Multiple myeloma management: What comes after lenalidomide-based therapy?

Authors

  • Martha Louzada, MD, MSc

DOI:

https://doi.org/10.58931/cht.2022.1213

Abstract

Over the past two decades a myriad of new combination strategies and  therapeutic agents for the treatment of multiple myeloma (MM) have been developed. Novel drug classes such as proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies have demonstrated very promising efficacy outcomes related to survival endpoints and improvements in quality of life for myeloma patients.

Author Biography

Martha Louzada, MD, MSc

Dr. Martha Louzada is a Brazilian-born Hematologist where she completed her medical training. She is an Associate Professor of Medicine and a Hematology Consultant at the University of Western Ontario/ London Health Sciences Centre where she joined the Department of Medicine in July 2010. She also holds a cross appointment in Oncology through the London Regional Cancer Program and a cross appointment as Associate Professor in the Department of Epidemiology and Biostatistics since 2013. Dr. Louzada is currently the Multiple Myeloma Working Group Director at LRCP. Dr. Louzada has a special interest in venous thromboembolism and cancer and also translational research in myeloma. She has over 50 peer reviewed publications and 30 oral or poster publications at international hematology meetings.

References

Benboubker L, Dimopoulos MA, Dispenzieri A, Catalano J, Belch AR, et al. Lenalidomide and dexamethasone in transplant-ineligible patients with myeloma. N Engl J Med. 2014 Sep 4;371(10):906-17. doi:10.1056/NEJMoa1402551 DOI: https://doi.org/10.1056/NEJMoa1402551

Durie BGM, Hoering A, Sexton R, Abidi MH, Epstein J, et al. Longer term follow-up of the randomized phase III trial SWOG S0777: bortezomib, lenalidomide and dexamethasone vs. lenalidomide and dexamethasone in patients (Pts) with previously untreated multiple myeloma without an intent for immediate autologous stem cell transplant (ASCT). Blood Cancer J. 2020 May 11;10(5):53. doi:10.1038/s41408-020-0311-8 DOI: https://doi.org/10.1038/s41408-020-0311-8

Attal M, Lauwers-Cances V, Hulin C, Leleu X, Caillot D, et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma.N Engl J Med. 2017 Apr 6;376(14):1311-1320. doi:10.1056/NEJMoa1611750 DOI: https://doi.org/10.1056/NEJMoa1611750

O’Donnell EK, Laubach JP, Yee AJ, Chen T, Huff CA, et al. A phase 2 study of modified lenalidomide, bortezomib and dexamethasone in transplant‐ineligible multiple myeloma. Br J Haematol. 2018 Jul;182(2):222-230. doi:10.1111/bjh.15261 DOI: https://doi.org/10.1111/bjh.15261

Stewart AK, Rajkumar SW, Dimopoulos MA, Masszi T, Spicka I, et al. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2015 Jan 8;372(2):142-52. doi:10.1056/NEJMoa1411321 DOI: https://doi.org/10.1056/NEJMoa1411321

Dimopoulos MA, Oriol A, Nahi H, San-Miguel J, Bahlis NJ, et al. Daratumumab, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016 Oct 6;375(14):1319-1331. doi:10.1056/NEJMoa1607751 DOI: https://doi.org/10.1056/NEJMoa1607751

Facon T, Kumar SK, Plesner T, Orlowski RZ, Moreau P, et al. Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma (MAIA): overall survival results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2021 Nov;22(11):1582-1596. doi:10.1016/S1470-2045(21)00466-6 DOI: https://doi.org/10.1016/S1470-2045(21)00466-6

Fonseca R, Abouzaid S, Bonafede M, Cai Q, Parikh K, Cosler L, Richardson P. Trends in overall survival and costs of multiple myeloma, 2000–2014. Leukemia. 2017 Sep;31(9):1915-1921. doi:10.1038/leu.2016.380 DOI: https://doi.org/10.1038/leu.2016.380

Brandt J, Shearer B, Morgan SG. Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare. J Pharm Policy Pract. 2018 Nov 7;11:28. doi:10.1186/s40545-018-0154-x DOI: https://doi.org/10.1186/s40545-018-0154-x

Shustik J, Tay J, Hollmann S, LeBlanc R. A Canadian cost impact analysis comparing maintenance therapy with bortezomib versus lenalidomide in multiple myeloma patients ineligible for stem cell transplant. Value in Health. May 2014;17(3):PA76. doi:10.1016/j.jval.2014.03.446 DOI: https://doi.org/10.1016/j.jval.2014.03.446

