ASH 2018: First-Line Combination Regimens in Transplant-Ineligible Patients With Myeloma
Posted: Thursday, December 20, 2018
In research presented at the 2018 Annual Meeting of the American Society of Hematology (ASH) & Exposition (Abstract 156), 1-year of additional follow-up of the phase III ALCYONE trial continues to support the progression-free survival benefit of daratumumab plus bortezomib, melphalan, and prednisone (D-VMP) treatment and bortezomib, melphalan, and prednisone alone (VMP) in patients with transplant-ineligible newly diagnosed multiple myeloma. In addition, improvements in the duration and depth of response continued to be reported with D-VMP, with no new safety signals emerging with the addition of daratumumab. Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, Greece, and colleagues presented these updated results.
Initial analysis of the ALCYONE study found that D-VMP therapy offered a benefit in terms of progression-free survival (median not reached versus 18.1 months) as well as a higher rate of minimal residual disease negativity (10-5 threshold: 22% vs. 6%) at a median follow-up at 16.5 months.
The study included 706 patients with multiple myeloma who were randomly assigned to receive either D-VMP (n = 350) or VMP (n = 356) treatment. The median age of patients was 71 years. At a median follow-up of 27.8 months, the median progression-free survival was not reached for those in the D-VMP cohort and 19.1 months for those receiving VMP. Patients receiving D-VMP also had a higher objective response rate (90.9% vs. 73.9%) and a longer duration of response (not reached vs. 21.1 months). The rate of grade 3 or 4 infection was 25.1% in the D-VMP cohort compared with 14.7% in the VMP group.
“With 1 year of additional follow-up, the combination of [daratumumab] and VMP in transplant-ineligible [patients with newly diagnosed multiple myeloma] continues to demonstrate a significant [progression-free survival] benefit, including in [patients] ≥75 years of age, and allows for maintenance of [progression-free survival] benefit during the subsequent line of therapy,” concluded Dr. Dimopoulos and colleagues.