653. Myeloma/Amyloidosis: Therapy, excluding Transplantation: Relapsed/Refractory Multiple Myeloma
Meletios A. Dimopoulos, Evangelos Terpos, Mario Boccadoro, et al.
Authors Conclusion from the Abstract: In this phase 3 study evaluating DARA SC plus Pd, D-Pd significantly reduced the risk of progression or death by 37% in pts with RRMM who had received ≥1 prior line of therapy vs Pd alone. No new safety concerns were observed. The IRR rate was very low and administration duration short, thus increasing convenience for pts and decreasing treatment burden. Collectively, these data show that D-Pd is an effective and convenient treatment for pts with RRMM who received ≥1 prior therapy, including len and a PI.
Michael Sebag, Nizar Bahlis, Christopher P. Venner, et al.
Authors Conclusion from the Abstract: The results of this randomized phase II trial demonstrate that in a highly pretreated MM population (2 lines of therapy but range 1-8) that the four-drug combination (DCdP) confers impressive ORR (88.6%) and a median PFS (20.5 months) that compares favourably to other studies with anti-CD38 antibodies combined with Pomalidomide (11.5 months for Isatuximab-Pom-Dex, albeit in patients with 3 median lines of prior therapy). In Len exposed patients, DCdP demonstrates an ORR of 93% and a PFS of 20.5 months which is similar to what has been reported recently in Len exposed patients with Dara-pom-dex but after only one previous line of therapy. Although the 3 combination (DCd) showed an inferior initial response rate, over half of patients recaptured a response after the addition of Pom. Finally, while the overall PFS is lower in Arm B, the times to subsequent therapies are so far similar in both arms of this study opening a sequential-based approach as a feasible and economic option for further study.
Thomas Martin, Joseph Mikhael, Roman Hajek, et al.
Authors Conclusion from the Abstract: There was a clinically meaningful improvement in depth of response in Isa-Kd vs Kd. CR rate in Isa-Kd of 39.7% was underestimated due to interference. Mass spectrometry results suggest that the potential adjusted CR rate could be reached for 45.8% of pts with 1 to 3 prior lines treated in Isa-Kd. More pts in Isa-Kd vs Kd reached MRD negativity (30% vs 13%) and at least twice as many reached CR MRD- (20.1% vs 10.6%; adjusted 24% vs 10.6%). Reaching MRD negativity was associated with longer PFS in both arms.
Maria-Victoria Mateos, Enrique M. Ocio, Anna Sureda Balari, et al.
Authors Conclusion from the Abstract: Cyclophosphamide added to Kd 70 mg/m2 weekly in RRMM pts after 1-3 PL prolonged the PFS as compared to Kd particularly in the lenalidomide-refractory population. The administration of K at a dose of 70 mg/m2 weekly was safe and more convenient and overall, the toxicity profile was manageable in both arms.
Wenming Chen, Zhongjun Xia, Baijun Fang, et al.
Authors Conclusion from the Abstract: This study demonstrated that CPT was an effective drug for the treatment of RRMM patients, even in the multi-line treated MM patients and PI and/or IMIDs refractory MM patients. The combination of CPT with TD significantly prolonged the PFS and OS, increased the ORR. CPT combined with TD was well tolerated, the adverse events were mild, transient and reversible. CPT is expected to be the first available anti-myeloma drug that targets death receptor 4/5.
Enrique M. Ocio, Yvonne A. Efebera, Roman Hájek, et al.
Authors Conclusion from the Abstract: Melflufen plus dex as a triplet regimen with BTZ or dara has encouraging activity in heavily pretreated RRMM with poor prognostic factors and was well tolerated. Analysis of the dara arm in more pts with longer follow-up suggests consistent responses with continued therapy.