Add-on elotuzumab improves long-term survival benefits of lenalidomide/dexamethasone

Inclusion of elotuzumab (ERd) to a lenalidomide/dexamethasone (Rd) regimen for patients with relapsed or refractory multiple myeloma (RRMM) improves overall survival (OS) in the long run, a recent analysis of the ELOQUENT-2 trial has found.

ELOQUENT-2 randomly assigned RRMM patients to receive either ERd or Rd, taken in 28-day cycles. Participants were followed until disease progression, discontinuation, or unacceptable toxicity. The present study looked at the final OS findings after a minimum follow-up of 170.6 months.

A total of 635 patients (median age, 66 years) received the test treatments. At the final follow-up, only 33 and 14 patients remained on-treatment with ERd and Rd, respectively. Discontinuations were mostly due to disease progression and toxicities.

There were 437 deaths recorded, and this tally was slightly higher in the Rd arm (225 vs 212). The addition of elotuzumab had extended the median OS by 8.7 months (48.3 months vs 39.6 months). Moreover, OS curves showed an early and sustained separation in favour of ERd. The 1-year estimates for ERd and Rd, for example, were 91 percent and 83 percent, respectively, and these rates continued to diverge over time.

Though the principal findings remained mostly consistent across many important clinical subgroups, the researchers noted some key differences. For example, ERd was significantly beneficial to patients who had undergone 2–3 prior lines of therapy, and in those who were ≥75 years of age.

“The durable and sustained efficacy of ERd, combined with an acceptable long-term safety and tolerability profile, supports this regimen as a standard for care for patients with RRMM and 1–3 prior lines of therapy,” researchers said.