Dr. Chari on the Subgroup Analysis of MMY1001 in Multiple Myeloma

Ajai Chari, MD, associate professor of medicine, Hematology and Medical Oncology, Mount Sinai Hospital, discusses the subgroup analysis of MMY1001 in multiple myeloma.

MMY1001 examined the use of daratumumab (Darzalex) in combination with carfilzomib (Kyprolis) and dexamethasone. The subgroup analysis looked specifically at lenalidomide- (Revlimid) refractory patients with relapsed multiple myeloma. The rationale came from the fact that there is an increasing use of lenalidomide maintenance after induction therapy and transplant, says Chari.

In looking at the 50 patients who were refractory to lenalidomide, there was no difference in the overall response rate between arms. Most interestingly, the progression-free survival (PFS) was 14 months for the lenalidomide-refractory population. Although PFS was not reported in the overall population, the results are very impressive for the lenalidomide-refractory patients, explains Chari.

Chari discourages cross-trial comparisons, but he says the trial that assessed the use of pomalidomide (Pomalyst) and dexamethasone in this population showed a 4-month PFS. Other regimens in the same space showed a PFS of up to 9 months. Physicians are hoping to validate the 14-month signal when carfilzomib and dexamethasone is compared with or without daratumumab.