Contributions
Abstract: PB2204
Type: Publication Only
Background
Patients with relapsed and/or refractory multiple myeloma represent a major clinical challenge as data on optimal treatment regimens in this group are limited and trials of new drugs are often difficult to compare. Responses are generally limited and short-lived and their prognosis remains unfavorable.
Aims
In a single-center retrospective observational study we analysed the efficacy of retreatment with immunomodulatory agents (IMiDs) and/or proteasome inhibitors (PIs) after treatment with daratumumab monotherapy in patients with relapsed and/or refractory multiple myeloma (RRMM).
Methods
In total 55 patients were treated with daratumumab monotherapy between 2010 and 2017. From this group 29 (53%) IMiD-refractory patients were retreated with an IMiD after daratumumab treatment and 6 (11%) PI-refractory patients were retreated with a PI-based regimen.
Results
From the IMiD-refractory patients 20/29 (69%) showed an improved response (defined as stable disease or better) upon IMiD retreatment compared to their previous IMiD-response before daratumumab treatment. In the PI-refractory group 5/6 patients (83%) had a superior response to PI retreatment compared to the pre-daratumumab PI-response. In many patients, variable regimens and/or doses were used, precluding an exact comparison between pre- and post-daratumumab. However, in 3 lenalidomide-refractory patients retreatment with the same lenalidomide dose in a similar schedule resulted in improvement of response compared to the pre-daratumumab treatment. The immunomodulatory effects of daratumumab treatment leading to an altered balance between immunosuppressive cell subsets and effector T cells may play a role in the observed high response rates in previously refractory patients. Furthermore, the excellent tolerability of daratumumab treatment may enable patients to recover from prior lines of treatment and receive full dosing of subsequent therapies.
Conclusion
In conclusion, a high proportion of RRMM patients benefitted from retreatment with IMiDs and PIs after daratumumab treatment. These retreatment options should therefore be explored in relapsed refractory patients progressing on daratumumab monotherapy.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Immunotherapy, Myeloma, Refractory
Abstract: PB2204
Type: Publication Only
Background
Patients with relapsed and/or refractory multiple myeloma represent a major clinical challenge as data on optimal treatment regimens in this group are limited and trials of new drugs are often difficult to compare. Responses are generally limited and short-lived and their prognosis remains unfavorable.
Aims
In a single-center retrospective observational study we analysed the efficacy of retreatment with immunomodulatory agents (IMiDs) and/or proteasome inhibitors (PIs) after treatment with daratumumab monotherapy in patients with relapsed and/or refractory multiple myeloma (RRMM).
Methods
In total 55 patients were treated with daratumumab monotherapy between 2010 and 2017. From this group 29 (53%) IMiD-refractory patients were retreated with an IMiD after daratumumab treatment and 6 (11%) PI-refractory patients were retreated with a PI-based regimen.
Results
From the IMiD-refractory patients 20/29 (69%) showed an improved response (defined as stable disease or better) upon IMiD retreatment compared to their previous IMiD-response before daratumumab treatment. In the PI-refractory group 5/6 patients (83%) had a superior response to PI retreatment compared to the pre-daratumumab PI-response. In many patients, variable regimens and/or doses were used, precluding an exact comparison between pre- and post-daratumumab. However, in 3 lenalidomide-refractory patients retreatment with the same lenalidomide dose in a similar schedule resulted in improvement of response compared to the pre-daratumumab treatment. The immunomodulatory effects of daratumumab treatment leading to an altered balance between immunosuppressive cell subsets and effector T cells may play a role in the observed high response rates in previously refractory patients. Furthermore, the excellent tolerability of daratumumab treatment may enable patients to recover from prior lines of treatment and receive full dosing of subsequent therapies.
Conclusion
In conclusion, a high proportion of RRMM patients benefitted from retreatment with IMiDs and PIs after daratumumab treatment. These retreatment options should therefore be explored in relapsed refractory patients progressing on daratumumab monotherapy.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Immunotherapy, Myeloma, Refractory