Phase 1, First-in-Human, Dose Escalation Study of JNJ-79635322, a Trispecific Antibody, in Participants With Relapsed or Refractory Multiple Myeloma or Previously Treated AL Amyloidosis JNJ-79635322

What's the purpose of this trial?

The primary purpose of this study is to identify the recommended phase 2 dose (RP2D\[s\]) and schedule(s) to be safe for JNJ-79635322 in Part 1 (dose escalation), and to characterize the safety and tolerability of JNJ-79635322 at the RP2D(s) selected and in disease subgroups in Part 2 (dose expansion).

This trial is currently open and accepting patients.


What will happen during the trial?

You may be able to join this trial if you:

The following criteria is a partial list of reasons why patients may be eligible to participate in this clinical trial. Further evaluation with a medical professional is required.

Inclusion Criteria:

For participants with relapsed or refractory multiple myeloma:

* Have a documented initial diagnosis of multiple myeloma according to International Myeloma Working Group (IMWG) diagnostic criteria
* Have relapsed or refractory disease, have been treated with a proteasome inhibitor, immunomodulatory drug (IMiD) agent, and an anti-CD38-based therapy for the treatment of multiple myeloma (MM), and should have been treated with at least 3 prior lines of therapy, or are refractory to proteosome inhibitor, IMiD agent, and an anti-CD38-based therapy regardless of prior lines of therapy
* Must have an Eastern Cooperative Oncology Group (ECOG) status of 0 or 1
* Have measurable disease at screening as defined by at least 1 of the following: a) Serum M-protein level greater than or equal to (\>=) 0.5 grams per deciliter (g/dL); or b) Urine M-protein level \>=200 milligrams (mg)/24 hours; or c) Light chain multiple myeloma: Serum immunoglobulin (Ig) free light chain (FLC) \>=10 milligrams per deciliter (mg/dL) and abnormal serum Ig kappa lambda FLC ratio; d) For participants without measurable disease in the serum, urine, or involved FLC, presence of 1 or more focus of extramedullary disease (EMD) which meets the following criteria: extramedullary plasmacytoma not contiguous with a bone lesion, at least 1 lesion \>=2 centimeter \[cm\] (at its greatest dimension) diameter on whole body Positron Emission Tomography and Computed Tomography (PET-CT) Scans (or whole body magnetic resonance imaging \[MRI\] approved by sponsor), and not previously radiated

For participants with previously treated AL amyloidosis:

* Initial histopathological diagnosis of amyloidosis
* Participant who is not a candidate for available AL amyloidosis therapy with established clinical benefit and should have received at least 3 cycles of 1 prior line of therapy or a total of at least 2 cycles of 2 or more prior lines of therapy for AL amyloidosis
* Measurable disease at screening defined by at least 1 of the following: serum involved free light chain (iFLC) \>=50mg/L or difference between involved and uninvolved free light chains (dFLC) \>=50mg/L, or serum m-protein \>= 0.5g/dL
* One or more organs impacted by systemic AL amyloidosis
* Left ventricular ejection fraction (LVEF) \>=45%

Exclusion Criteria:

For participants with relapsed or refractory multiple myeloma:

* Central Nervous System (CNS) involvement or clinical signs of meningeal involvement of multiple myeloma. If either is suspected, brain magnetic resonance imaging (MRI) and lumbar cytology are required
* Active plasma cell leukemia, Waldenstrom's macroglobulinemia, POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes), or primary light chain amyloidosis
* Received a cumulative dose of corticosteroids equivalent to greater than (\>) 140 mg of prednisone within the 14-day period before the start of study treatment administration
* Prior antitumor therapy within 21 days prior to the first dose of study treatment (proteasome inhibitor \[PI\] therapy or radiotherapy within 14 days, immunomodulatory drug (IMiD) agent therapy within 7 days, gene-modified adoptive cell therapy within 90 days, or CD3-redirecting therapy within 21 days)
* Prior allogeneic transplant within 6 months before the start of study treatment administration or autologous transplant within 12 weeks before the start of study treatment administration
* Live, attenuated vaccine within 4 weeks before the first dose of study treatment
* Non-hematologic toxicity from prior anticancer therapy that has not resolved to baseline levels or to Grade less than or equal to (\<=) 1 (except alopecia, tissue post-RT fibrosis \[any grade\] or peripheral neuropathy to Grade \<=3)
* The following medical conditions: pulmonary compromise requiring supplemental oxygen use to maintain adequate oxygenation, human immunodeficiency (HIV) infection, active hepatitis B or C infection, stroke or seizure within 6 months prior to first dose of study treatment, autoimmune disease, serious active viral or bacterial infection, uncontrolled systemic fungal infection, cardiac conditions (myocardial infarction \<=6 months prior to enrollment, New York Heart Association stage III or IV congestive heart failure, et cetera)

For participants with previously treated AL amyloidosis:

* CNS involvement or clinical signs of meningeal involvement of AL amyloidosis. If either is suspected, whole brain MRI and lumbar cytology are required
* Any form of non-AL amyloidosis, including but not limited to transthyretin (ATTR) amyloidosis
* Active plasma cell leukemia, Waldenstrom's macroglobulinemia, or POEMS syndrome
* Pulmonary compromise requiring supplemental oxygen use
* Any serious medical conditions such as: active viral, bacterial, fungal infection; active autoimmune disease; HIV infection, active hepatitis B or C infection, stroke or seizure within 6 months prior to first dose of study treatment, significant cardiovascular conditions
* Previous or current diagnosis of symptomatic multiple myeloma
* Macroglossia that impairs swallowing difficulty
* Received a cumulative dose of corticosteroids equivalent to \> 140 mg of prednisone within the 14-day period before the start of study treatment administration
* Prior antitumor therapy within 21 days prior to the first dose of study treatment (PI therapy or radiotherapy within 14 days, IMiD agent therapy within 7 days, gene-modified adoptive cell therapy within 90 days, or CD3-redirecting therapy within 21 days)
* Prior allogeneic transplant within 6 months before the start of study treatment administration or autologous transplant within 12 weeks before the start of study treatment administration
* Live, attenuated vaccine within 4 weeks before the first dose of study treatment
* Non-hematologic toxicity from prior anticancer therapy that has not resolved to baseline levels or to \<=1 (except alopecia, tissue post-RT fibrosis \[any grade\] or peripheral neuropathy to Grade \<=3)

Additional Trial Information

Phase 1

Enrollment: 180 patients (estimated)

View More

Published Results

Updated efficacy and safety results of JNJ-5322, a novel, next-generation BCMA×GPRC5D×CD3 trispecific antibody, in patients with Relapsed/Refractory multiple myeloma

December 09, 2025

Results: As of July 9, 2025, 36 patients received JNJ-5322 at the RP2D with a median follow-up of 14.4 months. At baseline, 26.5% (9/34) had high-risk cytogenetics, 13.9% had ISS stage III disease, and 8.3% had extramedullary disease. Patients received a median of 4 (range 2–11) prior lines of therapy; 75.0% were BCMA/GPRC5D naive and 52.8% were triple-class refractory. The most common nonhematologic TEAEs were infections (80.6% [gr 3, 33.3%]) and skin-related (66.7%, all gr 1/2) and nail-related (61.1%, majority [58.3%] gr 1) TEAEs. The most common hematologic TEAEs were lymphopenia (47.2% [gr 3/4, 44.4%]) and neutropenia (44.4% [gr 3/4, 33.3%]). The cumulative incidence of gr ≥3 infections plateaued within the first year of therapy. Intravenous immunoglobulin (IVIg) use was recommended to maintain Ig levels ≥400 mg/dL; 91.7% of patients received IVIg. Hypogammaglobulinemia was reported in 52.8% of patients; among these, 94.7% received IVIg. CRS occurred in 52.8% (gr 1, 41.7%; gr 2, 11.1%). In cohorts without (received 100 mg Q4W) and with (received 100 mg Q4W/Q8W) prophylactic tocilizumab, CRS occurred in 69.2% (gr 2, 15.4%) and 20.0% (gr 2, 0%), respectively. No ICANS events were reported. Taste changes occurred in 58.3% (gr 1, 41.7%; gr 2, 16.7%); median duration was 57 days. Of 36 patients who received the RP2D, 27 were BCMA/GPRC5D naive with a median follow-up of 15.0 months; these patients showed a high ORR of 100.0% with deepening of response (complete response or better [≥CR], 77.8%) and a 12-month progression-free survival rate of 96.3%. Apart from 1 patient who died while in very good partial response (due to pneumonia in the setting of hypogammaglobulinemia <200 mg/dL), all 26 patients remain in response at 15.0 months of median follow-up, demonstrating durable responses. MRD negativity at 10 –5 was achieved in 100.0% (10/10) of evaluable patients. Updated analyses with 6 additional months of follow-up will be presented at the conference.

