Sagar Lonial, MD, professor and chair, Department of Hematology & Medical Oncology, Emory University School of Medicine, chief medical officer, Winship Cancer Institute of Emory University, discusses multiple myeloma data presented at the 2018 ASCO Annual Meeting.
Updated findings from the multicenter phase I CRB-401 study of the anti-BCMA chimeric antigen receptor (CAR) T-cell therapy bb2121 showed a median progression-free survival (PFS) of 11.8 months and a median duration of response of 10.8 months for heavily pretreated patients with relapsed/refractory multiple myeloma. Lonial admits myeloma is a little late to the CAR T-cell therapy space, but this data is better than what has been seen in diffuse large B-cell lymphoma. There are more trials planned for relapsed myeloma, as in comparison with transplant.
The phase III OPTIMISMM study showed that adding pomalidomide (Pomalyst) to bortezomib (Velcade) and low-dose dexamethasone reduced the risk of disease progression or death by 39% in patients with relapsed/refractory multiple myeloma with prior exposure to lenalidomide (Revlimid).
Findings from the ARROW study showed a median PFS of 11.2 months (95% CI, 8.6-13.0) with once weekly carfilzomib and dexamethasone compared with 7.6 months (95% CI, 5.8-9.2) for the standard twice-weekly schedule of carfilzomib at 27 mg/m2 with dexamethasone (HR, 0.69; 95% CI, 0.54-0.83; P = .0029).
The 5-year follow-up of the ELOQUENT-2 study, of which Lonial is the lead author, showed a continued PFS benefit with elotuzumab (Empliciti) plus lenalidomide and dexamethasone of about 30% over lenalidomide and dexamethasone. Additionally, Lonial says that there may be a place for immunotherapy in myeloma, but where and when it should be used is under evaluation.