Outcome of carfilzomib/pomalidomide-based regimens after daratumumab-based treatment in relapsed multiple myeloma: A Canadian Myeloma Research Group Database analysis
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.
CONFLICT OF INTEREST STATEMENT
Richard LeBlanc: Advisory boards: Janssen, BMS, Amgen, Sanofi, and FORUS Therapeutics; Honoraria: Janssen. Hira Mian: Honoraria: BMS, Janssen, Amgen, Takeda, Sanofi, and GSK Awards: HHS Research Early Career Award from Hamilton Health Sciences Foundation. Donna Reece: Research funding: Otsuka, Celgene, Janssen, Takeda, Merck, BMS, and Millennium; Consultancy: Celgene, Jansen, Amgen, Karyopharm, and Takeda; Honoraria: Celgene Honoraria: Celgene, Janssen, Amgen, Takeda, Sanofi and GSK, Janssen, Amgen, and Takeda. Jiandong Su: No financial or perceived conflicts of interest. Esther Masih-Khan: No financial or perceived conflicts of interest. Michael Chu: Honoraria: Janssen, BMS, Gilead, Sanofi, and AstraZeneca. Victor Jimenez-Zepeda: Honoraria: Celgene, Janssen, Takeda, Merck, and BMS. Michael Sebag: Membership on an entity's Board of Directors or advisory committees: Janssen Inc., Amgen Canada, Takeda Canada, and Celgene Canada. Kevin Song: Research funding: Celgene. Honoraria: BMS, Janssen, Amgen, and Takeda. Martha Louzada: Honoraria: Janssen, Celgene, Amgen, and Pfizer. Rami Kotb: Research funding: Merck, Sanofi. Ownership/Shareholder: Karyopharm. Honoraria: Celgene/BMS, Janssen, Takeda, Amgen, Sanofi, and Merck. Alissa Visram: Consultancy/Honoraria fees from Janssen, Sanofi, and Pfizer. Darrell White: Honoraria: Amgen, Antengene, Celgene, Janssen, Karyopharm, Sanofi, and Takeda. Julie Stakiw: No financial or perceived conflicts of interest. Antony Reiman: No financial or perceived conflicts of interest. Muhammad Aslam: No financial or perceived conflicts of interest. Debra Bergstrom: Honoraria and advisory boards: BMS and Janssen. Rayan Kaedbey: Honoraria and advisory boards: BMS, Janssen, Pfizer, and Beigene. Engin Gul: No financial or perceived conflicts of interest. Christopher Venner: Honoraria: Janssen, Amgen, and Takeda; Research funding: Celgene.
Open Research
DATA AVAILABILITY STATEMENT
The data sets generated during and/or analyzed during the current study are not publicly available due to privacy laws, but access is available through the corresponding author on reasonable request.
