A Vaccine (DC/MM Fusion) in Combination with Elranatamab for the Treatment of Relapsed or Refractory Multiple Myeloma

Inclusion Criteria

• TUMOR COLLECTION: Participants must have an established diagnosis of multiple myeloma
• TUMOR COLLECTION: Participant must have multiple myeloma and have relapsed following or are refractory to proteasome inhibitors, immunomodulatory imide drugs (IMiDs) and anti-CD38 monoclonal antibody (mAb) therapy
• TUMOR COLLECTION: Participants must have at least 3 prior lines of therapy
• TUMOR COLLECTION: Participants must be >= 18 years of age
• TUMOR COLLECTION: Eastern Cooperative Oncology Group (ECOG) performance status =< 2
• TUMOR COLLECTION: Participants must have > 20% plasma cells in the bone marrow core or aspirate differential < 30 days prior to enrollment
• TUMOR COLLECTION: Absolute neutrophil count (ANC) > 1 K/uL
• TUMOR COLLECTION: Platelets > 50 K/uL without transfusional support
• TUMOR COLLECTION: Total bilirubin =< 1.5 x institutional upper limit of normal
• TUMOR COLLECTION: Aspartate aminotransferase (AST) =< 3 x institutional upper limit of normal
• TUMOR COLLECTION: Alanine aminotransferase (ALT) =< 3 x institutional upper limit of normal
• TUMOR COLLECTION: Creatinine clearance >= 40 mL/min for participants with creatinine levels above institutional normal
• TUMOR COLLECTION: The effects of DC/MM fusion vaccine on the developing human fetus are unknown. For this reason, women and men of child-bearing potential must agree to use adequate contraception (hormonal or barrier methods of birth control or abstinence) prior to study enrollment and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner are participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 6 months after completion of treatment
• TUMOR COLLECTION: Ability to understand and willingness to sign a written informed consent document
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: Resolution of all elranatamab related >= grade 3 or higher toxicities to grade 1 or baseline. Isolated laboratory abnormalities that are not considered to be clinically significant are not exclusionary
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: Successful production of at least 2 vaccines with a minimum of 1 x 10^6 fusion cells per vaccine
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: Absence of disease progression following 2 cycles of elranatamab therapy
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: ECOG performance status =< 2
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: Total bilirubin =< 1.5 x institutional upper limit of normal
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: AST =< 3 x institutional upper limit of normal
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: ALT =< 3 x institutional upper limit of normal
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: ANC > 1K/uL
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: Platelets > 50 K/uL without transfusional support
• PRIOR TO VACCINATION WITH DC/MM FUSIONS: Creatinine clearance >= 40 mL/min for participants with creatinine levels above institutional normal

Exclusion Criteria

• TUMOR COLLECTION: Patients who are receiving any other investigational agents
• TUMOR COLLECTION: Patients with purely non-secretory multiple myeloma (MM) (absence of a monoclonal protein [M protein] in serum as measured by electrophoresis and immunofixation and the absence of Bence-Jones protein in the urine defined by use of conventional electrophoresis and immunofixation techniques and the absence of involved serum free light chain > 100 mg/L). Patients with light chain MM detected in the serum by free light chain assay are eligible
• TUMOR COLLECTION: Patients with plasma cell leukemia
• TUMOR COLLECTION: Because of compromised cellular immunity, patients who have a known human immunodeficiency virus (HIV), active hepatitis C virus (HCV) or active hepatitis B virus (HBV)
• TUMOR COLLECTION: Myocardial infarction within 6 months prior to enrollment or New York Heart Association (NYHA) class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any electrocardiogram (ECG) abnormality at screening will be documented by the investigator as not medically relevant
• TUMOR COLLECTION: Active and clinically significant autoimmune or inflammatory disorder requiring active treatment
• TUMOR COLLECTION: Individuals with a history of a different malignancy are ineligible except for the following circumstances. Note: Individuals with a history of other malignancies are eligible if they have been disease-free for at least 2 years and are deemed by the investigator to be at low risk for recurrence of that malignancy. Individuals with the following cancers are eligible if diagnosed and treated within the past 5 years: noninvasive cancer (such as, any in situ cancers) and basal cell or squamous cell carcinoma of the skin
• TUMOR COLLECTION: Female patients who are pregnant (positive beta-human chorionic gonadotropin [HCG]) or breastfeeding
• TUMOR COLLECTION: Prior organ transplant requiring immunosuppressive therapy
• TUMOR COLLECTION: Patients who previously received programmed cell death protein 1 (PD-1) antibody and have experienced toxicities resulting in treatment discontinuation
• TUMOR COLLECTION: Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• TUMOR COLLECTION: History of Guillain-Barré syndrome (GBS) or GBS variants, or history of any grade >= 3 peripheral motor polyneuropathy