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.”
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.”
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