Oncology/Hematology / Myeloma

ADC Combined With Immunomodulators Active in R/R Myeloma

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fairly difficult
Combination involving CD138-directed antibody-drug conjugate induced responses in over 70%
Indatuximab ravtansine (BT062) combined with immunomodulatory drugs showed antitumor activity in patients with relapsed or refractory multiple myeloma, according to results from a phase I/IIa study.

An objective response was observed in 71.7% of patients receiving the anti-CD138 antibody-drug conjugate (ADC) plus lenalidomide (Revlimid) and dexamethasone, and in 70.6% of patients who received the ADC combined with pomalidomide (Pomalyst) and dexamethasone, reported Kevin Kelly, MD, of the Keck School of Medicine at the University of Southern California in Los Angeles.

The median durations of response were 32.2 months in the lenalidomide group (95% CI 12.7-55.2) and 12.6 months in the pomalidomide group (95% CI 3.0-25.6). Median progression-free survival (PFS) was 18.0 months (95% CI 9.7-42.3) and 16.6 months (95% CI 4.8-17.2), respectively.

"Multiple myeloma remains an incurable disease, and the overall survival for patients who are refractory to currently available therapy is less than 1 year," wrote Kelly and his colleagues in The Lancet Haematology.

"Despite recent advances that have resulted in improved outcome, all patients eventually relapse, become resistant to treatments, and are challenging to treat," the group continued. "Therefore, treatment regimens combining drugs with different mechanisms of action are especially attractive in multiple myeloma. The ADC indatuximab ravtansine is a novel therapeutic agent with a unique mechanism of action showing promising clinical value."

The study included 64 adult patients with multiple myeloma treated at nine U.S. hospitals from 2012 to 2015. Eligible patients had relapsed or refractory disease, and an Eastern Cooperative Oncology Group performance status or Zubrod score of ≤2.

Of these, 47 received indatuximab ravtansine in combination with lenalidomide and 17 received indatuximab ravtansine plus pomalidomide. Patients in the lenalidomide group had failed at least one previous therapy, while those in the…
Mike Bassett
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