653. Myeloma: Therapy, excluding Transplantation: IMiD/Proteasome Inhibitor Combinations and Maintenance Therapy

Monday, December 5, 2016: 4:30 PM-6:00 PM
Moderators:
Jeffrey Zonder, MD, Barbara Ann Karmanos Cancer Institute, Wayne State University and Rachid Baz, MD, H. Lee Moffitt Cancer Center and Research Institute
 
1141

Ruth Wester, Bronno van der Holt, Emelie Asselbergs, Mark van Duin, et al.


Conclusion: Carfilzomib, thalidomide, dexamethasone (KTd) is an effective regimen, with increasing CR percentages following KTd consolidation. With escalated doses of Carfilzomib responses and toxicity were comparable to standard dose of 27 mg/m2.

1142

Murielle Roussel, Valerie Lauwers-Cances, Nelly Robillard, Karim Belhadj, et al.

Conclusion: 8 cycles of KRd as induction and consolidation in the transplant setting produce high qualityresponses in NDMM pts. Safety profile seems acceptable but cardiovascular AEs if confirmed in other studiesmight impact resultsUpdated efficacy and safety data will be presented during the meeting including completeMRD analysis by NGS.

1143

Graham H Jackson, Faith E Davies, Charlotte Pawlyn, David A Cairns, et al.


Conclusion: The use of maintenance lenalidomide treatment results in highly significant improvements in PFS for patients of all ages and should be standard of care.

1144

Charlotte Pawlyn, Faith E Davies, Martin F Kaiser, David A Cairns, et al.

Conclusions: We present the first detailed analysis of IMiD refractory myeloma patients at diagnosis. There was no difference in the percentage of patients refractory to the different IMiDs thalidomide and lenalidomide. Very few patients were primarily refractory to both IMiDs and proteasome inhibitors, suggesting the mechanisms of primary resistance to IMiDs and PIs do not significantly overlap. However, where this did occur outcomes were poor. The biological mechanisms behind resistance will be further informed by molecular studies of these patients’ tumour samples.

1145

Sara Bringhen, Valeria Magarotto, Anna Marina Liberati, Angelo Belotti, et al.


Conclusions: This is the first phase I/II trial that combined weekly Carfilzomib with Pomalidomide and Dexamethasone. This combination was highly effective in RRMM. After a median follow-up of 10 months, wKRd showed a double median PFS in comparison with Pomalidomide-low dose dexamethasone (Sanmiguel et al Lancet Oncology 2013): 9.5 vs 4 months respectively, confirming the efficacy of combining a PI with an IMiD. An updated analysis will be presented at the meeting.

1146

Ehsan Malek, Caner Saygin, Rebecca Ye, Byung-gyu Kim, et al. (NO SLIDES AVAILABLE)

Conclusions: Our analysis indicates that the therapeutic benefit for patients recruited onto MM phase I trials was significantly higher than that reported for phase I trial of all cancer types (Horstmann et al. NEJM. 2005). Our results suggest an inverse correlation between the number of prior lines of therapies and the response rate that support earlier patient entry onto phase I studies to increase the therapeutic benefit. Also, our analysis shows that despite an increase in the number of compounds tested in MM phase I trials during the past 12 years, the overall toxicity from these trials has not increased. It is also possible that less patients would be undertreated by utilizing phase I designs other than 3+3 that deliver therapeutic dosage to a larger portion of enrolled patients.