The following article features coverage from the 2021 Lymphoma, Leukemia & Myeloma Congress. Click here to read more of Hematology Advisor’s conference coverage.

Among patients with relapsed/refractory multiple myeloma (RRMM) with extramedullary disease (EMD), combining melflufen with dexamethasone appears to be safe and potentially efficacious, according to research presented at the virtual 2021 Lymphoma, Leukemia & Myeloma (LL&M) Congress.

Among patients with RRMM with EMD—which is linked with disease cells that proliferate independently of the bone marrow—prognosis is poor. No standard therapy for this patient population currently exists, suggesting a need for therapeutic advancement.

Melflufen, a peptide-drug conjugate targeting aminopeptidases, has previously shown efficacy among patients with RRMM in the HORIZON study (ClinicalTrials.gov Identifier: NCT02963493). In this sub-analysis, researchers evaluated data from HORIZON to determine the safety and efficacy of melflufen with dexamethasone among patients with RRMM with EMD.


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Overall, data from 55 patients with RRMM with EMD were included in this analysis. Among these patients, 49% had soft-tissue plasmacytoma, while 51% had bone-related plasmacytoma; the median age was 64 years, 35% of patients had high-risk cytogenetics, and the median number of prior therapy lines was 5.

Among patients with RRMM with EMD, the overall response rate was 23.6% (95% CI, 13.2-37), the median duration of response was 5.5 months (95% CI, 1.8-not evaluable), the median progression-free survival was 2.9 months (95% CI, 2-3.8), and the median overall survival was 6.5 months (95% CI, 5.1-9.7).

Among 13 patients who reached a partial response or better and 28 patients who had stable disease or better, the median progression-free survival was 17.3 months and 5.3 months, respectively; the median overall survival was 18.5 months and 13.6 months, respectively.

Grade 3-4 treatment-emergent adverse events were noted in 78% of patients in the EMD subgroup, the most common of which were anemia (42%), thrombocytopenia (40%), neutropenia (38%), and pneumonia (9%). No treatment-related deaths were noted, however.

Read more of Hematology Advisor‘s coverage of LLM 2021 by visiting the conference page.

Reference

Richardson P, Mateos MV, Oriol A, et al. HORIZON (OP-106): melflufen plus dexamethasone in 55 patients with relapsed/refractory multiple myeloma with extramedullary disease—subgroup analysis. Poster presented at: 2021 Lymphoma, Leukemia & Myeloma Congress; October 19-23, 2021. Abstract OP-106.