone Induction Therapy With Either Intravenous or Subcutaneous Isatuximab in Patients With Newly Diagnosed Multiple Myeloma

A Phase 3 interventional study of Isatuximab and Isatuximab in Multiple Myeloma, sponsored by University of Heidelberg Medical Center. Completed at 91 sites in 2 countries. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-02-18.

Sponsored by University of Heidelberg Medical Center · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
514
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

The trial aims to demonstrate the non-inferiority of subcutaneous to intravenous isatuximab administration in transplant-eligible patients with newly diagnosed multiple myeloma.

Read the detailed description

Prospective, multicentre, randomised, parallel group, open, phase III clinical trial, for patients with confirmed diagnosis of untreated multiple myeloma requiring systemic therapy.

Investigational Medicinal Product: Isatuximab, subcutaneous administration via a wearable injector system.

Randomization: Patients are randomized in one of 2 study arms (A or B) before induction therapy. Patients randomized in arm A will receive 3 cycles of the monoclonal antibody isatuximab intravenously, combined with RVd regimen (Lenalidomide, Bortezomib, Dexamethasone). Each cycle will last for 42 days. Patients in arm B will receive 3 cycles RVd plus isatuximab subcutaneously. After induction therapy, patients will receive standard intensification (usually cyclophosphamide-based mobilization therapy, stem cell collection and high-dose melphalan followed by autologous stem cell transplantation (HDM/ASCT)). End of study will be after the first HDM/ASCT.

There is one primary objective:

Demonstration of non-inferiority of subcutaneous (SC) isatuximab compared to intravenous (IV) isatuximab, both in combination with RVd, with respect to rates of VGPR or better after induction therapy (according to standard International Myeloma Working Group (IMWG) response criteria).

Key secondary objectives are:

  1. Comparison of patient-reported outcomes (PRO) regarding route of administration of isatuximab (SC vs. IV) on induction therapy as assessed by modified CTSQ (modified 9-item questionnaire).
  2. Non-inferiority of rates of MRD negativity (assessed by NGS from BMA; sensitivity 10\^-5) independent of standard IMWG response after induction therapy.

The duration of the trial for each patients is expected to be approximately 10 months (induction and intensification treatment).

02

Conditions studied

  • Multiple Myeloma

Keywords

  • Neoplasms
  • Paraproteinemias
  • Lymphoproliferative Disorders
  • Immunoproliferative Disorders
  • Lenalidomide
  • Bortezomib
  • Dexamethasone
  • Isatuximab
  • Monoclonal antibodies
03

In context

Multiple Myeloma

3,760 studies on the registry are indexed under Multiple Myeloma; 769 are open to participants now.

This study's enrollment of 514 is above the median of 41 across 3,005 interventional studies indexed under Multiple Myeloma.

Browse Multiple Myeloma studies →

Lead sponsor

University of Heidelberg Medical Center is the lead sponsor of 21 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Confirmed diagnosis of untreated MM requiring systemic therapy (diagnostic criteria according to IMWG)
  • Patient is eligible for high-dose melphalan (200 mg/m\^2 melphalan) and stem cell transplantation
  • Measurable MM disease according to IMWG criteria, defined as any quantifiable monoclonal protein value, defined by at least one of the following three measurements: serum M-protein ≥ 10 g/L; urine light-chain (M-protein) of ≥ 200 mg/24 hours; involved FLC level ≥ 10 mg/dL provided sFLC ratio is abnormal
  • Age 18-70 years at trial inclusion

Exclusion criteria

Exclusion Criteria:

