Use of Elotuzuzmab, Panobinostat, and Ixazomib in Multiple Myeloma
Posted: Monday, April 6, 2020
In two meta-analyses, Nishanth Thalambedu, MD, of Abington Jefferson Health, Abington, Pennsylvania, and colleagues reported that the effects of elotuzumab, panobinostat, and ixazomib appear to be complex in patients with multiple myeloma. The reviews, originally slated for presentation at the 2020 NCCN Annual Conference (Abstracts CLO20-061, 062) and published in the JNCCN–Journal of the National Comprehensive Cancer Network, indicate that elotuzumab was associated with higher rates of very good partial responses and partial responses than panobinostat and ixazomib. However, complete response rates were lower with elotuzumab than with the combination therapy. In addition, panobinostat alone was associated with higher rates of anemia, thrombocytopenia, fatigue, and diarrhea but had a much lower risk of grade 3 and 4 complications than elotuzumab and ixazomib.
Using the MedLine and Cochrane databases, the researchers conducted two comprehensive literature searches. To evaluate the effects of panobinostat versus elotuzumab and ixazomib, data on nearly 900 patients (from 4 articles) were analyzed. To research the efficacy of elotuzumab versus panobinostat and ixazomib, the study team evaluated five relevant clinical trials (n = 984 patients).
Patients treated with panobinostat had a 10% lower risk of grade 3 and 4 complications but not a significantly different rate of complications compared with those who received elotuzumab (P = .47). A subgroup analysis revealed a significantly lower complication rate for panobinostat than ixazomib (P = .04). While panobinostat was linked to a lower risk of lymphopenia (P < .0001); the risk doubled for anemia with a much higher risk of thrombocytopenia (P < .0001) than elotuzumab and ixazomib.
In a separate analysis, patients treated with elotuzumab had significantly greater odds of achieving a very good partial response than did those receiving combination therapy with panobinostat and ixazomib (P < .01). Elotuzumab was also associated with significantly higher rates of partial responses than other agents (P = .03). However, significantly fewer complete responses were recorded with elotuzumab versus panobinostat and ixazomib (P < .0001).
Disclosure: The authors reported no conflicts of interest.
