Long-Term Survival Rates Favor Novel Triplet Regimen for Multiple Myeloma
A novel triplet regimen had the largest progression-free survival (PFS) benefit compared with three other triplet regimens for patients with relapsed or refractory multiple myeloma, according to a presentation at the 35th Annual Chemotherapy Foundation Symposium (November 9-11, 2017; New York, NY).
There have been four recently approved treatment regimens to demonstrate PFS benefit for patients with relapsed or refractory multiple myeloma: elotuzumab plus lenalidomide and dexamethasone (ERd), carfilzomib plus Rd (KRd), ixazomib plus Rd (NRd), and daratumumab plus Rd (DRd). However, no head-to-head comparison studies have been conducted.
To compare the effects of each of these regimens in relapsed or refractory multiple myeloma, researchers evaluated PFS outcomes of four phase III studies: ELOQUENT-2, ASPIRE, TOURMALINE-MM, and POLLUX. Digitalized software helped researchers trace the PFS curve of each arm in each study.
After analyzing the results for a 6-month follow-up period, researchers observed that patients who were treated with ERd and DRd had the highest relative PFS benefit.
ERd demonstrated the most durable and greatest relative PFS benefit at 12, 24, 36, and 48 months (20.2%, 45.8%, 45.5%, and 53.0%, respectively). PFS benefit was reportedly maintained through 50 months and beyond.
Similarly, DRd had the greatest relative benefit (43.0%). This rate was only evaluable at the 12-month analysis, due to data availability past that point.
KRd and NRd were not found to sustain additional PFS benefit by the end of data availability. While treatment with KRd showed a PFS benefit of 21.7%, 34.3%, and 19.1% (12, 24, and 26 months, respectively), treatment with NRd demonstrated a PFS benefit of only 9.7% and 24.1% (12 and 24 months, respectively).
Researchers noted that while elotuzumab plus lenalidomide and dexamethasone as well as daratumumab plus lenalidomide and dexamethasone seem to offer the superior PFS rates for patients with relapsed or refractory multiple myeloma, results “may not be generalizable to real-world populations” because the data set was based solely on patients enrolled in clinical trials.—Zachary Bessette