Efficacy of current treatment approaches for patients with NDMM with high-risk features (defined as del(17p), t(4;14), or t(14;16))
| Clinical trial . | Transplant-eligible NDMM . | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| SWOG-1211 . | Cassiopeia . | Forte . | Griffin . | |||||||
| Population | High risk* | ITT | High risk | ITT | High risk | ITT | High risk | |||
| Treatment | EloVRd vs VRd | DVTd vs VTD | DVTd vs VTD | KRd-T/KRd12 | KRd-T/KRd12 | DRVd vs RVd | DRVd vs RVd | |||
| PFS (m)/HR | 31 vs 34/0.96 | NR/0.47 | NR/0.67 | NR/0.64 | NR/0.51 | NR/NA | NR/NA | |||
| Clinical trial . | Transplant-ineligible NDMM . | |||||||||
| SWOG . | ALCYONE . | MAIA . | ||||||||
| Population | ITT | High risk | ITT | High risk | Frail patients | ITT | High risk | Frail patients | ||
| Treatment | VRd- > Rd vs Rd | VRd- > Rd vs Rd | DVMP vs VMP | DVMP vs VMP | DVMP vs VMP | DRd vs Rd | DRd vs Rd | DRd vs Rd | ||
| PFS (m)/HR | 43 vs 30/0.74 | 38 vs 16/NA | 36 vs 18/0.50 | 18 vs 18/0.78 | 33 vs 19/0.51 | NR vs 34/0.54 | 45 vs 29/0.57 | NR vs 30/0.62 | ||
| Clinical trial . | Relapsed-refractory MM . | |||||||||
| POLLUX . | ASPIRE . | ELOQUENT-2 . | TOURMALINE-MM1 . | |||||||
| Population | ITT | High risk | Early relapse | ITT | High risk | Early relapse | ITT | High risk | ITT | High risk |
| Treatment | DRd vs Rd | DRd vs Rd | KRd vs Rd | KRd vs Rd | EloRd vs Rd | EloRd vs Rd | IRd vs Rd | IRd vs Rd | ||
| PFS (m)/HR | 44.5 vs 17.5/0.44 | 26.8 vs 8.3/0.37 | 0.38 | 26.3 vs 17.3/0.69 | 23 vs 13.9/0.7 | 21.4 vs 10.7/0.7 | 19.4 vs 14.9/0.70 | NA/0.72(del17p) NA/0.56 (t(4;14) | 20.6 vs 14.7/0.74 | 21.4 vs 9.7/0.54 |
| Clinical trial . | CASTOR . | ENDEAVOR . | CANDOR . | IKEMA . | ||||||
| Population | ITT | High risk | ITT | High risk | ITT | High risk | Early relapse | ITT | High risk | |
| Treatment | DVd vs Vd | DVd vs Vd | Kd vs Vd | Kd vs Vd | DKd vs Kd | DKd vs Kd | IsaKd vs Kd | IsaKd vs Kd | ||
| PFS (m)/HR | 16.7 vs 7.1/0.31 | 12.6 vs 6.2/0.41 | 18.7 vs 9.4/0.53 | 8.8 vs 6.0/0.7 | 28.6 vs 15.9/0.59 | 15.6 vs 5.6/0.49 | CRrate 28 vs 3% | NR vs 19.1/0.53 | NA/0.72 | |
| Clinical trial . | OPTIMISMM . | BOSTON . | ICARIA . | ELOQUENT-3 . | ||||||
| Population | ITT | High risk | ITT | High risk | ITT | High risk | ITT | High risk | ||
| Treatment | PVd vs Vd | PVd vs Vd | SVd vs Vd | SVd vs Vd | IsaPd vs Pd | IsaPd vs Pd | EloPd vs Pd | EloPd vs Pd | ||
| PFS (m)/HR | 11.2 vs 7.1/0.61 | NA/0.56 | 11.2 vs 5.8/0.61 | NA/0.67 | 11.5 vs 6.4/0.59 | NA/0.66 | 10.3 vs 4.7/0.54 | 0.52 | ||
| Clinical trial . | STORM . | HORIZON . | DREAMM-2 . | KARMMA-1 . | ||||||
| Population | ITT | High risk | ITT | High risk | ITT | High risk | ITT | High risk | ||
| Treatment | Sd | Sd | Melflufen-dex | Melflufen-dex | Belamaf | Belamaf | Ide-cel | Ide-cel | ||
| PFS (m)/HR | 3.7 | 3.3* and 4.6* | 4.2 | 3.0 | 3.9 | 2.1 | 8.8 | 10.4 | ||
| Clinical trial . | Transplant-eligible NDMM . | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| SWOG-1211 . | Cassiopeia . | Forte . | Griffin . | |||||||
| Population | High risk* | ITT | High risk | ITT | High risk | ITT | High risk | |||
| Treatment | EloVRd vs VRd | DVTd vs VTD | DVTd vs VTD | KRd-T/KRd12 | KRd-T/KRd12 | DRVd vs RVd | DRVd vs RVd | |||
| PFS (m)/HR | 31 vs 34/0.96 | NR/0.47 | NR/0.67 | NR/0.64 | NR/0.51 | NR/NA | NR/NA | |||
| Clinical trial . | Transplant-ineligible NDMM . | |||||||||
| SWOG . | ALCYONE . | MAIA . | ||||||||
| Population | ITT | High risk | ITT | High risk | Frail patients | ITT | High risk | Frail patients | ||
