Triplet Therapy for Resistant Multiple Myeloma: Real-World View
Posted: Tuesday, December 8, 2020
Kevin Boyd, MRCP, PhD, of The Royal Marsden Hospital National Health Service Foundation Trust, London, and colleagues found that the treatment combination of panobinostat, bortezomib, and dexamethasone may be effective for some heavily pretreated patients with multiple myeloma. More specifically, benefits were observed among patients who were not refractory to proteasome inhibitors, those who were responsive, and potentially those with non–high-risk cytogenetics. The results, however, indicated the treatment is associated with significant hematologic toxicity. Often, the neurologic and gastrointestinal side effects were dose-limiting for patients and must be carefully monitored and managed. This real-world report from two tertiary myeloma centers in London was published in the British Journal of Haematology.
The researchers retrospectively reviewed a heavily pretreated population of patients with multiple myeloma (n = 75). All patients were previously treated with a proteasome inhibitor and an immunomodulatory drug. All had received a median of four previous lines of therapy.
The overall response rate was 47%. The minimal or better response rate was 60%. The researchers observed a positive relationship between the achievement of partial responses and longer progression-free (P < .001) and overall survival (P = .007). Those patients who were previously refractory to proteasome inhibitors had significantly shorter progression-free (P = .008) and overall survival (P = .04) than those who were not previously refractory to these agents. The subset of patients who received thalidomide plus panobinostat, bortezomib, and dexamethasone also had significantly shorter progression-free and overall survival than those who did not receive this regimen (P = .004 and P < .001, respectively).
“For future directions, our results suggest there may be value in investigating attenuated dosing schedules when panobinostat is combined with bortezomib in the multiply relapsed setting,” the study team concluded.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.