Elotuzumab plus pomalidomide and dexamethasone in relapsed/refractory multiple myeloma: a multicenter, retrospective real-world experience with 200 cases outside of controlled clinical trials

Gentile, Massimo; Vigna, Ernesto; Palmieri, Salvatore; Galli, Mónica; Derudas, Daniele; Mina, Roberto; Pepa, Roberta Della; Zambello, Renato; Martino, Enrica Antonia; Bruzzese, Antonella; Mangiacavalli, Silvia; Zamagni, Elena; Califano, Catello; Musso, Maurizio; Conticello, Concetta; Cerchione, Claudio; Mele, Giuseppe; Renzo, Nicola Di; Offidani, Massimo; Tarantini, Giuseppe; Casaluci, Gloria Margiotta; Rago, Angela; Ria, Roberto; Uccello, Giuseppina; Barilà, Gregorio; Palumbo, Gaetano; Pompa, Alessandra; Vincelli, Iolanda Donatella; Brunori, Marino; Accardi, Fabrizio; Amico, Valeria; Amendola, Angela; Fontana, Raffaele; Bongarzoni, Velia; Rossini, Bernardo; Cotzia, Emilia; Gozzetti, Alessandro; Rizzi, Rita; Sgherza, Nicola; Ferretti, Eleonora; Bertuglia, Giuseppe; Nappi, Davide; Petrucci, Maria Teresa; Raimondo, Francesco Di; Neri, Antonino; Morabito, Fortunato; Musto, Pellegrino

doi:10.3324/haematol.2023.283251

Cited by 5 publications

(11 citation statements)

References 26 publications

(52 reference statements)

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“…Consequently, these results indicate that elotuzumab should be used prior to anti-CD38 antibody administration. This result is consistent with the findings from previously reported univariate analyses [14].…”

Section: Discussionsupporting

confidence: 94%

Real-World Clinical Outcomes in Patients With Multiple Myeloma Administered With Elotuzumab-Based Treatment

Kikuchi,

Tsukada,

Oda

et al. 2023

Cureus

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Objective Elotuzumab is used to treat relapsed and/or refractory multiple myeloma (MM). However, the optimal patient selection and sequencing in MM therapy are less clear. Therefore, this retrospective cohort study assessed the clinical outcomes of patients with MM who underwent elotuzumab-based therapy. Methods We reviewed the medical records of 85 patients with relapsed/refractory MM who received elotuzumab for the first time. Participants were divided into progressive disease (PD group) and those without PD (non-PD group) at elotuzumab treatment initiation, and each group was analyzed separately. Survival rates were calculated using Kaplan-Meier curves and compared using log-rank tests. Results The median follow-up period was 33.6 (range: 0.5-72.0) months. The median progression-free survival (PFS) and overall survival (OS) of PD and non-PD groups at elotuzumab therapy initiation were 5.3 months and not reached (NR), respectively ( P < 0.0001), and 26.8 months and NR, respectively. Patients with triple-class refractory disease in both groups had worse PFS and OS. Twenty-one patients in the non-PD group received elotuzumab as post-hematopoietic stem cell transplantation, whose PFS and OS were NR (95% CI, 21.4 months-NR) and NR (95% CI, NR-NR), respectively. Conclusions Elotuzumab exhibited limited therapeutic efficacy in patients with triple-class refractory MM but better treatment outcomes in situations with adequate disease control and post-transplant treatment.

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Section: Discussionsupporting

confidence: 94%

Real-World Clinical Outcomes in Patients With Multiple Myeloma Administered With Elotuzumab-Based Treatment

Kikuchi,

Tsukada,

Oda

et al. 2023

Cureus

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“…The extended follow-up duration of our cohort of patients treated with EloPd in a real-life setting corroborates the findings of our previous analysis. 18 The median PFS of 7.5 months, ascertained in the current study, aligns consistently with our previous investigation, 18 but is inferior to that observed in the registered trial ELOQUENT-3 (10.3 months). 17 Likewise, OS remained inferior to that reported in the original trial (19.2 months versus 29.8 months), 17 slightly longer than OS emerged from our previous analysis.…”

Section: Discussionsupporting

confidence: 92%

Elotuzumab plus pomalidomide and dexamethasone in relapsed/refractory multiple myeloma: Extended follow‐up of a multicenter, retrospective real‐world experience with 321 cases outside of controlled clinical trials

