Startseite Kongressberichte & Archiv 2021 ASCO Annual Meeting Haematological Malignancies Hematologic Malignancies—Plasma Cell Dyscrasia
Hematologic Malignancies—Plasma Cell Dyscrasia
Upfront autologous stem cell transplantation (ASCT) versus carfilzomib-cyclophosphamide-dexamethasone (KCd) consolidation with K maintenance in transplant-eligible, newly diagnosed (NDTE) multiple myeloma (MM).
Kwee Yong, Marquita Camilleri, William Wilson, et al.
The study authors conclude, that In newly diagnosed multiple myeloma patients KCd consolidation was non-inferior to ASCT when receiving carfilzomib-cyclophosphamide-dexamethasone (KCd) induction and carfilzomib maintenance. High-risk patients had inferior outcomes, that were not influenced by ASCT or consolidation randomization. Clinical trial information: NCT02315716
Depth of response and minimal residual disease status in ultra high-risk multiple myeloma and plasma cell leukemia treated with daratumumab, bortezomib, lenalidomide, cyclophosphamide and dexamethasone (Dara-CVRd): Results of the UK optimum/MUKnine trial.
Martin F. Kaiser, Andrew Hall, Katrina Walker, et al.
The study authors conclude, that this is the first report on a trial for ultra high-risk (UHiR) newly diagnosed multiple myeloma and plasma cell leukemia investigating Dara-CVRd induction and augmented ASCT. High Response rates were observed in this difficult-to-treat patient population. Toxicity was comparable to other induction regimens. But according to the authors, some early progressions stress the need for innovative approaches to UHiR NDMM. Clinical trial information: NCT03188172
Carfilzomib-based induction/consolidation with or without autologous transplant (ASCT) followed by lenalidomide (R) or carfilzomib-lenalidomide (KR) maintenance: Efficacy in high-risk patients.
Francesca Gay, Roberto Mina, Delia Rota-Scalabrini, et al.
The study authors conclude, that carfilzomib-lenalidomide-dexamethasone induction/consolidation with ASCT (KRd_ASCT) and carfilzomib-lenalidomide maintenance are highly effective in standard risk and also in single high-risk and double-hit patients, with impressive 4-year progression-free survival (PFS) from diagnosis (KRd_ASCT: HiR 62%, DH 55%) and 3-year PFS from maintenance (KR: HiR 69%, DH 67%). This supports their use in single high-risk patients. Clinical trial information: NCT02203643
Subcutaneous daratumumab + bortezomib, cyclophosphamide, and dexamethasone (VCd) in patients with newly diagnosed light chain (AL) amyloidosis: Updated results from the phase 3 ANDROMEDA study.
Efstathios Kastritis, Vaishali Sanchorawala, Giampaolo Merlini, et al.
The study authors conclude, that updated results from the ANDROMEDA study reinforce the clinical superiority of DARA-VCd over VCd in patients with newly diagnosed AL amyloidosis and represent a new standard of care in AL amyloidosis. Clinical trial information: NCT03201965
Daratumumab (DARA) maintenance or observation (OBS) after treatment with bortezomib, thalidomide and dexamethasone (VTd) with or without DARA and autologous stem cell transplant (ASCT) in patients (pts) with newly diagnosed multiple myeloma (NDMM): CASSIOPEIA Part 2.
Philippe Moreau, Pieter Sonneveld, for the CASSIOPEIA Study Investigators;
The study authors observed a clinical benefit of daratumumab maintenance in transplant-eligible newly diagnosed multiple myeloma patients. Progression-free survival for daratumumab vs observation was significantly longer. With current follow-up, maintenance PFS benefit appeared only in pts treated with VTd asinduction/consolidation. Patients who received D-VTd induction/consolidation with or without daratumumab maintenance achieved similar progression-free survival; daratumumab significantly increased deeper response and MRD negativity rates vs observation. Daratumumab was well-tolerated without new safety signals. Clinical trial information: NCT02541383
Ciltacabtagene autoleucel, a B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T-cell (CAR-T) therapy, in relapsed/refractory multiple myeloma (R/R MM): Updated results from CARTITUDE-1.
Saad Zafar Usmani, Jesus G. Berdeja, Deepu Madduri, et al.
The study authors conclude, that a single infusion of cilta-cel yielded early, deep, and durable responses in heavily pretreated patients with multiple myeloma. There was a manageable safety profile at the recommended phase 2 dose. Further investigations in other MM populations in earlier lines of therapy and in outpatient settings are running. Clinical trial information: NCT03548207
Efficacy and safety of elranatamab (PF-06863135), a B-cell maturation antigen (BCMA)-CD3 bispecific antibody, in patients with relapsed or refractory multiple myeloma (MM).
Nizar J. Bahlis, Noopur S. Raje, Caitlin Costello, et al.
The study authors conclude, that the humanized bispecific monoclonal antibody Elranatamab had a manageable safety profile. subcutaneous dosing (≥215μg/kg) achieved an ORR of 75% with CR/sCR rate of 30%. This demonstrates the safety and efficacy of subcutaneous elranatamab in this relapsed/refractory population and supports the ongoing development of the drug for patients with multiple myeloma as monotherapy and combined with other therapies. Clinical trial information: NCT03269136
Updated phase 1 results of teclistamab, a B-cell maturation antigen (BCMA) × CD3 bispecific antibody, in relapsed/refractory multiple myeloma (MM).
Amrita Y. Krishnan, Alfred L. Garfall, Maria-Victoria Mateos, et al.
The study authors conclude, that the BCMA × CD3 bispecific IgG4 antibody Teclistamab that redirects CD3+ T cells to BCMA-expressing multiple myeloma cells at the recommended phase 2 dose (weekly 1500 µg/kg SC) was well-tolerated. The treatment showed encouraging efficacy with durable, deepening responses. This supports further investigation as monotherapy and in combination with other agents. With the extended exposure profile at the recommended phase 2 dose and delayed and low-grade cytokine release syndrome observed with subcutaneous administration, alternative subcutaneous dosing strategies are being explored. Clinical trial information: NCT03145181.
Updated results of a phase 1, first-in-human study of talquetamab, a G protein-coupled receptor family C group 5 member D (GPRC5D) × CD3 bispecific antibody, in relapsed/refractory multiple myeloma (MM).
Jesus G. Berdeja, Amrita Y. Krishnan, Albert Oriol, et al.
Talquetamab (JNJ-64407564) is a bispecific IgG4 antibody that redirects T cell killing to MM cells. The study authors conclude, that at the recommended phase 2 dose (weekly 405 µg/kg SC), talquetamab showed a high clinical response rate. The treatment was well-tolerated in patients with relapsed/refractory multiple myeloma. Other SC dosing strategies are being explored. The study results support monotherapy development and combination approaches with this novel agent. Clinical trial information: NCT03399799