Phase 3, Two-Stage, Randomized, Multicenter, Open-label Study Comparing Iberdomide, Daratumumab and Dexamethasone (IberDd) versus Daratumumab, Bortezomib, and Dexamethasone (DVd) in Subjects with Relapsed or Refractory Multiple Myeloma (RRMM)

1. Subject is >= 18 years of age at the time of signing the informed consent
form (ICF).
2. Subject must understand and voluntarily sign an ICF prior to any
study-related assessments/procedures being conducted.
3. Subject is willing and able to adhere to the study visit schedule and other
protocol requirements.
4. Subject has documented diagnosis of MM and measurable disease, defined as
any of the
following:
a. M-protein quantities >= 1 g/dL by serum protein electrophoresis (sPEP) or >=
200 mg/24-hour urine collection by urine protein electrophoresis (uPEP); or
b. Light chain MM without measurable disease in serum or urine: serum free
light chain (FLC) levels > 100 mg/L (10 mg/dL) involved light chain and an
abnormal kappa/lambda FLC ratio
5. Subject has received 1 to 2 prior lines of anti-myeloma therapy.
6. Subject achieved a response (partial response [PR] or better) to at least 1
prior antimyeloma regimen.
7. Subject must have documented disease progression during or after their last
antimyeloma regimen.
8. Prior treatment with CD38-directed therapy:
In Stage 1, subjects with prior CD38-directed therapy are not eligible.
In Stage 2, prior treatment with CD38-directed therapy is permitted only if all
the following are fulfilled:
a. Best response achieved during CD38-directed therapy was > PR.
b. Subject did not progress while receiving CD38-directed therapy or within 60
days of last dose of therapy.
c. Subject did not discontinue CD38-directed therapy due to a related AE.
d. Last dose of daratumumab was >= 3 months prior to randomization.
9. .Prior treatment with bortezomib therapy is permitted, if all the following
are fulfilled:
a.Best response achieved during bortezomib-containing therapy was at least a
minimal response (MR).
b.Subject did not progress while receiving bortezomib therapy or within 60 days
of last dose of therapy.
10.Subject has an Eastern Cooperative Oncology Group (ECOG) performance status
score of 0, 1 or 2.
11. Females of childbearing potential (FCBP) must:
a. Have two negative pregnancy tests as verified by the Investigator prior to
starting study treatment. She must agree to ongoing pregnancy testing during
the course of the study, and after end of study treatment. This applies even if
the subject practices true abstinence* from heterosexual contact.
b. Either commit to true abstinence* from heterosexual contact (which must be
reviewed on a monthly basis and source documented) or agree to use, and be able
to comply with, 2 forms of contraception: one highly effective, and one
additional effective (barrier) measure of contraception without interruption 28
days prior to starting study treatment, during the study treatment (including
dose interruptions), and for at least 28 days after the last dose of
iberdomide, 3 months after the last dose of daratumumab or 7 months after the
last dose of bortezomib, whichever is longest.
12. Male subjects must:
a. Practice true abstinence or agree to use a condom during sexual contact
with a pregnant female or a female of childbearing potential while
participating in the study, during dose interruptions and for at least 90 days
after the last dose of iberdomide, 3 months after the last dose of daratumumab,
or 4 months after the last dose of bortezomib, whichever is longer even if he
has undergone a successful vasectomy.
13. Male subjects must agree to refrain from donating sperm while on study
treatment, during dose interruptions and for at least 90 days following last
dose of study treatment.
14. Subjects must agree to refrain from donating blood while on study
treatment, during dose interruptions and for at least 28 days following the
last dose of study treatment.
15. All male and female subjects must follow all requirements defined in the
Pregnancy Prevention Program

1. Subject has any significant medical condition, including active or
uncontrolled infection, presence of laboratory abnormality, or psychiatric
illness that places the subject at an unacceptable risk for treatment-related
complications, if he/she were to participate in the study.
2. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
within 14 days for mild or asymptomatic infections or within 28 days for
severe/critical illness prior to randomization. Acute symptoms must have
resolved and there must be no sequelae that would place the subject at a higher
risk of clinically significant complications from receiving study treatment,
based on the Investigator*s assessment in consultation with the Sponsor Medical
Monitor.
3. Subject has any condition that confounds the ability to interpret data from
the study.
4. Subject has any of the following laboratory abnormalities:
a. Absolute neutrophil count (ANC) < 1,000 cells/µL. It is not permissible to
administer granulocyte colony-stimulating factor (GCSF) to achieve minimum ANC
levels.
b. Platelet count: < 75,000 cells/µL for subjects in whom < 50% of bone marrow
nucleated cells are plasma cells; or a platelet count < 50,000 cells/µL for
subjects in whom >= 50% of bone marrow nucleated cells are plasma cells. It is
not permissible to transfuse subjects to achieve minimum platelet counts.
c. Hemoglobin < 8 g/dL (< 4.9 mmol/L).
d. Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73m2 or requiring
dialysis. The eGFR can be calculated using the modification of diet in renal
disease (MDRD) formula adjusted for actual BSA.
e. Corrected serum calcium > 13.5 mg/dL (> 3.4 mmol/L).
f. Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >
2.5 × upper limit of normal (ULN).
g. Serum total bilirubin > 1.5 × ULN or > 3.0 mg/dL for subjects with
documented Gilbert*s syndrome.
