Dr. Gasparetto on Key Trials in Relapsed/Refractory Multiple Myeloma

Cristina Gasparetto, MD, an associate professor of medicine, Duke University Medical Center, and director, Multiple Myeloma Program at Duke Cancer Institute, discusses key trials in relapsed/refractory multiple myeloma.

Several studies have evaluated combinations of pomalidomide (Pomalyst) and dexamethasone. Most recently, the phase III ELOQUENT-3 trial randomized patients to pomalidomide plus dexamethasone and elotuzumab (Empliciti) or pomalidomide and dexamethasone alone. The triplet was found to improve overall response rates (ORR) and progression-free survival (PFS). Notably, the addition of elotuzumab to the doublet did not cause an increase in toxicity, says Gasparetto, making it a good combination for patients with early relapsed myeloma.

Similarly, the phase III OPTIMISMM study evaluated the combination of pomalidomide, dexamethasone, and the proteasome inhibitor bortezomib (Velcade). The study was presented by Paul G. Richardson, MD, of Dana-Farber Cancer Institute, in 2018. Results showed that the combination was superior to the doublet with increased ORR and PFS. These studies show that, even in the relapsed setting, triplets can have higher response rates and durability of response than doublets, concludes Gasparetto.