Elotuzumab, lenalidomide, and dexamethasone (EloRd) as salvage therapy for patients with multiple myeloma (MM) may be safe and effective, according to results from a multicenter, retrospective study published in Haematologica. Italian researchers assessed a real-world cohort of patients with MM and confirmed findings from the phase 3 Eloquent-2 clinical trial (ClinicalTrials.gov Identifier: NCT01239797) investigating this triple therapy.

This regimen is 1 of 5 triple schedules backed by high-level evidence and uniform consensus as a preferred regimen for patients with relapsed/refractory (R/R) MM. For this investigation, researchers enrolled 300 patients with R/R MM who were treated between April 2017 and April 2019 at 40 Italian centers.

At baseline, 24.3% of patients were resistant to the most recent line of therapy, 57% had symptomatic relapse, 18.7% had biochemical relapse, 26% had prior lenalidomide treatment, and 38.3% had received autologous stem cell transplant.

The overall response rate was found to be 77%; 7.6% of patients achieved complete remission, and 29.3% of patients achieved very good partial remission. The researchers noted that these results were similar to those of the Eloquent-2 trial, which reported an overall response rate of 79%. Median progression-free survival was 17.6 months, and the rate of 1-year progression-free survival was 59.1%; these were also similar to findings from Eloquent-2.

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Previous treatment with lenalidomide was found to be associated with poorer outcomes. Moreover, the researchers confirmed the Eloquent-2 trial results demonstrating that patients with a short disease history may be more prone to disease progression. “Based on both studies, we suggest incorporating EloRd as a first salvage regimen in lenalidomide-naive patients and in patients with relatively longer disease duration,” wrote the reseachers.

Reference

Gentile M, Specchia G, Derudas D, et al. Elotuzumab, lenalidomide, and dexamethasone as salvage therapy for patients with multiple myeloma: Italian, multicenter, retrospective clinical experience with 300 cases outside of controlled clinical trials. Haematol. doi: 10.3324/haematol.2019.241513