Literature Scan
ELOQUENT-3: A New Elotuzumab-Based Triplet
Combination in Previously Treated Myeloma
Results from the phase II ELOQUENT-3
trial demonstrate that the combination
of elotuzumab plus pomalidomide and
dexamethasone extended progression-
free survival (PFS) compared with
pomalidomide and dexamethasone
alone in patients with multiple myeloma
(MM) that was refractory and/or relapsed
following treatment with lenalidomide
and a proteasome inhibitor (PI). The
findings, which were published in the New
England Journal of Medicine, also confirm
the previously reported safety profile
of this three-drug regimen, suggesting
that the approach could represent an
alternative triplet regimen for patients
with lenalidomide-refractory disease.
In ELOQUENT-3, Meletios A.
Dimopoulos, MD, of National and Kap-
odistrian University of Athens in Greece,
and co-authors evaluated the safety and
efficacy of elotuzumab plus pomalidomide
and dexamethasone, compared with
pomalidomide and dexamethasone alone
in 117 patients with previously treated
MM. Patients were enrolled from March
2016 through April 2017 at 43 sites in Eu-
rope, North America, Japan, and Australia.
All participants had received at least
two prior therapies and had disease
that was considered refractory to PI,
lenalidomide, and the most recent
treatment; patients with relapsed and
refractory disease must have achieved at
least a partial response (PR) to previous
treatment with PI or lenalidomide or
both but must also have had disease that
progressed within six months and was
refractory to last treatment.
After randomization by number of
previous lines of therapy (2-3 or ≥4) and
International Staging System disease
stage at enrollment:
(10 mg/kg on days 1, 8, 15, and 22
during cycles 1-2 and 20 mg/kg on
day 1 of each cycle thereafter)
Treatment was given in 28-day cycles until
disease progression, unacceptable toxicity,
or withdrawal of consent.
“The characteristics of the two treat-
ment groups were generally well balanced
at baseline,” the researchers noted, with a
median of three previous lines of therapy
TABLE.
(range = 2-8) in both groups. “In all, 68
percent of the patients in the elotuzumab
group and 72 percent in the control group
had MM that was refractory to both
lenalidomide and a PI.”
At the time of data cutoff (February
2018), patients were followed for a mini-
mum of 9.1 months. During the follow-up
period, 40 percent of elotuzumab-treated
patients and 20 percent of the control
group were continuing to receive their
Investigator-Assessed Treatment Response
Overall response — no. (% [95% CI])
Elotuzumab group
(N=60) Control group
(N=57)
32 (53 [40-66]) 15 (26 [16-40])
Best overall response — no. (%)
• 57 patients received pomalidomide
(4 mg/day on days 1-21 of each
cycle) plus dexamethasone (40 mg/
week for patients ≤75 years or 20
mg/week for patients >75 years) Stringent complete response 2 (3) 0
Complete response 3 (5) 1 (2)
• 60 patients received pomalidomide
and dexamethasone plus elotuzumab 7 (12) 4 (7)
Partial response
Very good partial response
20 (33) 10 (18)
Stable disease 13 (22) 16 (28)
Progressive disease 7 (12) 9 (16)
Not evaluable 4 (7) 9 (16)
Save the Date!
61st ASH
Annual Meeting
and Exposition
®
Orlando, Florida • December 7-10, 2019
Join a global community of
hematologists at the premier
event of the year.
“We meet as
family at ASH.”
“Where science
meets medicine,
face to face.”
“It’s the
discussion
and
dialogue
that brings
it to life.”
www.hematology.org/annualmeeting
ASH 61st ACN HalfPage 10-5x7.indd 1
26
ASH Clinical News
1/16/19 4:58 PM
March 2019