  • Patient has known (or ) to any of the components of study therapy
  • Systemic amyloid light-chain amyloidosis (except for localized AL amyloidosis limited to the skin or the bone marrow)
  • Plasma cell leukemia
  • Previous chemotherapy or radiotherapy during the past 5 years except local radiotherapy in case of local MM progression
  • Severe cardiac dysfunction ( classification III-IV)
  • Patients with active or uncontrolled or C or detectable liver disease due to hepatitis B or C
  • positivity
  • Patients with active, uncontrolled infections
  • Patients with severe renal insufficiency or requiring hemodialysis
  • Patients with peripheral neuropathy or neuropathic pain, grade 2 or higher (as defined by the NCI )
  • Patients with a history of any active during the past 5 years with the exception of following malignancies after curative therapy: basal cell carcinoma of the skin, squamous cell skin carcinoma, stage 0 cervical carcinoma or any in situ malignancy
  • count \< 75 x 10\^9/L
  • ≤ 8.0 g/dL, unless related to MM
  • (ANC) \< 1.0 x 10\^9/L (the use of colony stimulating factors within 14 days before the test is not allowed)
  • Corrected serum calcium > 14 mg/dL (> 3.5 mmol/L)
  • Pregnancy and lactation

For further details on inclusion/exclusion criteria please refer to the study protocol.

Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
514 participants (actual)

Study arms

  • Active comparator
    Arm A - Intravenous isatuximab

    Patients in arm A are treated with 3 cycles RVd + i.v. isatuximab, followed by a standard intensification and autologous stem cell transplantation.

    Drug: Isatuximab · Drug: Lenalidomide · Drug: Bortezomib · Drug: Dexamethasone

  • Experimental
    Arm B - Subcutaneous isatuximab

    Patients in arm B are treated with 3 cycles RVd + s.c. isatuximab, followed by a standard intensification and autologous stem cell transplantation.

    Drug: Isatuximab · Drug: Lenalidomide · Drug: Bortezomib · Drug: Dexamethasone

Interventions

  • IV isatuximab will be administered weekly in the first cycle (Cycle 1) on days 1, 8, 15, 22, 29, and biweekly on the 2 subsequent cycles at days 1, 15 and 29, at the dose of 10 mg/kg.

    Also known as: Sarclisa

  • SC isatuximab will be administered on days 1, 8, 15, 22, 29 of cycle 1, and on days 1, 15 and 29 of cycles 2-3, at the dose of 1400 mg

    Also known as: Sarclisa

  • Both arms: 25 mg per os on day 1-14 and d22-35 in induction cycle 1-3

  • Both arms: 1.3 mg/m\^2 subcutaneous on day 1, 4, 8, 11, 22, 25, 29 32 in 3 induction cycles

    Also known as: Velcade

  • 20 mg per os on day 1-2, 4-5, 8-9, 11-12, 15; and 22-23, 25-26, 29-30, 32-33 in induction cycles 1-3.

06

What researchers measure

Primary outcomes

  1. Demonstration of non-inferiority of subcutaneous (SC) isatuximab compared to intravenous (IV) isatuximab, both in combination with RVd.

    Rates of VGPR or better (according to standard IMWG response criteria), defined as proportion of patients with at least VGPR after induction therapy (according to standard International Myeloma Working Group (IMWG) response criteria).

    Time frame: 18 weeks after start of study treatment

Secondary outcomes

  1. Quality of life compared between Arm A and B.

    Comparison of PRO (patient-reported outcome) regarding route of administration of isatuximab (SC vs. IV) on induction therapy as assessed by modified CTSQ (modified 9-item questionnaire)

    Time frame: 18 weeks after start of study treatment

  2. Non-inferiority of rates of MRD negativity in Arm B compared to Arm A

    Rates of NGS-MRD negativity (sensitivity 10\^-5, from bone marrow aspirate) after induction therapy

    Time frame: 18 weeks after start of study treatment

  3. Rates of MRD negativity by NGS and NGF (sensitivity 10^-5, from BMA) independent of standard IMWG response after first HDM/ASCT

    defined as proportion of negative patients with the corresponding MRD method (NGS or NGF) at the defined timepoint (after induction therapy or first HDM/ASCT)

    Time frame: 18 weeks (timepoint "after induction") or 35 weeks (timepoint "after first HDM/ASCT") after start of study treatment

