Dr Siegel on the Use of Carfilzomib/Iberdomide/Dexamethasone Therapy in Multiple Myeloma

David Samuel Dicapua Siegel, MD, medical oncologist, chief, Myeloma Division, John Theurer Cancer Center, Hackensack University Medical Center, discusses the implications of findings from a phase 1/2 study (NCT05199311) evaluating induction treatment with carfilzomib (Kyprolis), iberdomide (CC-220), and dexamethasone (KID) in patients with newly diagnosed, transplant-eligible multiple myeloma.

Data from this multi-institution, open-label investigation were presented at the 2023 ASH Annual Meeting, where investigators shared that induction treatment with KID seems well tolerated, as evidenced by the limited report of grade 3 treatment-emergent adverse effects. For patients who successfully finished the treatment, the induction cycles with KID did not disrupt stem cell mobilization.

Medications, such as those included in the KID regimen, have been investigated in clinical trials primarily involving patients with relapsed/relapsed refractory multiple myeloma, Siegel begins. Notably, iberdomide has demonstrated effectiveness even in patients whose disease has developed resistance to lenalidomide (Revlimid), he states. This crucial observation indicates that KID is a potential strategy to overcome resistance, a common challenge in patients with myeloma, Siegel explains. In the phase 1/2 trial, investigators explored the application of Iberdomide in patients with newly diagnosed myeloma. The KID regimen deviates from the standard of care in newly diagnosed multiple myeloma, which is carfilzomib, lenalidomide, and dexamethasone, he notes.

In this trial, investigators replaced lenalidomide with iberdomide, Siegel continues. In the analysis of 16 patients that was shared at the meeting, all patients demonstrated positive responses to KID, and the toxicity profile of iberdomide was comparable with that of lenalidomide, he elucidates. These findings imply that iberdomide exhibits superior activity vs lenalidomide without introducing significant new toxicity signals, he emphasizes.

The findings derived from the study confirm the safety of iberdomide and showcase its effectiveness, Siegel continues. Importantly, the use of iberdomide does not hinder stem cell collection and instead facilitates subsequent stem cell transplants, he adds. This finding presents a noteworthy advancement, positioning iberdomide as a promising and potentially foundational therapy for multiple myeloma in the coming decades, he notes. As investigators are in the early stages of the trial and have analyzed 16 of the intended 60 patients, the results so far are promising and indicate a positive trajectory for the duration of this research, Siegel concludes.