There is a clear progression-free survival benefit for panobinostat plus bortezomib and dexamethasone among patients with multiple myeloma who received 2 or more prior regimens including bortezomib and an immunomodulatory agent, a new study published online ahead of print in the journal Blood has shown.1
Panobinostat, a potent pan-deacetylase inhibitor that affects the growth and survival of multiple myeloma cells through alteration of epigenetic mechanisms and protein metabolism, led to a significant improvement in progression-free survival when used in combination with bortezomib and dexamethasone in patients with relapsed and refractory multiple myeloma in the PANORAMA 1 trial. In a subgroup analysis, researchers sought to evaluate outcomes of patients in that phase 3 trial based on prior treatment.
Of those included in the study, 485 had received a prior immunomodulatory agent, 193 had received prior bortezomib and an immunomodulatory agent, 147 had received 2 or more regimens including bortezomib and an immunomodulatory agent.
Results showed that median progression-free survival for patients who received 2 or more therapies was 12.5 months in the panobinostat and 4.7 months in the placebo group (HR, 0.47; 95% CI, 0.31 – 0.72).
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In those who received a prior immunomodulatory agent, median progression-free survival was 12.3 months with panobinostat vs 7.4 months with placebo (HR, 0.54; 95% CI, 0.43 – 0.68), and 10.6 months vs 5.8 months, respectively, in those who had received bortezomib and an immunomodulatory agent (HR, 0.52; 95% CI, 0.36 – 0.76).
In regard to safety, the most common grade 3 or 4 adverse events in the panobinostat group were thrombocytopenia, lymphopenia, neutropenia, diarrhea, and asthenia/fatigue. Of note, on-treatment deaths among those who received a prior immunomodulatory agent and bortezomib, regardless of prior regimen number, were similar between the 2 treatment groups.
- Richardson PG, Hungria VTM, Yoon S-S, et al. Panobinostat plus bortezomib and dexamethasone in relapsed/relapsed and refractory myeloma: outcomes by prior treatment [published online ahead of print December 2, 2015]. Blood. doi: 10.1182/blood-2015-09-665018.