ASH 2021: Combination Iberdomide and Dexamethasone for Resistant Multiple Myeloma
Posted: Monday, December 13, 2021
Sagar Lonial, MD, FACP, of Winship Cancer Institute, Emory University, Atlanta, and colleagues conducted the ongoing phase I/II CC-220-MM-001 study to evaluate the synergy of dexamethasone with iberdomide—a novel, oral cereblon E3 ubiquitin ligase modulator—in multiple myeloma. Their results, presented during the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 162), suggest that this treatment combination demonstrates promising efficacy and tolerability while maintaining health-related quality of life.
The investigators focused on 107 patients with relapsed or refractory multiple myeloma who received at least three prior therapy lines and experienced progressive disease. Participants were administered iberdomide on days 1 through 21 in combination with dexamethasone on days 1, 8, 15, and 22 of each 28-day cycle.
The median time since diagnosis was 6.9 years, and the median number of prior therapy lines was six. High-risk cytogenetics and extramedullary plasmacytomas were reported in 29.9% and 25.2% of patients, respectively. Approximately 99.1% of individuals were refractory to the last treatment, and 97.2% were triple-class refractory to autologous stem cell transplantation, proteasome inhibitors, and anti-CD38 monoclonal antibodies.
At the median follow-up of 7.7 months, the median number of treatment cycles was four, and 13 patients remained on treatment; 69.2% discontinued treatment due to progressive disease. The overall response rate was 26.2%, including 19 partial responses, 8 very good partial responses, and 1 stringent complete response. The disease control rate was 79.4%, and the median progression-free survival was 3.0 months; the median overall survival was 11.2 months.
Treatment-emergent adverse events of grade 3 or 4 were observed in 88 patients, with the most common being neutropenia, anemia, thrombocytopenia, and leukopenia. Grade 3 or 4 infections, such as pneumonia and COVID-19, affected 27.1% of participants. Notably, iberdomide dose interruptions and reductions were reported in 52.3% and 18.7% of individuals, respectively, with five patients discontinuing therapy because of adverse events.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
