EHA 2018: Addition of Elotuzumab to Pomalidomide and Dexamethasone in Resistant Myeloma
Posted: Monday, July 9, 2018
The addition of the immunostimulatory monoclonal antibody elotuzumab to a combination of pomalidomide and dexamethasone significantly delayed disease progression and death in patients with relapsed or refractory multiple myeloma, according to the results of ELOQUENT-3, the first randomized trial to evaluate this regimen. Meletios Dimopoulos, MD, of the National and Kapodistrian University of Athens, Greece, and colleagues presented their findings at the 2018 European Hematology Association (EHA) Annual Congress (Abstract LB2606).
“These data suggest that [elotuzumab plus pomalidomide and dexamethasone] may be a new treatment option for patients with [relapsed/refractory multiple myeloma] who have failed lenalidomide and a proteasome inhibitor,” concluded the authors.
The trial included 117 patients who had failed to respond to at least 2 prior lines of therapy. Participants were randomized 1:1 to receive either pomalidomide and dexamethasone plus elotuzumab (n = 60) or pomalidomide and dexamethasone (n = 57), given in 28-day cycles.
The elotuzumab arm experienced a 46% reduction in the risk of disease progression or death compared with the control group, considered both “clinically meaningful and highly significant” by the investigators. The median progression-free survival with the triplet regimen was 10.3 months versus 4.7 months with the doublet regimen. The overall response rate was also higher in the elotuzumab arm (53% vs. 26%).
Despite longer exposure and similar dose intensity between the study arms, the rate of adverse events was lower in the elotuzumab group, including grade 3 or 4 neutropenia and anemia, and the safety profile was consistent with prior findings. At database lock, more patients remained on the elotuzumab regimen (40%) compared with the control group (20%).
