Triplet Regimen Under Study in Frail Patients Newly Diagnosed With Multiple Myeloma
Posted: Thursday, October 21, 2021
A recent study published in the Journal of Clinical Oncology showed that the triplet regimen of ixazomib, daratumumab, and low-dose-dexamethasone may be active in frail patients newly diagnosed with multiple myeloma. However, the three-drug regimen did result in treatment discontinuation because of toxicity and early mortality in these study patients. According to Sonja Zweegman, MD, PhD, of the VU University Medical Center, Amsterdam, and colleagues, the study is the first of its kind to indicate that a patient’s level of may be associated with outcome.
“This is critical, since there is evidence that patients with advanced cancer and older age are more likely to prefer quality over length of life,” stated the investigators.
In the phase II trial of the HOVON 143 study, 65 frail patients were given the triplet regimen throughout 9 induction cycles of 28 days each. Maintenance therapy with ixazomib and daratumumab followed until disease progression for up to 2 years.
The overall response rate during induction was 78%, with a median progression-free survival of 13.8 months. In patients defined as frail by age, median progression-free survival was 21.6 months, and the 12-month overall survival was 92%. Patients defined as frail by geriatric impairments and/or comorbidities had a median progression-free survival of 13.8 months, with an overall survival rate of 78%. Moreover, patients defined as frail by both criteria had a median progression-free survival of 10.1 months, with an overall survival rate of 70%. Global health status or quality of life improved significantly after three induction cycles and increases continued for patients who completed all nine induction cycles.
The researchers concluded that future studies should be designed to determine outcomes in frailty subcategories based on age alone versus age with geriatric impairments and/or comorbidities. They believe this approach may help to guide more precise and successful treatment regimens for these groups.
Disclosure: The study authors’ disclosure information can be found at ascopubs.org.
