Dr. Lonial Discusses Ongoing Phase III Trials in Multiple Myeloma

Sagar Lonial, MD, professor and chair, Department of Hematology & Medical Oncology, Emory University School of Medicine, chief medical officer, Winship Cancer Institute of Emory University, discusses ongoing phase III studies in patients with multiple myeloma.

Carfilzomib (Kyprolis) with lenalidomide (Revlimid) and dexamethasone versus bortezomib (Velcade) with lenalidomide and dexamethasone is currently being studied in an ECOG trial called E1A11. This trial has enrolled almost 800 patients, and is investigating which proteasome inhibitor is more beneficial upfront, and as maintenance therapy. This trial is still enrolling, so doctors have the opportunity to refer their patients to it, explains Lonial.

In the phase III ASPIRE trial, the median overall survival (OS) with the carfilzomib combination was 48.3 months versus 40.4 months with lenalidomide/dexamethasone alone (HR, 0.79, 95% CI, 0.67-0.95). The OS benefit seen at the final analysis was consistent, even in those who received prior treatment with bortezomib. There was a 25% reduction in the risk of death with carfilzomib in those not treated with bortezomib versus a 16% reduction for those treated with the proteasome inhibitor.

Ixazomib (Ninlaro) with lenalidomide and dexamethasone versus lenalidomide and dexamethasone is being tested for both transplant-eligible and ineligible-patients with myeloma. According to Lonial, physicians are eagerly awaiting follow-up results from this study.