Saad Z. Usmani, MD, MBA, FACP, Talks Benefits of Evaluating Elotuzumab Plus RVd in Newly Diagnosed Myeloma

Saad Z. Usmani, MD, MBA, FACP, spoke about the safety profile of standard triplet therapy with or without elotuzumab for patients with newly diagnosed, high-risk multiple myeloma in the phase 3 SWOG 1211 trial and how results of this trial may be used in future datasets to inform treatment in this setting.

At the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, Saad Z. Usmani, MD, MBA, FACP, chief of the Myeloma Service at Memorial Sloan Kettering Cancer Center in New York, spoke with CancerNetwork® about comparing safety outcomes associated with lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVd) with or without elotuzumab (Empliciti) in the phase 1/2 SWOG 1211 trial (NCT01668719) in patients with newly diagnosed high-risk multiple myeloma.1 He also touched upon how these data may be compared with other trial datasets, such as the phase 3 ENDURANCE trial (NCT01863550) examining carfilzomib (Kyprolis) plus lenalidomide and dexamethasone (KRd) vs RVd.

Transcript:

There were no differences in safety. One of the things that we tried to look at was subgroups of patients with deletion 17p and 1q21 abnormalities to see specifically [the progression-free survival outcomes] within those subgroups. Interestingly with deletion 17p, it’s a small group of patients, but there was a non-statistical benefit in PFS [which was] numerically higher in the experimental arm of the study. Nevertheless, no new specific concerns [were noted regarding] increased infection risk with additional elotuzumab.

We’re thinking about combining this data set with some smaller subsets from the ENDURANCE study that had evaluated KRd vs RVd as frontline induction for standard-risk patients.2 Focusing on the enrichment-designed, high-risk trials continues to be important. There’s a frontline clinical trial being planned right now to answer the important standard of care questions for this patient population. We are seeing a lot of data on CAR T-cell therapy at ASCO as well as bispecific antibody updates. This new trial that we’re designing will incorporate those treatments in some of the experimental arms.

References

  1. Usmani SZ, Hoering A, Ailawadhi S, et al. Randomized phase II trial of bortezomib, lenalidomide, dexamthasone with/without elotuzumab for newly diagnosed, high risk multiple myeloma (SWOG-1211). J Clin Oncol. 2022;40(suppl 16):8054. doi: 10.1200/JCO.2022.40.16_suppl.8054
  2. Kumar SK, Jacobus SJ, Cohen AD, et al. Carfilzomib or bortezomib in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma without intention for immediate autologous stem-cell transplantation (ENDURANCE): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2020;21(10):1317-1330. doi:10.1016/S1470-2045(20)30452-6