Study Highlights Need for New Treatment Approaches, Novel Therapies for Relapsed/Refractory MM

Less than a third (29.8%) of patients with relapsed and/or refractory multiple myeloma (RRMM) who have been exposed to 3 classes of medications respond to real-life standard of care treatment, according to the LocoMMotion study.

“Despite treatment advances, patients with [MM] often progress through standard drug classes including proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and anti-CD38 monoclonal antibodies (mAbs), wrote Maria-Victoria Mateos, MD, University Hospital of Salamanca, Spain, and coauthors.

“The 92 varied regimens utilized demonstrate a lack of clear [standard of care] for heavily pretreated, triple-class exposed patients with RRMM in real-world practice and result in poor outcomes. This supports a need for new treatments with novel mechanisms of action,” they continued.

The LocoMMotion study is an ongoing, prospective, noninterventional, multinational study, said to be the first prospective study of its kind. The researchers analyzed data from 248 participants across 76 sites in Europe and the United States who had an Eastern Cooperative Oncology Group Performance Status Score of 0 or 1 and had prior treatment with at least 3 lines of therapy (or were double refractory to a PI and an IMiD). Participants were subsequently treated with a median of 4 cycles of standard of care therapy. Experimental drugs were not allowed.

The most frequently used PI was carfilzomib (25.4%), IMiD was pomalidomide (29.8%), and anti-CD38 mAbs was daratumumab (9.3%). Almost two-thirds (64.5%) of participants had undergone a previous stem cell transplantation. Between 2020 and 2021, participants had been exposed to 99 unique subsequent regimens.

The data cut-off was May 21, 2021, and the median follow-up was 11.01 months. By that time, 43.1% of the participants had died, 49.2% were ongoing in the study, and 7.7% had discontinued participation. The median progression-free survival was 4.6 months, while overall survival was 12.4 months.

Treatment-emergent adverse events were reported in 83.5% of participants, more than half (52.8%) of which were grade 3 or 4. Altogether, 107 deaths had occurred, 74 caused by progressive disease and 19 caused by treatment-emergent adverse events. 

Source:
Mateos MV, Weisel K, De Stefano V, et al. LocoMMotion: a prospective, non-interventional, multinational study of real-life current standards of care in patients with relapsed and/or refractory multiple myeloma. Leukemia. 2022;36(5):1371-1376. doi:10.1038/s41375-022-01531-2