Real-world outcomes for the treatment of relapsed/refractory multiple myeloma patients with lenalidomide-dexamethasone combinations in a Latin American country. A retrospective cohort study from grupo argentino de mieloma múltiple

ABSTRACT

Objectives

We compared the efficacy of lenalidomide-dexamethasone (Rd) based treatments for relapsed/refractory multiple myeloma patients (pts), in a real-world setting. In addition, we evaluated adverse events (AE), progression-free survival (PFS) and overall survival (OS).

Methods

In our retrospective, multicentric study, 156 pts with RRMM were included. 74/156 pts (47%) were refractory to bortezomib (V) and 43/156 (27%) pts to lenalidomide (R), with 24/156 (15%) of pts double refractory. Eighty-six pts (55%) received Rd with carfilzomib (KRd), 30 pts (19%) bortezomib (VRd), 30 pts (19%) daratumumab (DRd), and 10 pts (6%) ixazomib (IRd).

Results

The overall response (ORR) (≥ partial response) for the entire cohort was 71%, with a very good partial response rate or better (≥VGPR) of 35%. We found no significant differences in CR or ≥VGRP rates between treatments (p:0.229). Regardless of the combination received, those patients who achieved CR had significantly improved PFS (p: 0.007). The most frequent cause of treatment discontinuation was disease progression in 55/156 pts (35%). 8 pts (5%) discontinued treatment due to treatment-related adverse events (AE).

Conclusion

This is the first report of Rd combinations for the treatment of RRMM in Latin America. All combinations proved to be effective with an acceptable toxicity.

KEYWORDS:

• Multiple myeloma
• lenalidomide
• latin America
• relapsed/refractory
• real world

Author Contributions

Patricio J. Duarte and Natalia P. Schutz collected, assembled, analyzed, and interpreted data; conceived the study and wrote the manuscript. Paola Ochoa, Sebastian Yantorno, Sergio Orlando, Sergio Lopresti, Soledad Zabaljauregui, Florencia Aizpurua, Claudia Shanley, Elvira Gianini, Gonzalo Garate, Cecilia Foncuberta, Jorge Milone, Dardo Riveros, Dorotea Fantl collected, assembled, analyzed, and interpreted data. All authors approved the final manuscript.

Declaration of interest

P Duarte receives honoraria for lectures from Takeda, Janssen, Amgen, Bristol-Myers Squibb, research support from Takeda, Janssen, Sanofi and consulting honoraria from Amgen. N Schutz receives honoraria for lectures from Takeda, Janssen, Amgen, research support from Takeda, Amgen, Janssen, Sanofi and consulting honoraria from Amgen. C Shanley receives consulting honoraria from Amgen. G Garate receives honoraria for lectures from Takeda, Janssen, Amgen, and consulting honoraria from Amgen. C Foncuberta receives consulting honoraria from Amgen. D Riveros receives honoraria for lectures from Takeda, Janssen, Amgen, Bristol-Myers Squibb, research support from Takeda, Janssen, Sanofi. D Fantl receives honoraria for lectures from Takeda, Janssen, Amgen, Tecnopharma, research support form Takeda, Amgen, Janssen, Sanofi, and consulting honoraria from Amgen. The other authors have no conflict of interest to declare.