Final overall survival results from the ELOQUENT-2 study indicated that patients with relapsed or refractory multiple myeloma had a significant improvement in overall survival with elotuzumab plus lenalidomide-dexamethasone (Rd) compared with Rd alone.1

ELOQUENT-2 randomly assigned 646 patients with one to 3 prior lines of therapy to treatment to either elotuzumab — which targets SLMF7 — plus Rd or Rd alone. The primary endpoints of the study were progression-free survival and overall response rate. The primary analysis showed a 30% reduction in the risk for progression or death and significantly improved overall response rate with the triplet regimen.

This final overall survival analysis had a minimum follow-up of 70.6 months. Elotuzumab plus Rd demonstrated an 8.7-month improvement in overall survival compared with Rd alone (48.3 vs 39.6 months; hazard ratio, 0.82; 95% CI, 0.68-1.00; P =.0408). This benefit was observed across all predefined subgroups including those with high-risk disease, del (17p) mutations in 1 or more cell, prior stem cell transplantation, or ISS stage III disease.

According to the researchers, these data support “this regimen as a standard of care for patients with relapsed/refractory multiple myeloma and one to 3 prior lines of therapy.”


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However, they also pointed out that “the myeloma treatment landscape has continued to evolve since the conception and conduct of this trial, and few patients in ELOQUENT-2 had received previous treatment with lenalidomide.”

“Therefore, a limitation of this trial is that prior treatments received by patients in this trial may no longer reflect real-world clinical practice,” the researchers wrote. “However, given the length of follow-up required for assessing the significance of OS benefits, this limitation may apply to many clinical trials in relapsed/refractory multiple myeloma.”

Reference

Dimopoulos MA, Lonial S, White D, et al. Elotuzumab, lenalidomide, and dexamethasone in RRMM: final overall survival results from the phase 3 randomized ELOQUENT-2 study. Blood Cancer J. 2020;10(9):91. doi:10.1038/s41408-020-00357-4