| Treatment | VRd- > Rd vs Rd | VRd- > Rd vs Rd | DVMP vs VMP | DVMP vs VMP | DVMP vs VMP | DRd vs Rd | DRd vs Rd | DRd vs Rd | ||
| PFS (m)/HR | 43 vs 30/0.74 | 38 vs 16/NA | 36 vs 18/0.50 | 18 vs 18/0.78 | 33 vs 19/0.51 | NR vs 34/0.54 | 45 vs 29/0.57 | NR vs 30/0.62 | ||
| Clinical trial . | Relapsed-refractory MM . | |||||||||
| POLLUX . | ASPIRE . | ELOQUENT-2 . | TOURMALINE-MM1 . | |||||||
| Population | ITT | High risk | Early relapse | ITT | High risk | Early relapse | ITT | High risk | ITT | High risk |
| Treatment | DRd vs Rd | DRd vs Rd | KRd vs Rd | KRd vs Rd | EloRd vs Rd | EloRd vs Rd | IRd vs Rd | IRd vs Rd | ||
| PFS (m)/HR | 44.5 vs 17.5/0.44 | 26.8 vs 8.3/0.37 | 0.38 | 26.3 vs 17.3/0.69 | 23 vs 13.9/0.7 | 21.4 vs 10.7/0.7 | 19.4 vs 14.9/0.70 | NA/0.72(del17p) NA/0.56 (t(4;14) | 20.6 vs 14.7/0.74 | 21.4 vs 9.7/0.54 |
| Clinical trial . | CASTOR . | ENDEAVOR . | CANDOR . | IKEMA . | ||||||
| Population | ITT | High risk | ITT | High risk | ITT | High risk | Early relapse | ITT | High risk | |
| Treatment | DVd vs Vd | DVd vs Vd | Kd vs Vd | Kd vs Vd | DKd vs Kd | DKd vs Kd | IsaKd vs Kd | IsaKd vs Kd | ||
| PFS (m)/HR | 16.7 vs 7.1/0.31 | 12.6 vs 6.2/0.41 | 18.7 vs 9.4/0.53 | 8.8 vs 6.0/0.7 | 28.6 vs 15.9/0.59 | 15.6 vs 5.6/0.49 | CRrate 28 vs 3% | NR vs 19.1/0.53 | NA/0.72 | |
| Clinical trial . | OPTIMISMM . | BOSTON . | ICARIA . | ELOQUENT-3 . | ||||||
| Population | ITT | High risk | ITT | High risk | ITT | High risk | ITT | High risk | ||
| Treatment | PVd vs Vd | PVd vs Vd | SVd vs Vd | SVd vs Vd | IsaPd vs Pd | IsaPd vs Pd | EloPd vs Pd | EloPd vs Pd | ||
| PFS (m)/HR | 11.2 vs 7.1/0.61 | NA/0.56 | 11.2 vs 5.8/0.61 | NA/0.67 | 11.5 vs 6.4/0.59 | NA/0.66 | 10.3 vs 4.7/0.54 | 0.52 | ||
| Clinical trial . | STORM . | HORIZON . | DREAMM-2 . | KARMMA-1 . | ||||||
| Population | ITT | High risk | ITT | High risk | ITT | High risk | ITT | High risk | ||
| Treatment | Sd | Sd | Melflufen-dex | Melflufen-dex | Belamaf | Belamaf | Ide-cel | Ide-cel | ||
| PFS (m)/HR | 3.7 | 3.3* and 4.6* | 4.2 | 3.0 | 3.9 | 2.1 | 8.8 | 10.4 | ||
High-risk definition: gene expression profiling high risk, t(14;16), t(14;20), del(17p), amp1q21, plasma cell leukemia, elevated serum LDH (2 × upper limit of normal).
Belamaf, belantamaf mafodotin; dex, dexamethasone; DKd, daratumumab, carfilzomib, and dexamethasone; DRd, daratumumab, lenalidomide, and dexamethasone; DRVd, daratumumab, lenalidomide, bortezomib, and dexamethasone; DVd, daratumumab, bortezomib, and dexamethasone; DVMP, daratumumab, bortezomib, melphalan, and prednisone; DVTd, daratumumab, bortezomib, thalidomide, and dexamethasone; Elo, elotuzumab; EloPd, elotuzumab, pomalidomide, and dexamethasone; EloRd, elotuzumab, lenalidomide, and dexamethasone; Ide-cel, idecabtagene vicleucel; IRd, ixazomib, lenalidomide, and dexamethasone; IsaKd, isatuximab, carfilzomib, and dexamethasone; IsaPd, isatuximab, pomalidomide, and dexamethasone; ITT, intention-to-treat population; Kd, carfilzomib and dexamethasone; KRd, carfilzomib, lenalidomide, and dexamethasone; KRd-T, carfilzomib, lenalidomide, and dexamethasone followed by transplant; KRd 12, KRd for 12 cycles; m, months; NA, not available; NR, not reached; PVd, pomalidomide, bortezomib, and dexamethasone; Rd, lenalidomide and dexamethasone; RVd, lenalidomide, bortezomib, and dexamethasone; Sd, selinexor and dexamethasone; SVd, selinexor, bortezomib, and dexamethasone; VTd, bortezomib, thalidomide, and dexamethasone.