ASPIRE Trial: Triplet Therapy in Relapsed or Refractory Multiple Myeloma
Posted: Monday, March 19, 2018
In previously treated patients with multiple myeloma, carfilzomib, lenalidomide, and dexamethasone (KRd) offers a survival benefit over lenalidomide and dexamethasone (Rd), according to the results of the phase III ASPIRE trial, published in the Journal of Clinical Oncology. The study, conducted by David S. Siegel, MD, PhD, of the John Theurer Cancer Center at Hackensack University Medical Center, and colleagues, found the use of the triplet regimen significantly decreased the risk of death compared with Rd.
“KRd is a highly effective therapy for patients at first relapse, which should be reflected in future treatment algorithms,” the researchers concluded.
For the trial, 792 patients were randomized to receive KRd or Rd in 28-day cycles. Patients treated with KRd had a statistically significant and clinically meaningful 21% reduction in all-cause mortality versus Rd, with a median follow-up of 67.1 months. Median overall survival was improved by 7.9 months with the triplet regimen compared with the doublet regimen (48.3 months vs. 40.4 months). For patients who received 1 prior line of therapy, median overall survival was 11.4 months longer with KRd and 6.5 months longer after at least 2 prior lines of therapy. In addition, no new safety signals were noted.
Notably, the authors observed, the overall survival benefit did not seem to be a result of poor outcomes in the Rd group, as the reported median overall survival is similar to that in other phase III studies of relapsed or refractory multiple myeloma.