Elotuzumab Regimen Active in High-risk Smoldering Multiple Myeloma

Share this content:
A drug combination may offer treatment for smoldering multiple myeloma.
A drug combination may offer treatment for smoldering multiple myeloma.

The combination of elotuzumab, lenalidomide, and dexamethasone is well tolerated and active in patients with high-risk smoldering multiple myeloma who would otherwise remain untreated, according to a study presented at the American Society of Hematology (ASH) 58th Annual Meeting and Exposition.1

Elotuzumab, a monoclonal antibody directed against signaling lymphocyte activation molecule family 7 (SLAMF7), is indicated in combination with lenalidomide and dexamethasone for the treatment of relapsed/refractory multiple myeloma.

Because current recommendations of therapy for smoldering multiple myeloma, a precursor to multiple myeloma, continue to be patient observation, researchers sought to evaluate the 3-drug elotuzumab combination in this patient population.

For the phase 2 study, researchers enrolled 39 patients with high-risk smoldering myeloma. All participants received elotuzumab 10 mg/kg intravenously weekly on days 1, 8, 15, and 22 for the first 2 28-day cycles in combination with lenalidomide orally daily on days 1 to 21 and dexamethasone. For cycles 3 to 8, patients received elotuzumab on days 1, 8, and 15. Patients were then eligible to continue on maintenance therapy with elotuzumab 20 mg/kg on day 1 and lenalidomide on days 1 to 21 of each 28-day cycle.

Results showed that 71% of the 34 evaluable patients achieved an overall response, including 9 very good partial responses and 15 partial responses. The clinical benefit rate was 97%.

Due to potential interference of elotuzumab with immunoelectrophoresis, researchers are evaluating whether some of the very good partial responses are possible complete responses.

Treatment-related grade 3 toxicities included hypophosphatemia in 23%, neutropenia in 8%, infection in 8%, and anemia, pulmonary embolism, rash, and diarrhea each in 3%. To date, investigators have not observed grade 4 or 5 toxicities.

The findings suggest that elotuzumab plus lenalidomide and dexamethasone represents a potential strategy for early intervention in patients with high-risk smoldering myeloma.

Reference

1. Ghobrial IM, Badros AZ, Vredenburgh JJ, et al. Phase II trial of combination of elotuzumab, lenalidomide, and dexamethasone in high-risk smoldering multiple myeloma. Paper presented at: American Society of Hematology (ASH) 58th Annual Meeting and Exposition; December 3-6, 2016; San Diego, CA.

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs