Combination therapy involving a novel treatment is associated with reduced risk of death and improved progression-free survival (PFS) in patients with advanced multiple myeloma, according to research presented at the 22nd Congress of the European Hematology Association (June 22-25, 2017; Madrid, Spain).
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Elotuzumab (Empliciti, Bristol-Myers Squibb) is an immunostimulatory monoclonal antibody that targets SLAMF7 – a highly-expressed protein in multiple myeloma cells. In a previous 3-year follow-up analysis, elotuzumab plus lenalidomide and dexamethasone demonstrated a sustained 27% reduced risk of disease progression and death and an overall survival (OS) trend towards benefit compared with lenalidomide plus dexamethasone alone in patients with relapsed/refractory multiple myeloma.
Meletios A Dimopoulos, MD, chairman, Department of Clinical Therapeutics, National and Kapodistrian University of Athens (Greece), and colleagues conducted a study to evaluate the long-term efficacy of safety of elotuzumab plus lenalidomide and dexamethasone following extended 4-year follow-up. A total of 646 patients were randomized to receive either elotuzumab plus lenalidomide and dexamethasone (n = 321) or lenalidomide and dexamethasone alone (n = 325) in 28-day cycles until disease progression or unacceptable toxicity. Primary endpoints were PFS and overall response rate (ORR). Safety and OS were secondary endpoints.
At four years, patients in the elotuzumab group continued to demonstrate a clinically significant and sustained relative improvement of 50% in PFS rate. PFS in patients receiving elotuzumab were consistent across certain patient subsets and sustained through two-year, three-year, and four-year follow-up.
Additionally, patients receiving elotuzumab demonstrated an ORR of 79%, compared with 66% among patients in the control group. Similarly, median OS favored patients receiving elotuzumab (48 months) over patients in the control group (40 months).
Rates of adverse events were similar between patients in both groups and consistent with those reported at two- and three-year follow-up.
“This data at four-year follow-up is particularly notable as it suggests the ability of this Immuno-Oncology agent to build a sustainable immune response in some patients with advanced multiple myeloma,” said Dr Dimopoulos in a press release (June 24, 2017).—Zachary Bessette
