Multiple Myeloma Coverage from Every Angle

ASH 2020: Novel Immunotherapy Plus Chemotherapy in Resistant Multiple Myeloma

By: Julia Fiederlein
Posted: Wednesday, December 9, 2020

A first-in-human agent targeting death receptor 4/5 appears to be safe and effective in patients with relapsed or refractory multiple myeloma when combined with thalidomide and dexamethasone, according to Wenming Chen, MD, of Capital Medical University, Beijing, China, and colleagues. The results of a multicenter phase III trial of CPT—a recombinant permuted human TNF-related apoptosis-inducing ligand—were presented during the virtual edition of the 2020 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 416).

Patients who were previously treated with at least two lines of therapy were randomly assigned in 2:1 ratio to receive thalidomide and dexamethasone in combination with CPT (n = 276) or a placebo (n = 139). The median duration of progression-free survival was 5.5 months with CPT and 3.1 months with the placebo (P < .0001). The objective response rate (30.4% vs. 13.7%; P = .0002) and the median duration of overall survival (21.8 vs. 17.0 months; P = .0166) seemed to improve with CPT, compared with the placebo; improvements in the time to disease progression, duration of response, and health-related quality of life were also reported. Events of disease progression or death occurred in 73.6% of patients treated with CPT and in 79.9% of those treated with the placebo.

The rates of serious adverse events (40.6% vs. 37.4%) and death (7.6% vs. 8.6%) were similar with CPT and the placebo. Increased monocyte counts; hypocalcemia; upper respiratory tract infections; and elevated levels of alanine transaminase, aspartate transaminase, and lactate dehydrogenase were observed more frequently with CPT than with placebo. Grade 3 or 4 pneumonia (25.0% vs. 23.7%), hyperglycemia (21.0% vs. 12.2%), and decreased neutrophil counts (26.8% vs. 26.6%) were reported in both treatment arms.

Disclosure: For full disclosures of the study authors, visit

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