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NCT Number: NCT07564219

BEAM-MM - β-Hydroxybutyrate-Enhanced Adaptive Immunity in Multiple Myeloma

This study investigates whether raising blood levels of beta-hydroxybutyrate (BHB) - a natural molecule produced by the body during fasting or a low-carbohydrate diet - is safe and feasible and can improve the effectiveness of immunotherapy in patients with multiple myeloma, while remaining safe and well-tolerated. Patients will be randomly assigned to one of four intervention groups or a control group. The intervention groups will either follow a ketogenic diet (less than 10% of calories from carbohydrates) or receive oral supplementation with deltaG® Ketone Monoester Performance [(R)-3-hydroxybutyl (R)-3-hydroxybutyrate; CAS 1208313-97-6; TdeltaS Global, Inc., Oxford, UK], administered orally three times daily at either a low dose (13.5 g per serving, 40.5 g/day) or a high dose (25 g per serving, 75 g/day), in accordance with the FDA GRAS-approved dosing range. The control group will receive standard nutritional care. The study includes two parts: Part A enrolls patients receiving bispecific antibody treatment, and Part B enrolls patients receiving CAR-T cell therapy. Both dosing levels are applied in each part.

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Key information

Conditions

Multiple Myeloma (MM) Bispecific Antibodies Blood Protein Disorders CAR T Cells Cardiovascular Diseases Hematologic Diseases Hemic and Lymphatic Diseases Hemorrhagic Disorders Hemostatic Disorders Immune System Diseases Immunoproliferative Disorders Lymphoproliferative Disorders Multiple Myeloma Neoplasms Neoplasms by Histologic Type Neoplasms, Plasma Cell Paraproteinemias Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Medical Center Hamburg-Eppendorf

Hamburg, Free and Hanseatic City of Hamburg, 20251, Germany

Location status: Recruiting

Location contact

Jan Weller, MD

CONTACT

[email protected]

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Multiple Myeloma with indication for CAR-T cell therapy with Ciltacabtagene autoleucel (target antigen: BCMA) or a BCMA-directed bispecific antibody (e.g., Teclistamab, Elranatamab, Linvoseltamab).
  • Age ≥18 years on the day the informed consent is signed.

Exclusion criteria

  • Active infection requiring systemic therapy.
  • Known history of infection with Human Immunodeficiency Virus (HIV) or Hepatitis.
  • Significant short-term weight loss (>10% within the last 6 weeks).
  • ECOG Performance Status ≥2.
  • Prior immunoeffector cell therapy (CAR-T cell therapy or bispecific antibodies).
  • Active immunosuppression due to another condition (e.g., autoimmune disease, second malignancy).
  • Very high tumor burden with high risk for tumor lysis syndrome, as determined by myeloma-specific markers or markedly elevated LDH (per the treating myeloma team).
  • Women of childbearing potential in whom pregnancy cannot be reliably excluded prior to study entry.

Treatment and study plan

Ketogenic diet

Behavioral

Induction of a stable ketogenic metabolic state to increase blood BHB levels in order to improve T-cell function through immunometabolic reprogramming.

Duration: 4 weeks (28 days)

Macronutrient distribution:

  • Carbohydrates: <10% of daily caloric intake (approx. 20-30 g/day)
  • Fats: 70-75% of daily caloric intake
  • Proteins: 15-20% of daily caloric intake

Ketogenic Drinks

Behavioral

Ketone Performance, DeltaG

Primary outcomes

  1. Safety and Tolerability

    Time frame: Day 0 to 28 of the intervention

    No occurrence of Cytokine Release Syndrome (CRS) Grade ≥3 or neurotoxicity (ICANS) Grade ≥3, AND completion of the full 28-day intervention in ≥80% of participants per arm (≥4/5 per arm).

  2. CAR-T-Cell Expansion

    Time frame: Day 7 after infusion

    Number of CAR-T-Cells per ml of blood

  3. Effector Cytokines

    Time frame: Day 1 or 3 after bispecfiic antibody treatment

    Protein abundance per ml of blood or cytokines signature of effector cells

Study contacts

Contact information is provided by the study sponsor or research team.

Jan Weller, MD

CONTACT

[email protected]

0049 40 7410 0

Lisa Leypoldt, MD

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

Universitätsklinikum Hamburg-Eppendorf

Other

Registry information

Acronym: BEAM-MM

Important dates

Study start
2026
Primary completion
2027
Study completion
2028
First posted
May 4, 2026
Registry last updated
May 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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