Elotuzumab in combination with pomalidomide, bortezomib, and dexamethasone in relapsed and refractory multiple myeloma

Elotuzumab is a monoclonal antibody targeting signaling lymphocyte activation molecule F7 on plasma and natural killer cells, which enhances the activity of lenalidomide, pomalidomide, and bortezomib in multiple myeloma (MM). The OPTIMISMM study showed improved outcomes with the combination of pomalidomide, bortezomib, and dexamethasone (PVd) in relapsed/refractory MM. Therefore, we studied adding elotuzumab to PVd (elo-PVd) in relapsed/refractory MM in a multicenter phase 2 trial. The primary objective was to determine the overall response rate (ORR). Patients with relapsed/refractory disease and ≥1 prior line of treatment (including lenalidomide and a proteasome inhibitor) were eligible. For each 28-day cycle, elotuzumab was weekly for the first 2 cycles and then every other week; pomalidomide on days 1 to 21; bortezomib on days 1, 8, and 15; and dexamethasone weekly. The trial enrolled 48 patients with a median 3 prior lines (range, 1-9). Prior therapies included pomalidomide (33%), daratumumab (25%), and isatuximab (4%). The ORR was 56.3%, and the median progression-free survival (PFS) was 10 months. In patients with 1 prior line of therapy, ORR was 73.7%; median PFS was 23.4 months. Common grade ≥3 adverse events were neutropenia (33%); infections, any (33%); lung infection (27%); hypophosphatemia (19%); and thrombocytopenia (15%). Elo-PVd is, to our knowledge, one of the first trials of a quadruplet regimen in relapsed/refractory MM incorporating a monoclonal antibody to show efficacy across diverse prior treatments, including triple-class exposed patients with prior anti-CD38 monoclonal antibody. This trial was registered at ClinicalTrials.gov as #NCT02718833.

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Publication Details

Journal
Blood Advances
Published
2024-12-03
DOI
https://doi.org/10.1182/bloodadvances.2024014717
Citations
7
Primary Topic
Multiple Myeloma Research and Treatments
Type
article
Field-Weighted Citation Impact
3.18

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article

Elotuzumab in combination with pomalidomide, bortezomib, and dexamethasone in relapsed and refractory multiple myeloma

Craig Emmitt Cole, Robert Allyn Redd, Kathleen J. Lively, Erica Campagnaro et al.
7 citations
Blood Advances
Multiple Myeloma Research and Treatments
3.18
article

Elotuzumab in combination with pomalidomide, bortezomib, and dexamethasone in relapsed and refractory multiple myeloma

Craig Emmitt Cole, Robert Allyn Redd, Kathleen J. Lively, Erica Campagnaro, Andrew R. Branagan, Kenneth Carl Anderson, Marilyn T. Gammon, Paul Gerard Guy Richardson, Jacob P. Laubach, Jens G. Lohr, Cynthia C. Harrington, Noopur S Raje, Omar Nadeem, Andrew Jenho Yee, Elizabeth O’Donnell, Daniel Ciampi de Andrade, Giada Bianchi, Brea Lipe, Jill N. Burke, Robert Schlossman, Robb S. Friedman, Samantha J. Shaprio, Cassandra Reimonn
article en
7 citations

Abstract

Elotuzumab is a monoclonal antibody targeting signaling lymphocyte activation molecule F7 on plasma and natural killer cells, which enhances the activity of lenalidomide, pomalidomide, and bortezomib in multiple myeloma (MM). The OPTIMISMM study showed improved outcomes with the combination of pomalidomide, bortezomib, and dexamethasone (PVd) in relapsed/refractory MM. Therefore, we studied adding elotuzumab to PVd (elo-PVd) in relapsed/refractory MM in a multicenter phase 2 trial. The primary objective was to determine the overall response rate (ORR). Patients with relapsed/refractory disease and ≥1 prior line of treatment (including lenalidomide and a proteasome inhibitor) were eligible. For each 28-day cycle, elotuzumab was weekly for the first 2 cycles and then every other week; pomalidomide on days 1 to 21; bortezomib on days 1, 8, and 15; and dexamethasone weekly. The trial enrolled 48 patients with a median 3 prior lines (range, 1-9). Prior therapies included pomalidomide (33%), daratumumab (25%), and isatuximab (4%). The ORR was 56.3%, and the median progression-free survival (PFS) was 10 months. In patients with 1 prior line of therapy, ORR was 73.7%; median PFS was 23.4 months. Common grade ≥3 adverse events were neutropenia (33%); infections, any (33%); lung infection (27%); hypophosphatemia (19%); and thrombocytopenia (15%). Elo-PVd is, to our knowledge, one of the first trials of a quadruplet regimen in relapsed/refractory MM incorporating a monoclonal antibody to show efficacy across diverse prior treatments, including triple-class exposed patients with prior anti-CD38 monoclonal antibody. This trial was registered at ClinicalTrials.gov as #NCT02718833.

Blood AdvancesVol. 9(5)
Harvard University (US), University of Massachusetts Chan Medical School (US), University of Michigan (US), Newton Wellesley Hospital (US), University of Rochester Medical Center (US), Massachusetts General Hospital (US), Michigan United (US), Michigan Medicine (US), Dana-Farber Cancer Institute (US), Michigan Cancer Research Consortium (US), Center for Cancer Research (US), West Michigan Cancer Center (US), U-M Rogel Cancer Center (US), University of Rochester (US)
Multiple Myeloma Research Foundation, Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, Sanofi, Celgene, CSL Behring, Prothena, BeiGene, Genentech, Pharmacyclics
Openalex Percentile: Top 7%
Multiple Myeloma Research and Treatments
3.18
DOIOpen Access PDFOpenAlex
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