  4. Rates of best overall response to treatment (BOR)

    proportion of patients with BOR (at least PR or better) to treatment until end of study (based on timepoints post induction cycle 2 and 3, prior to HDM/ASCT and post first HDM/ASCT)

    Time frame: Depending on the timepoint of best response out of all response assessments, up to 10 months from randomization

  5. Progression-free survival (PFS)

    Time from randomization (at study inclusion) to progression or death from any cause whichever occurs first

    Time frame: Until EOS (28 months after start of study)

07

Study locations

91 sites
  • Universitätsklinikum Krems
    Krems, 3500, Austria
  • Ordensklinikum Linz
    Linz, 4020, Austria
  • Landeskrankenhaus Feldkirch-Rankweil
    Rankweil, 6830, Austria
  • Universitätsklinikum der Paracelsus, 3. Med. Abteilung/Onkologie Ambulanz
    Salzburg, 5020, Austria
  • Universitätsklinikum St. Pölten - Lilienfeld
    Sankt Pölten, 3100, Austria
  • Phyrn-Eisenwurzen Klinikum Steyr
    Steyr, 4400, Austria
  • Klinik Ottakring
    Vienna, 1160, Austria
  • Klinikum Wels-Grieskirchen
    Wels, 4600, Austria
  • Uniklinik RWTH Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation
    Aachen, 52074, Germany
  • Asklepios Kliniken Hamburg GmbH
    Altona, 20099, Germany
  • Klinikum Augsburg, II. Medizinische Klinik Hämatologie/Onkologie
    Augsburg, 86156, Germany
  • Helios Klinikum Bad Saarow, Klinik für Hämatologie, Onkologie und Palliativmedizin
    Bad Saarow, 15526, Germany
  • MedZentrum Klinikum Bayreuth GmbH
    Bayreuth, 95445, Germany
  • Charité, III. Medizinische Abteilung (Hämatologie/Onkologie)
    Berlin, 12200, Germany
  • Vivantes Klinikum Neukölln, Klinik für Hämatologie und Onkologie
    Berlin, 12351, Germany
  • Klinik für Hämatologie und Stammzelltransplantation, Helios Klinikum Berlin-Buch
    Berlin, 13125, Germany
  • Vivantes Klinikum Spandau
    Berlin, 13585, Germany
  • Bielefeld Praxis, Studiengesellschaft Onkologie
    Bielefeld, 33604, Germany
  • Evangelisches Klinikum Bethel
    Bielefeld, 33611, Germany
  • Johanniter-Krankenhaus Bonn
    Bonn, 53113, Germany
  • Universitätsklinikum Bonn, Medizinische Klinik III
    Bonn, 53127, Germany
  • Städtisches Klinikum Braunschweig
    Braunschweig, 38114, Germany
  • Klinikum Bremen-Mitte
    Bremen, 28205, Germany
  • Klinikum Chemnitz gGmbH
    Chemnitz, 09116, Germany
  • Universitätsklinikum Köln
    Cologne, 50937, Germany
  • Carl-Thiem-Klinikum Cottbus gGmbH, 2. Medizinische Klinik
    Cottbus, 03048, Germany
  • Klinikum Darmstadt, Medizinische Klinik V Hämatologie/Onkologie
    Darmstadt, 64283, Germany
  • Städtisches Klinikum Dessau
    Dessau, 06847, Germany
  • St.-Johannes-Hospital
    Dortmund, 44137, Germany
  • Universitätsklinikum Carl Gustav Carus an der TU Dresden, Medizinische Klinik und Poliklinik I
    Dresden, 01307, Germany
  • Helios St. Johannes Klinik Duisburg, Medizinische Klinik 2
    Duisburg, 47166, Germany
  • Universitätsklinikum Düsseldorf, Klinik für Hämatologie, Onkologie und Klinische Immunologie
    Düsseldorf, 40225, Germany
  • Marien Hospital Düsseldorf GmbH, Klinik für Onkologie, Hämatalogie und Palliativmedizin
    Düsseldorf, 40479, Germany
