The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of MPR‘s conference coverage.
Among patients with multiple myeloma (MM) with at least 1 high-risk cytogenetic abnormality, a carfilzomib (K)-based induction or consolidation regimen, with or without autologous transplant (ASCT) and followed by lenalidomide (R) or KR maintenance, may yield strong progression-free survival (PFS) rates, according to research presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.
Patients with MM with cytogenetic abnormalities represent a population with unmet clinical needs and for whom novel therapy regimens are badly needed. Previous results from the randomized FORTE trial (ClinicalTrials.gov Identifier: NCT02203643) suggested that a KR-dexamethasone (KRd) induction or consolidation regimen with ASCT (KRd_ASCT) may yield improved PFS outcomes compared with no ASCT and with other therapeutic combinations.
For this part of FORTE, researchers evaluated the comparative safety and efficacy of KRd_ASCT with K, cyclophosphamide, and d (KCd) with ASCT (KCd_ASCT) and with KRd without ASCT (KRd12), all followed by KR or R maintenance therapy, among patients with cytogenetic abnormalities and those without, who were considered standard-risk (SR). Patients with cytogenetic abnormalities, including del17p, t(4;14), t(14;16), del1p, and 1q gain (3 copies) or amp1q (at least 4 copies), were classified as either single-high-risk or greater (HiR) or double-hit or greater high-risk (DH).
Of the 474 patients enrolled, 396 were included in this analysis; 243 were HiR, 105 were DH, and 153 were SR. Patients with SR disease has 4-year PFS rates of 80% with KRd_ASCT, 67% with KRd12, and 57% with KCd_ASCT.
Among patients in the HiR group, KRd_ASCT yielded improved PFS rates vs KRd12 (hazard ratio [HR], 0.6; P =.04) and vs KCd_ASCT (HR, 0.57; P =.01); these corresponded to 4-year PFS rates of 62%, 45%, and 45%, respectively.
Among patients in the SR group, KR improved 3-year PFS rates vs R numerically, but not significantly (90% vs 73%, respectively; HR, 0.42; P =.06), though this finding was significant among patients in the HiR group (69% vs 56%, respectively; HR, 0.6; P =.04).
Patients with amp1q had the worst outcomes regardless of treatment assignment.
Data on overall survival are not yet mature, according to the study’s presenter.
Disclosure: The study author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Read more of MPR’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.
Gay F, Mina R, Rota-Scalabriniet D, al. Carfilzomib-based induction/consolidation with or without autologous transplant (ASCT) followed by lenalidomide (R) or carfilzomib-lenalidomide (KR) maintenance: efficacy in high-risk patients. J Clin Oncol. 2021;39:(suppl 15; abstr 8002). doi: 10.1200/JCO.2021.39.15_suppl.8002
This article originally appeared on Hematology Advisor