Elotuzumab May Provide Greatest Sustained Relative PFS Benefit in Multiple Myeloma
Four recently approved treatment regimens have demonstrated a PFS benefit for patients with RRMM relative to Rd, but no head-to-head studies have been conducted.
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Elotuzumab (E) plus lenalidomide (R) and dexamethasone (d) had the largest progression-free survival (PFS) benefit compared with 3 other novel triplet regimens among patients with relapsed/refractory multiple myeloma (RRMM) relative to Rd, according to a poster presentation at the 35th Annual Chemotherapy Foundation Symposium in New York.1
Four recently approved treatment regimens — Rd plus elotuzumab (ERd), carfilzomib (KRd), ixazomib (NRd), and daratumumab (DRd) — have demonstrated a range of PFS benefit for patients with RRMM relative to Rd, but no head-to-head studies have been conducted.
For this analysis, researchers evaluated the PFS outcomes of 4 phase 3 studies: ELOQUENT-2 (ERd vs Rd), ASPIRE (KRd vs Rd), TOURMALINE-MM (NRd vs Rd), and POLLUX (DRd vs Rd). By using digitalization software, the authors traced the PFS curve of each arm of each study and created a data file containing the coordinates for each curve.
After 6 months of follow-up, patients who were treated with ERd and DRd had the highest relative PFS benefit numerically.
DRd had the greatest relative PFS benefit (43.0%), but this was only at the 12-month analysis and there were no more data to evaluate past this point. Treatment durability has still not been determined for DRd.
ERd had the most durable and greatest relative PFS benefit with 20.2%, 45.8%, 45.5%, and 53.0%, at 12, 24, 36, and 48 months, respectively. Study authors reported that the benefit was maintained through 50+ months.
By the end of data availability, KRd and NRd did not sustain additional PFS benefit relative to Rd. Treatment with KRd demonstrated a PFS benefit of 21.7%, 34.3%, and 19.1% for 12, 24, and 36 months, respectively, whereas treatment with NRd demonstrated a PFS benefit of 9.7% and 24.1% for 12 and 24 months, respectively.
The findings “may not be generalizable to real-world populations” due to the evaluation of patients enrolled only clinical trials, the authors noted.
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Betts KA, Chen C, Zichlin ML, et al. Relative progression-free survival over time with novel triplet regimens for the treatment of relapsed/refractory multiple myeloma. Poster presented at: 35th Annual Chemotherapy Foundation Symposium; New York; November 8-10, 2017. Poster 560.