Martino,

Palmieri,

Galli

et al. 2024

Hematological Oncology

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The ELOQUENT‐3 trial demonstrated the superiority of the combination of elotuzumab, pomalidomide, and dexamethasone (EloPd) in terms of efficacy and safety, compared to Pd in relapsed/refractory multiple myeloma (RRMM), who had received at least two prior therapies, including lenalidomide and a proteasome inhibitor. The present study is an 18‐month follow‐up update of a previously published Italian real‐life RRMM cohort of patients treated with EloPd. This revised analysis entered 319 RRMM patients accrued in 41 Italian centers. After a median follow‐up of 17.7 months, 213 patients (66.4%) experienced disease progression or died. Median progression‐free survival (PFS) and overall survival (OS) were 7.5 and 19.2 months, respectively. The updated multivariate analysis showed a significant reduction of PFS benefit magnitude both in advanced International Staging System (ISS) (II and III) stages and previous exposure to daratumumab cases. Instead, advanced ISS (II and III) stages and more than 2 previous lines of therapy maintained an independent prognostic impact on OS. Major adverse events included grade three‐fourths neutropenia (24.9%), anemia (13.4%), lymphocytopenia (15.5%), and thrombocytopenia (10.7%), while infection rates and pneumonia were 19.3% and 8.7%, respectively. A slight increase in the incidence of neutropenia and lymphocytopenia was registered with longer follow‐up. In conclusion, our real‐world study still confirms that EloPd is a safe and possible therapeutic choice for RRMM. Nevertheless, novel strategies are desirable for those patients exposed to daratumumab.

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“…Overall, many studies worldwide have already shown how several previous lines of therapy negatively impact survival in those settings of patients 2–4 …”

Section: Future Perspectivementioning

confidence: 99%

“…Treatment of multiple myeloma (MM) drastically improved in recent decades, due to the introduction of novel drugs into clinical practice, such as proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and monoclonal antibodies (MoAbs), which have extended progression‐free survival (PFS) and overall survival (OS) of MM patients 1–19 . Given the disease's natural history, which is marked by alternating periods of remission and relapses, the majority of patients are doomed to be refractory to those agents.…”

Section: Introductionmentioning

confidence: 99%

Teclistamab‐cqyv in multiple myeloma

Martino,

Bruzzese,

Labanca

et al. 2023

European J of Haematology

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Multiple myeloma (MM) is an incurable neoplasm characterized by significant morbidity and mortality. Despite advances in treatment, MM patients eventually experienced a relapse of the disease. Penta‐drug refractory patients continue to be the hard core of relapsed/refractory (RR) settings. Teclistamab‐cqyv is a humanized IgG4 antibody and a bispecific BCMA‐director CD3 T‐cell engager. It recruits endogenous T cells, by targeting CD3 receptors expressed on their surface, resulting in their activation against BCMA, an antigen expressed by plasma cells. US Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved Teclistamab‐cqyv in monotherapy for the treatment of RRMM patients who have received at least three prior therapies, including immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and anti‐CD38 monoclonal antibodies (MoAbs) and have demonstrated disease progression during the last therapy. Its effectiveness was demonstrated in a pivotal clinical trial where the overall response rate (ORR) reached 60%. Other clinical studies are currently ongoing to investigate the association of the bispecific antibody with novel drugs with encouraging preliminary results, especially in the setting of heavily pretreated patients. In this review, the authors will provide a comprehensive overview of the drug, including its mechanism of action, major clinical trials, and future perspectives.

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Elotuzumab plus pomalidomide and dexamethasone in relapsed/refractory multiple myeloma: a multicenter, retrospective real-world experience with 200 cases outside of controlled clinical trials

Cited by 5 publications

References 26 publications

Real-World Clinical Outcomes in Patients With Multiple Myeloma Administered With Elotuzumab-Based Treatment

Real-World Clinical Outcomes in Patients With Multiple Myeloma Administered With Elotuzumab-Based Treatment

Elotuzumab plus pomalidomide and dexamethasone in relapsed/refractory multiple myeloma: Extended follow‐up of a multicenter, retrospective real‐world experience with 321 cases outside of controlled clinical trials

Teclistamab‐cqyv in multiple myeloma

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