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. 2023 Nov;111(5):815-823.
doi: 10.1111/ejh.14082. Epub 2023 Aug 13.

Outcome of carfilzomib/pomalidomide-based regimens after daratumumab-based treatment in relapsed multiple myeloma: A Canadian Myeloma Research Group Database analysis

Richard LeBlanc  1 , Hira Mian  2 , Donna Reece  3   4 , Jiandong Su  4 , Esther Masih-Khan  3   4 , Michael Chu  5 , Victor Jimenez-Zepeda  6 , Michael Sebag  7 , Kevin Song  8 , Martha Louzada  9 , Rami Kotb  10 , Alissa Visram  11 , Darrell White  12 , Julie Stakiw  13 , Antony Reiman  14 , Muhammad Aslam  15 , Debra Bergstrom  16 , Rayan Kaedbey  17 , Engin Gul  4 , Christopher Venner  18
Affiliations

Outcome of carfilzomib/pomalidomide-based regimens after daratumumab-based treatment in relapsed multiple myeloma: A Canadian Myeloma Research Group Database analysis

Richard LeBlanc et al. Eur J Haematol. 2023 Nov.

Abstract

Introduction: Although daratumumab-containing regimens improve multiple myeloma (MM) outcomes, recurrence is inevitable.

Methods and objective: We performed a retrospective study using the Canadian Myeloma Research Group Database to benchmark the efficacy of carfilzomib- or pomalidomide-based therapies immediately following progression on daratumumab treatment.

Results: We identified 178 such patients; median number of prior lines of therapy was 3, 97% triple-class exposed, and 60% triple-class refractory. In our cohort, 75 received a subsequent carfilzomib-based therapy, 79 received a pomalidomide-based therapy, and 24 received a treatment with both immunomodulatory drug (IMiD) and proteasome inhibitor (PI) using carfilzomib and/or pomalidomide. The median progression-free survival (PFS) and overall survival (OS) for the entire cohort were 4.5 and 14.2 months, respectively. Carfilzomib-based therapy yielded a median PFS and OS of 4.5 and 10.2 months, respectively, compared to 5.2 and 21.7 months for pomalidomide-based therapy. Patients who received both IMiD and PI with carfilzomib and/or pomalidomide had a median PFS and OS of 4.1 and 14.5 months, respectively.

Conclusion: Our observations demonstrate the poor outcome of MM patients when standard regimens based on carfilzomib and/or pomalidomide are utilized directly after daratumumab-based therapy given in the relapsed setting. Novel therapies, including immune therapies, are urgently needed to improve the outcomes of these daratumumab-exposed patients.

Keywords: carfilzomib; multiple myeloma; pomalidomide; post-daratumumab; real-world data.

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References

REFERENCES

    1. Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011;364(11):1046-1060.
    1. Kazandjian D, Landgren O. A look backward and forward in the regulatory and treatment history of multiple myeloma: approval of novel-novel agents, new drug development, and longer patient survival. Semin Oncol. 2016;43(6):682-689.
    1. Moreau P, Attal M, Hulin C, et al. Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study. Lancet. 2019;394(10192):29-38.
    1. Moreau P, Hulin C, Perrot A, et al. Maintenance with daratumumab or observation following treatment with bortezomib, thalidomide, and dexamethasone with or without daratumumab and autologous stem-cell transplant in patients with newly diagnosed multiple myeloma (CASSIOPEIA): an open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(10):1378-1390.
    1. Voorhees PM, Kaufman JL, Laubach J, et al. Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial. Blood. 2020;136(8):936-945.

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