  • St. Antonius-Hospital Eschweiler, Klinik für Hämatologie / Onkologie
    Eschweiler, 52249, Germany
  • Universitätsklinikum Essen
    Essen, 45147, Germany
  • KEM I Evang. Kliniken Essen-Mitte gGmbH, Evangelisches Krankenhaus Essen-Werden gGmbH, Klinik für Hämatologie, Onkologie und Stammzelltransplantation
    Essen, 45239, Germany
  • Malteser Krankenhaus, St. Franziskus Hospital, Hämatologie/Onkologie
    Flensburg, 24939, Germany
  • Centrum für Hämatologie und Onkologie Bethanien
    Frankfurt am Main, 60389, Germany
  • Universitätsklinikum Frankfurt, Medizinische Klinik 2, Hämatologie/Onkologie
    Frankfurt am Main, 60590, Germany
  • Universitätsklinikum Freiburg
    Freiburg im Breisgau, 79110, Germany
  • Gießen UK
    Giessen, 35385, Germany
  • Universitätsklinikum Göttingen
    Göttingen, 37075, Germany
  • Universitätsmedizin Greifswald, Klinik und Poliklinik für Innere Medizin C
    Greifswald, 17475, Germany
  • Katholisches Krankenhaus Hagen gGmbH, Klinik für Hämatologie und Onkologie
    Hagen, 58097, Germany
  • Universitätsklinikum Halle
    Halle, 06120, Germany
  • Universitätsklinikum Hamburg-Eppendorf, Zentrum für Onkologie
    Hamburg, 20246, Germany
  • Medizinische Hochschule Hannover
    Hanover, 30625, Germany
  • Onkologische Schwerpunktpraxis Heidelberg
    Heidelberg, 69115, Germany
  • Universitätsklinikum Heidelberg, Medizinische Klinik V
    Heidelberg, 69120, Germany
  • SLK Kliniken Heilbronn, Medizinische Klinik III
    Heilbronn, 74078, Germany
  • Universitätsklinikum des Saarlandes, Klinik für Innere Medizin 1
    Homburg, 66421, Germany
  • Klinikum der Friedrich-Schiller-Universität Jena, Klinik für Innere Medizin II, Abteilung Hämatologie und internistische Onkologie
    Jena, 07740, Germany
  • Westpfalz-Klinikum
    Kaiserslautern, 67655, Germany
  • Städtisches Klinikum Karlsruhe
    Karlsruhe, 76133, Germany
  • Klinikverbund Allgäu, Klinikum Kempten, Hämatologie / Onkologie
    Kempten, 87439, Germany
  • Universitätsklinikum Schleswig-Holstein, Campus Kiel
    Kiel, 24105, Germany
  • Gemeinschaftsklinikum Mittelrhein
    Koblenz, 56073, Germany
  • Gemeinschaftspraxis für Hämatologie und Onkologie
    Lebach, 66822, Germany
  • Universitätsklinikum Leipzig
    Leipzig, 04103, Germany
  • Klinikum der Stadt Ludwigshafen
    Ludwigshafen, 67063, Germany
  • Universitätsklinikum Schleswig-Holstein, Campus Lübeck
    Lübeck, 23538, Germany
  • Universitätsklinikum Magdeburg
    Magdeburg, 39120, Germany
  • Universitätsmedizin der Johannes Gutenberg-Universität Mainz, III. Medizinische Klinik und Poliklinik
    Mainz, 55131, Germany
  • Mannheimer Onkologie Praxis
    Mannheim, 68161, Germany
  • Universitätsklinikum Mannheim, III. Medizinische Klinik
    Mannheim, 68167, Germany
  • Philipps-Universität Marburg, Abteilung Hämatologie, Onkologie und Immunologie am Universitätsklinikum Gießen und Marburg GmbH
    Marburg, 35037, Germany
  • Klinikum Hochsauerland
    Meschede, 59870, Germany
  • Kliniken Maria Hilf GmbH, Medizinische Klinik I
    Mönchengladbach, 41063, Germany
  • Kliniken Ostalb - Standort Stauferklinikum, Hämatologie und Onkologie
    Mutlangen, 73557, Germany
  • Rotkreuzklinikum
    München, 80634, Germany
  • Klinikum rechts der Isar der Technischen Universität München, Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie
