Elotuzumab Effective for Multiple Myeloma

Michael E. Williams, MD, ScM reviewing Lonial S et al. N Engl J Med 2015 Aug 13.

Adding the monoclonal antibody elotuzumab to lenalidomide plus dexamethasone improved response rates and duration of response in patients with relapsed or refractory disease.

The development of therapeutic monoclonal antibodies for myeloma has lagged well behind such advances in treating non-Hodgkin lymphoma. Now, investigators have conducted an industry-sponsored, randomized, phase III trial to test the potential benefit of adding the monoclonal antibody elotuzumab to standard therapy (lenalidomide plus dexamethasone) versus standard therapy alone in 646 patients with relapsed or refractory myeloma who had received a median of two prior treatments. Of these patients, 35% were resistant to their most recent regimen, and 32% had poor-risk cytogenetics, including del(17p).

At a median follow-up of 24.5 months, the overall response rate was improved with the elotuzumab regimen versus standard therapy (79% vs. 66%; P<0.001), as was median progression-free survival (19.4 vs. 14.9 months; P<0.001). No unexpected toxicities were identified. About 10% of elotuzumab recipients had mostly grade 1 or 2 infusion reactions.

Citation(s):

Lonial S et al. Elotuzumab therapy for relapsed or refractory multiple myeloma. N Engl J Med 2015 Aug 13; 373:621.