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ASCO 2022: Combination Therapy With Umbilical Cord Blood–Derived Natural Killer Cells for Myeloma

By: Lauren Harrison, MD, MS
Posted: Wednesday, June 29, 2022

The use of umbilical cord blood–derived natural killer cells in combination with elotuzumab, lenalidomide, high-dose melphalan, and autologous stem cell transplantation (ASCT) appears to be an effective strategy for some patients with high-risk multiple myeloma. Preclinical data suggested adding elotuzumab to lenalidomide augmented the cord blood natural killer cell antibody-dependent cell-mediated cytotoxicity against myeloma cells. Samer Ali Srour, MBChB, MS, of The University of Texas MD Anderson Cancer Center, Houston, presented this work on behalf of his colleagues at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 8009).

“These results indicate excellent hematologic and MRD responses and improved survival for these patients, suggesting this approach could provide an additional treatment opportunity,” stated Dr. Srour in an MD Anderson press release.

This phase II trial enrolled 30 patients with high-risk multiple myeloma, which was defined as disease relapse within 18 months of ASCT; high-risk genetic signatures; t(4;14), t(14;16), t(14;20) translocations; and deletions on chromosome 17 or 13. Patients enrolled in the trial received intravenous elotuzumab, oral lenalidomide, melphalan, and cord blood–derived natural killer cells/ prior to undergoing ASCT. Researchers assessed the measurable residual disease (MRD) status of patients 3 months after ASCT using multiparametric flow cytometry.

Prior to ASCT, 73% of patients had achieved a very good partial response or better, with 40% achieving a complete response and 40% reaching MRD negativity. About 3 months after ASCT, 97% of patients had achieved a very good partial response or better, and 75% achieved MRD negativity. In addition, after the median follow-up of 26 months, four patients experienced disease progression. Among these patients, three had MRD positivity after ASCT. The 2-year progression-free survival rate was 83%, and the 2-year overall survival rate was 97%. There were no unexpected serious adverse effects that were attributable to the natural killer cells, according to the investigators.

Disclosure: For a full list of authors’ disclosures, visit coi.asco.org.


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