    München, 81675, Germany
  • Universitätsklinikum Münster, 1. Medizinische Klinik A
    Münster, 48149, Germany
  • Klinikum Nürnberg
    Nuremberg, 90419, Germany
  • Klinik Oldenburg
    Oldenburg, 26133, Germany
  • Klinikum Osnabrück
    Osnabrück, 49076, Germany
  • Brüderkrankenhaus St. Josef
    Paderborn, 33098, Germany
  • Krankenhaus Barmherzige Brüder Regensburg, Klinik für Onkologie und Hämatologie
    Regensburg, 93049, Germany
  • Universitätsklinikum Regensburg
    Regensburg, 93053, Germany
  • CaritasKlinikum Saarbrücken St. Theresia
    Saarbrücken, 66113, Germany
  • Diakonie-Klinikum Schwäbisch Hall gGmbH, Innere Medizin III (Tumorerkrankungen, Palliativmedizin)
    Schwäbisch Hall, 74523, Germany
  • Zentrum für ambulante Hämatologie und Onkologie (ZAHO)
    Siegburg, 53721, Germany
  • Onkologische Schwerpunktpraxis Speyer
    Speyer, 67346, Germany
  • Klinikum der Landeshauptstadt Stuttgart - Katharinenhospital
    Stuttgart, 70174, Germany
  • Diakonie-Klinikum Stuttgart
    Stuttgart, 70176, Germany
  • Robert-Bosch-Krankenhaus
    Stuttgart, 70376, Germany
  • Universität Tübingen, Medizinische Universitätsklinik, Innere Medizin II: Onkologie, Hämatologie, Klinische Immunologie und Rheumatologie
    Tübingen, 72076, Germany
  • Universitätsklinikum Ulm
    Ulm, 89081, Germany
  • Schwarzwald-Baar Klinikum
    Villingen-Schwenningen, 78052, Germany
  • Helios Dr. Horst Schmidt Kliniken Wiesbaden GmbH
    Wiesbaden, 65199, Germany
  • Helios Universitätsklinikum Wuppertal
    Wuppertal, 42283, Germany
  • University of Würzburg, Med. Klinik und Poliklinik II
    Würzburg, 97080, Germany
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Apr 2023 to primary completion in Jan 2026, 33 months.

Of 71 non-industry phase 3 interventional studies under Multiple Myeloma, half reached primary completion within 87 months of starting (the median), counting those still running; a quarter within 48 and three quarters within 108. This study's 33 months is below that.

Counting every sponsor, half of 178 studies reached it within 56 months; a quarter within 35 and three quarters within 95.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 21, 2023
First posted
Apr 7, 2023
StartActual
Apr 14, 2023
Primary completionActual
Jan 30, 2026
CompletionActual
Jan 30, 2026
Last update
Feb 18, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 18, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05804032
Lead sponsor
University of Heidelberg Medical Center
Collaborators
Deutsche Studiengruppe Multiples Myelom (DSMM), KKS Netzwerk, Sanofi
Responsible party
Prof. Dr. Hartmut Goldschmidt (Principal Investigator, University of Heidelberg Medical Center) — Principal investigator
First posted
Apr 7, 2023
Start date
Apr 14, 2023
Primary completion
Jan 30, 2026
Completion
Jan 30, 2026
Last update
Feb 18, 2026

Study contacts

Hartmut Goldschmidt, Prof.
principal investigator · GMMG study group

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Discussion

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Studies of the drugs tested here: Isatuximab · Lenalidomide · Bortezomib · Dexamethasone

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