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Shaji K. Kumar, MD

Prashant Kapoor, MD, FACP


Follow-up on Elotuzumab-Based Regimen in High-Risk Multiple Myeloma

By: Joshua D. Madera, MS
Posted: Monday, August 1, 2022

For patients with high-risk multiple myeloma, adding the monoclonal antibody elotuzumab to the combination induction therapy regimen of lenalidomide, bortezomib, and dexamethasone (RVd) did not improve survival outcomes, according to a presentation given at the European Hematology Association (EHA) 2022 Congress (Abstract P965). However, Saad Usmani, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues believe the overall and progression-free survival outcomes observed for those with del17p and gain or amplification of 1q21 may serve as critical benchmarks for the design of future clinical studies.

A total of 103 patients with high-risk multiple myeloma were recruited for the study. High-risk multiple myeloma was defined by primary plasma cell leukemia, del(17)p, amplification of 1q21, gene-expression profiling high-risk, t(14;20), t(14;16), or an elevated serum lactate dehydrogenase level greater than two times the upper limit of normal. Patients were stratified to receive RVd therapy (n = 54) or RVd plus elotuzumab (n = 49).

The study findings did not reveal a significant difference in median progression-free survival between the treatment groups (hazard ratio [HR] = 1.11). Additionally, no significant difference was observed in overall survival (HR = 0.85). Furthermore, 76% of all patients experienced grade 3 or higher treatment-related adverse effects, with no significant difference between groups. When the investigators examined patients with the gain or amplification of the 1q21 mutation, the median progression-free survival was 31 and 37 months with RVd versus RVD plus elotuzumab, respectively (HR = 1.48), and the median overall survival was 61 and 68 months, respectively (HR = 1.23).

Disclosure: The authors reported no conflicts of interest.

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