The American Society of Clinical Oncology (ASCO) released a preview today of a landmark Winship-led study that could significantly increase treatment options for multiple myeloma patients. The study is being featured in ASCO's official press program and will be presented by lead author Sagar Lonial, MD, Chief Medical Officer of Winship Cancer Institute of Emory University, at the 2015 ASCO meeting in Chicago, May 29 to June 2.
The ELOQUENT-2 trial looks at the addition of a new targeted drug, elotuzumab, to standard chemotherapy and represents the first use of a monoclonal antibody in a multiple myeloma phase III trial. Lonial says the potential of this immune-based approach can be seen in the overall response rate as well as the longer duration of progression-free survival.
Lonial will present the full findings at ASCO on the morning of Tuesday, June 2. The news release from ASCO follows.
Adding elotuzumab to standard treatment cuts the risk of recurrent multiple myeloma progression by 30 percent
Interim results of a phase III trial suggest an innovative immune-based therapy may offer a new option for patients with relapsed multiple myeloma. The new monoclonal antibody elotuzumab, added to standard lenalidomide and dexamethasone chemotherapy, extended the duration of remissions by about five months, on average, compared to standard treatment alone.
"It appears that, for patients with relapsed multiple myeloma who would otherwise be offered lenalidomide and dexamethasone, addition of this new targeted drug makes the outcomes even better," said lead study author Sagar Lonial, MD, a professor of hematology at the Winship Cancer Institute, Emory University School of Medicine in Atlanta, GA. "It was particularly striking that the difference between the elotuzumab and control groups seems to get bigger over time, which really speaks to the power of this immune based approach."
Elotuzumab attaches to a cell surface protein called SLAMF7, which is found on myeloma cells and on a type of immune cells known as natural killer (NK) cells. Scientists believe that elotuzumab mounts a two-pronged attack on cancer – by targeting myeloma cells directly and by enhancing the NK cells' ability to kill myeloma cells.
Currently, there are no monoclonal antibodies approved for treatment of multiple myeloma. This is the largest study of a monoclonal antibody in multiple myeloma and the first phase III trial exploring a targeted immune-based approach to treating the disease.
In the study, 646 patients with recurrent multiple myeloma were randomly assigned to receive lenalidomide and dexamethasone (control group) or lenalidomide and dexamethasone with elotuzumab.
At a median follow-up period of 24 months, elotuzumab reduced the risk of cancer progression and death by 30%. Patients in the elotuzumab group experienced a significantly longer period without disease progression (19.4 months, on average) than those in the control group (14.9 months, on average). In addition, two subgroups of patients with high-risk features ─ genetic abnormalities termed del(17p) and t[4;14] ─ appeared to benefit from elotuzumab as well. Conventional therapies tend to be less effective in those high-risk patients.
Overall, elotuzumab was well tolerated and did not exacerbate patient’s quality of life and symptom burden. Mild infusion reactions occurred with the first few doses received in 10 percent of patients in the elotuzumab arm.
In 2014, the FDA granted a breakthrough therapy designation to elotuzumab in combination with lenalidomide and dexamethasone to treat patients with relapsed multiple myeloma. This designation helps accelerate the development and review process for drugs to treat serious or life-threatening illnesses. Ongoing clinical trials are exploring the possibility of incorporating elotuzumab into therapies for patients with newly diagnosed multiple myeloma and testing various combinations of elotuzumab and existing treatments.
This study received funding from Bristol-Myers Squibb.
ASCO media requests: mediateam@ASCO.org