Stay Up
to Date
Stay Up
to Date
Breaking News,
Updates, & More
Breaking News,
Updates, & More
Click Here to
Subscribe
Click Here to
Subscribe

Durable Benefit with Addition of Elotuzumab to Lenalidomide/Dexamethasone in Patients with RRMM

Conference Correspondent  - Conference Correspondent, ASH

Elotuzumab, an immunostimulatory monoclonal antibody, was recently approved by the US Food and Drug Administration for the treatment of patients with RRMM. Elotuzumab has a dual mechanism of action, directly activating natural killer cells and initiating antibody-dependent, cell-mediated cytotoxicity targeted against myeloma cells, with minimal effect on normal tissues.

In the 2-year analysis of the phase 3 ELOQUENT-2 study, patients with relapsed/refractory multiple myeloma and 1 to 3 prior therapies were randomized 1:1 to elotuzumab plus lenalidomide/dexamethasone or lenalidomide/dexamethasone in 28-day cycles until their disease progressed or their toxicities limited further treatment. Primary end points were progression-free survival and overall response rate. Secondary and other end points included overall survival and health-related quality of life, as measured by assessing worst pain using the Brief Pain Inventory–Short Form (BPI-SF).

A total of 646 RRMM patients were randomized to 1 of the 2 treatment arms. Patients’ median age was 66 years (20% ≥75 years), 32% of patients had a 17p deletion, 10% had a t(4;14) mutation, the median prior number of therapies was 2, and 35% of patients were refractory to their last therapy.

The elotuzumab-containing regimen resulted in a significant 30% reduction in the risk for disease progression or death versus lenalidomide/dexamethasone (hazard ratio, 0.70; 95% confidence interval, 0.57-0.85; P = .0004); the addition of elotuzumab to lenalidomide/dexamethasone was well tolerated, with minimal added toxicity.

 Grade 3-4 adverse events occurred in ≥15% of patients as follows:

Adverse event (Grade 3 or 4) Elotuzumab + lenalidomide/dexamethasone (n = 321) Lenalidomide/dexamethasone (n = 325)
Lymphopenia 78% (n = 250) 49% (n = 159)
Neutropenia 35% (n = 112) 44% (n = 143)
Anemia 20% (n = 64) 21% (n = 68)
Thrombocytopenia 21% (n = 67) 20% (n = 65)

Infections (any grade) occurred in 83% of patients in the elotuzumab plus lenalidomide/dexamethasone arm and 75% in the lenalidomide/dexamethasone arm. Infusion reactions (mostly grade 1-2) occurred in 11% of patients treated with elotuzumab plus lenalidomide/dexamethasone. With regard to patient-reported pain (BPI-SF), sustained improvement in worst pain was observed in patients who showed a clinically meaningful response to treatment, with more patients demonstrating sustained improvement in the elotuzumab plus lenalidomide/dexamethasone arm (n = 74) versus the lenalidomide/dexamethasone arm (n = 56).

These findings led investigators to conclude that the addition of elotuzumab to lenalidomide resulted in an effective and durable benefit, with minimal incremental toxicities associated with the addition of elotuzumab. Future studies will provide insight into the long-term benefits of elotuzumab plus lenalidomide/dexamethasone combination therapy.

Related Items
Sexual Dysfunction After Cancer: Why Aren’t We Talking About It?
Meg Barbor, MPH
TON - July 2018, Vol 11, No 3 published on July 25, 2018 in Conference Correspondent, ONS
The Importance of Compassion: Perspective From a Lifelong Patient
Meg Barbor, MPH
TON - July 2018, Vol 11, No 3 published on July 25, 2018 in Conference Correspondent, ONS
Using a Team Approach to Tackle Opioid Abuse in Patients with Cancer
Meg Barbor, MPH
TON - July 2018, Vol 11, No 3 published on July 25, 2018 in Conference Correspondent, ONS
Addressing the Second Victim Phenomenon
Charles Bankhead
TON - July 2018, Vol 11, No 3 published on July 25, 2018 in Conference Correspondent, ONS
Palliative Care Use Dismal Among Patients with Hematologic Malignancies
TON - March 2018, Vol 11, No 1 published on March 9, 2018 in Conference Correspondent, ASH, Palliative Care, Hematologic Cancers
Oral Multiple Myeloma Medication Linked to Decreased Productivity Loss
Chase Doyle
TON - March 2018, Vol 11, No 1 published on March 9, 2018 in Conference Correspondent, ASH, Multiple Myeloma
Ivosidenib, New IDH1 Inhibitor, Elicits Complete Response in Relapsed Acute Myeloid Leukemia
Wayne Kuznar
TON - March 2018, Vol 11, No 1 published on March 9, 2018 in Conference Correspondent, Drug Updates, ASH
“Superhero” Navigators Convene at the 8th Annual Navigation & Survivorship Conference
Meg Barbor, MPH
TON - March 2018, Vol 11, No 1 published on March 9, 2018 in AONN+ News, Conference Correspondent
Silent Patients Find Their Voices Through an Advocate’s Journey
Meg Barbor, MPH
TON - March 2018, Vol 11, No 1 published on March 9, 2018 in Patient Advocacy, Conference Correspondent, ESMO
Measuring Financial Well-Being in Cancer Survivorship
Meg Barbor, MPH
TON - March 2018, Vol 11, No 1 published on March 9, 2018 in Conference Correspondent, Survivorship
Last modified: December 5, 2017