Multiple myeloma, a cancer of plasma cells in the bone marrow, has become an increasingly manageable disease over the past two decades, thanks to successive waves of innovative therapies. However, this progress comes with a significant challenge: many patients eventually develop resistance to these treatments, leaving physicians and patients with dwindling options. According to Business Wire, CellCentric’s latest milestone, the initiation of DOMMINO-1, a pivotal Phase 2 clinical trial, represents a promising advancement for those facing this difficult reality.
The DOMMINO-1 trial is evaluating inobrodib, a first-in-class oral medication that works by inhibiting p300 and CBP proteins, in combination with the well-established drugs pomalidomide and dexamethasone (collectively called InoPd). This combination targets a particularly challenging patient population: those with heavily pretreated, relapsed, or refractory multiple myeloma (RRMM) who have progressed despite bispecific T cell engagers or other cutting-edge therapies.
Compelling Early Results
The rationale for this trial is grounded in compelling preliminary data. InoPd demonstrated a 60% overall response rate in earlier studies, with response rates at least twice as high as alternative approaches for patients specifically refractory to pomalidomide following bispecific antibody therapy or anti-BCMA treatments. Importantly, inobrodib’s tolerability profile was consistent with standard pomalidomide-dexamethasone therapy, meaning patients would not face substantially worse side effects from the new addition.
Trial Design and Scope
DOMMINO-1 is enrolling 100 adult patients across clinical sites in the United Kingdom and United States, with the first patient dosed at The Royal Marsden NHS Foundation Trust in London. The trial is an open-label, single-arm study designed to evaluate both safety and efficacy. The inobrodib dose of 20 mg was carefully selected through Project Optimus, a dose-optimization initiative conducted in collaboration with the U.S. Food and Drug Administration and other regulatory authorities.
The primary measure of success is overall response rate, while researchers will also track progression-free survival, overall survival, and duration of response. Participants must have previously received bispecific antibodies and demonstrate resistance to multiple standard therapies, making them among the most difficult-to-treat myeloma patients.
Practical Advantages for Patients
Beyond its clinical efficacy, InoPd offers a significant practical advantage: it is entirely oral. This is particularly meaningful because more than 70% of multiple myeloma patients receive treatment in community settings rather than specialized cancer centers. An all-oral regimen eliminates the need for frequent infusions or intensive monitoring, making treatment more accessible and less disruptive to patients’ daily lives and caregivers’ schedules.
Broader Development
CellCentric is exploring inobrodib across multiple pathways. Beyond the InoPd combination, the company is investigating inobrodib with bispecific therapies elranatamab and teclistamab, and is also studying its potential as maintenance therapy. Having already evaluated inobrodib in over 450 patients, the company has built substantial clinical experience with the drug.
With FDA Fast Track and Orphan Drug Designations already granted for RRMM, DOMMINO-1 represents a significant step toward potentially transforming treatment options for multiple myeloma patients facing limited choices—offering hope grounded in encouraging early evidence.
