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Novel Four-Drug Combination Therapy for Newly Diagnosed Multiple Myeloma

By: Cordi Craig
Posted: Wednesday, January 9, 2019

The addition of daratumumab to the standard induction therapy for multiple myeloma—ixazomib, lenalidomide, and dexamethasone—appeared to be safe and effective among patients with newly diagnosed disease, according to a study presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 304). The study represents the first reported results of the four-drug combination therapy in this patient population, the authors claimed.

Early results suggest “excellent efficacy with rapid responses that deepen quickly over the initial cycles of therapy,” Shaji K. Kumar, MD, and colleagues, of the Mayo Clinic, Rochester, Minnesota, concluded. “The regimen was well tolerated … and [there was] no influence on the ability to collect stem cells.”

The phase II trial enrolled 40 patients with newly diagnosed multiple myeloma. The analysis included response rate data on 38 patients.

The authors observed rapid responses after two cycles, with 90% of patients achieving a partial response or better. Among patients who completed four cycles of treatment (n = 32), all of them achieved a partial response or better, and half of them were very good partial responses. Overall, the best confirmed response rate was 95%. Of them, 11% achieved complete responses, and 47% achieved very good partial responses.

Dose modifications and holds were required for ixazomib (n = 3), lenalidomide (n = 11), daratumumab (n = 2), and dexamethasone (n = 8), primarily due to skin rash or hematologic reasons. Hematologic (37%) and nonhematologic (11%) grade 3 treatment-related adverse events or higher were seen in 42% of patients.

Disclosure: The study authors’ disclosures can be found at ash.confex.com.



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