5. Subject has plasma cell leukemia, Waldenstrom*s macroglobulinemia or POEMS
syndrome ), or clinically significant amyloidosis.
6. Subject has peripheral neuropathy Grade 3, Grade 4 or Grade 2 with pain.
7. Subject has gastrointestinal disease that may significantly alter the
absorption of iberdomide and/or other oral study treatment.
8. Subject has prior history of malignancies, other than MM, unless the subject
has been free of the disease for >= 5 years with the exception of the following
noninvasive malignancies:
• Basal cell carcinoma of the skin
• Squamous cell carcinoma of the skin in situ (stage 0)
• Carcinoma in situ of the cervix
• Carcinoma in situ of the breast
• Incidental histologic finding of prostate cancer (T1a or T1b using the TNM
[tumor, nodes, metastasis] clinical staging system) or prostate cancer that is
curative
9. Subject with known central nervous system involvement with MM.
10. Subject has received immunosuppressive medication within the last 14 days
of initiating study treatment. The following are exceptions to this criterion:
• Intranasal, inhaled, topical or local corticosteroid injections (eg,
intra-articular
• injection)
• Systemic corticosteroids at doses that do not exceed 10 mg/day of prednisone
(or an
• equivalent dose of an alternative glucocorticoid, see Table 7)
• Steroids as premedication for hypersensitivity reactions (eg, computed
tomography [CT] scan premedication)
11. Subject has impaired cardiac function or clinically significant cardiac
disease, including:
a. Myocardial infarction within 1 year before randomization, or an unstable or
uncontrolled disease/condition related to or affecting cardiac function
b. Uncontrolled cardiac arrhythmia or clinically significant electrocardiogram
(ECG) abnormalities
12. Subject received prior therapy with iberdomide.
13. Subject received any of the following:
a. Plasmapheresis within the last 28 days of initiating study treatment
b. Major surgery (as defined by the Investigator) within 28 days of initiating
study treatment
c. Radiation therapy, other than local palliative therapy, for myeloma
associated bone lesions within 14 days of initiating study treatment
d. Use of any systemic anti-myeloma drug therapy within 14 days of initiating
study treatment
14. Subject received any investigational agent within 28 days.
• Subjects who are participating in other interventional trials may not
participate in BMS clinical trials, except for those who have completed
treatment with the prior investigational agent(s) and are currently in
Long-term Follow up.
• Trial participation for subjects whom have received an investigational
vaccine (such as an investigational SARS-CoV-2 vaccine) will be determined by
discussion between the Investigator and Sponsor Medical Monitor.
15. Subject has previously received a live vaccine within 3 months of
initiating study treatment.
16. Concurrent administration of a strong inhibitor or inducer of cytochrome
P450 (CYP3A4/5) (including within 14 days of initiating study treatment).
17. Subject is unable or unwilling to undergo protocol required thromboembolism
or herpes zoster prophylaxis.
18. Subject has previously received allogeneic stem cell transplantation at any
time during prior therapy or received autologous stem cell transplantation
within 12 weeks of initiating study treatment.
19. Subject has known chronic obstructive pulmonary disease (COPD) with a
forced expiratory volume in 1 second (FEV1) < 50% of predicted normal. Note
that forced expiratory testing (FEV1) is required for subjects suspected of
having COPD.
20. Subject has known moderate or severe persistent asthma within the last 2
years, or currently has uncontrolled asthma of any classification.
21. Subject is a female who is pregnant, nursing or breastfeeding, or who
intends to become pregnant during participation in the study.
22. Subject is positive for human immunodeficiency virus (HIV), chronic or
active hepatitis B, active hepatitis A, or active hepatitis C:
a. Known to be seropositive for HIV.
b. Seropositive for hepatitis B . Subjects with resolved infection must be
screened using real-time polymerase chain reaction (PCR) measurement of
hepatitis B virus (HBV) deoxyribonucleic acid (DNA) levels. Those who are PCR
positive will be excluded.
c. Known to be seropositive for hepatitis C virus (HCV); anti-HCV antibody
positive or HCV- ribonucleic acid (RNA) quantitation positive, except in the
setting of a sustained virologic response (SVR), defined as aviremia at least
12 weeks after completion of antiviral therapy.
23. Subject has known allergies, hypersensitivity, or intolerance to boron or
mannitol, hyaluronidase, sorbitol, corticosteroids, monoclonal antibodies or
human proteins, cereblon modulating agents or their excipients or known
sensitivity to mammalian-derived products.
24. Subject has any contraindications to daratumumab, bortezomib or
dexamethasone, per local PI.
25. Vulnerable, under judicial protection, people without freedom by
administrative or judicial decision, people with psychiatric conditions without
their consent, people accepted in a health or social institution for other
purposes than the research, adults under legal guardianschip, curatorship, and
people incapable of giving consent personally.