Conclusions: With longer follow-up in part 1 of the phase 1 trial, JNJ-5322 continues to demonstrate responses comparable to CAR-T therapy (ORR 100.0%) that are durable and continue to deepen (≥CR 77.8%), with a safety profile similar or improved compared with BsAbs targeting BCMA or GPRC5D. JNJ5322 offers off-the-shelf, Q4W dosing and 1 SUD with low rates of gr 2 CRS that may enable an efficient approach to dual antigen targeting via convenient administration and outpatient treatment. These findings support further evaluation of JNJ-5322 in patients with RRMM.

First-in-human study of JNJ-79635322 (JNJ-5322), a novel, next-generation trispecific antibody (TsAb), in patients (pts) with relapsed/refractory multiple myeloma (RRMM): Initial phase 1 results.

May 28, 2025

As of Jan 15, 2025, 126 pts received JNJ-5322 (36 at 100 mg Q4W); median follow-up (mFU) 8.2 mo. Median age 64 yrs; median 4 prior lines of therapy; 100% triple-class exposed (56% refractory); 31% high-risk cytogenetics; 23% had prior anti-BCMA/-GPRC5D therapy (77% naïve). The putative RP2D was identified as 100 mg Q4W. Overall, 99% of pts had ≥1 AE, most commonly CRS (59%; all grade [gr] 1 [45%]/2 [14%]; no gr ≥3), nail AEs (gr 1/2 56%), taste AEs (gr 1/2 56%), neutropenia (48%; gr 3/4 41%), and non-rash skin AEs (47%; gr 3/4 1%). Overall, 16% had weight decreases (no gr ≥3), 16% had rashes (no gr ≥3), 2% had ICANS (all gr 1), and 75% had infections (gr 3/4 28%). 5 pts had dose-limiting toxicities. 4 pts died due to AEs. In response-evaluable pts, ORR was 86% (75% ≥VGPR) at the RP2D (n=36), and 73% (66% ≥VGPR) overall (n=124). ORR was 100% (89% ≥VGPR) at the RP2D among pts naïve to anti-BCMA/-GPRC5D therapies (n=27), and all patients remain in response (mFU 8.5 mo). Median time to first response was 1.2 mo.

Trial Locations

All Trial Locations

View all clinical trial locations sorted by state.

California

City of Hope Comprehensive Cancer Center Beckman Research Institute

Duarte, CA

Open and Accepting

City of Hope Orange County Lennar Foundation Cancer Center

Irvine, CA

Open and Accepting

Colorado

New Jersey

Memorial Sloan Kettering Basking Ridge

Basking Ridge, NJ

Open and Accepting

Memorial Sloan Kettering Monmouth

Middletown, NJ

Open and Accepting

Memorial Sloan Kettering Bergen

Montvale, NJ

Open and Accepting

New York

Memorial Sloan Kettering Cancer Center

New York, NY

Open and Accepting

Memorial Sloan Kettering Commack

Commack, NY

Open and Accepting

Mount Sinai Hospital Tisch Cancer Institute

New York, NY

Open and Accepting

Memorial Sloan Kettering Nassau

Uniondale, NY

Open and Accepting

Memorial Sloan Kettering Westchester

West Harrison, NY

Open and Accepting

North Carolina

Atrium Health's Levine Cancer Institute - Charlotte (Main) Atrium Health

Charlotte, NC

Open and Accepting

Pennsylvania

Texas

MD Anderson Cancer Center The University of Texas

Houston, TX

Open and Accepting
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