Cherniawsky HM, Kukreti V, Reece D, Masih-Khan E, McCurdy A, Jimenez-Zepeda VH, et al. The survival impact of maintenance lenalidomide: an analysis of real-world data from the Canadian Myeloma Research Group national database. Haematologica. 2021 Jun 1;106(6):1733-1736. doi:10.3324/haematol.2020.259093 DOI: https://doi.org/10.3324/haematol.2020.259093

Dimopoulos M, Weisel K, Moreau P, Anderson LD, White D, et al. Pomalidomide, bortezomib, and dexamethasone for multiple myeloma previously treated with lenalidomide (OPTIMISMM): outcomes by prior treatment at first relapse. Leukemia. 2021 Jun;35(6):1722-1731. doi:10.1038/s41375-020-01021-3. DOI: https://doi.org/10.1038/s41375-020-01021-3

Palumbo A, Chanan-Khan A, Weisel K, Nooka AK, Masszi T, et al. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. N Engl J Med. 2016 Aug 25;375(8):754-66. doi:10.1056/NEJMoa1606038 DOI: https://doi.org/10.1056/NEJMoa1606038

Spencer A, Lentzch S, Weisel K, Avet-Loiseau H, Mark TM, et al. Daratumumab plus bortezomib and dexamethasone versus bortezomib and dexamethasone in relapsed or refractory multiple myeloma: updated analysis of CASTOR. Haematologica. 2018 Dec;103(12):2079-2087. doi:10.3324/haematol.2018.194118 DOI: https://doi.org/10.3324/haematol.2018.194118

Bahlis NJ, Dimopoulos MA, White DJ, Benboubker L, Cook G, et al. Daratumumab plus lenalidomide and dexamethasone in relapsed/refractory multiple myeloma: extended follow-up of POLLUX, a randomized, open-label, phase 3 study. Leukemia. 2020 Jul;34(7):1875-1884. doi:10.1038/s41375-020-0711-6 DOI: https://doi.org/10.1038/s41375-020-0711-6

Richardson PG, Oriol A, Beksac M, Liberati AM, Galli M, et al. Pomalidomide, bortezomib, and dexamethasone for patients with relapsed or refractory multiple myeloma previously treated with lenalidomide (OPTIMISMM): a randomised, open-label, phase 3 trial. Lancet Oncol. 2019 Jun;20(6):781-794. doi:10.1016/S1470-2045(19)30152-4 DOI: https://doi.org/10.1016/S1470-2045(19)30152-4

Chari A, Suvannasankha A, Fay JW, Arnulf B, Kaufman JL, et al. Daratumumab plus pomalidomide and dexamethasone in relapsed and/or refractory multiple myeloma. Blood. 2017 Aug 24;130(8):974-981. doi:10.1182/blood-2017-05-785246 DOI: https://doi.org/10.1182/blood-2017-05-785246

Attal M, Richardson PG, Rajkumar SV, San-Miguel J, Beksac M, et al. Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): a randomised, multicentre, open-label, phase 3 study. Lancet. 2019 Dec 7;394(10214):2096-2107. doi:10.1016/S0140-6736(19)32556-5 DOI: https://doi.org/10.1016/S0140-6736(19)32556-5

Dimopoulos MA, Terpos E, Boccadoro M, Delimpasi S, Beksac M, et al. Apollo: Phase 3 randomized study of subcutaneous daratumumab plus pomalidomide and dexamethasone (D-Pd) versus pomalidomide and dexamethasone (Pd) alone in patients with Relapsed/Refractory Multiple Myeloma (RRMM). Blood. 2020;136(Suppl. 1):5–6. doi:10.1182/blood-2020-135874 DOI: https://doi.org/10.1182/blood-2020-135874

Mian HS, Eisfeld C, Venner CP, Jimenez-Zepeda V, Khandanpour C, et al. Efficacy of daratumumab containing regimens post lenalidomide maintenance in transplant eligible patients: Real-world experience from the Canadian Myeloma Research Group Database. Blood. 2020;136(Suppl 1):26-27. doi:10.1182/blood-2020-133372 DOI: https://doi.org/10.1182/blood-2020-133372

Downloads

Published

2022-07-01

How to Cite

1.
Louzada M. Multiple myeloma management: What comes after lenalidomide-based therapy?. Can Hematol Today [Internet]. 2022 Jul. 1 [cited 2024 Dec. 22];1(2):21–24. Available from: https://canadianhematologytoday.com/article/view/1-2-3-louzada

Issue

Volume 1, Issue 2, July 2022

Section

Articles

Most read articles by the same author(s)