The National and Kapodistrian University of Athens, Greece
Clínica Universidad de Navarra-CIMA, IDISNA, CIBERONC, Pamplona, Spain.
Haematologica. 2018 Dec;103(12):2088-2096. doi: 10.3324/haematol.2018.194282. Epub 2018 Sep 20.
In the POLLUX study, daratumumab plus lenalidomide/dexamethasone significantly reduced risk of progression/death lenalidomide/dexamethasone alone in relapsed/refractory multiple myeloma. We provide one additional year of follow up and include the effect on minimal residual disease and in clinically relevant subgroups. After 25.4 months of follow up, daratumumab plus lenalidomide/dexamethasone prolonged progression-free survival lenalidomide/dexamethasone alone (median not reached 17.5 months; hazard ratio, 0.41; 95% confidence interval, 0.31-0.53; <0.0001). The overall response rate was 92.9% 76.4%, and 51.2% 21.0% achieved a complete response or better, respectively (both <0.0001). At the 10 sensitivity threshold, 26.2% 6.4% were minimal residual disease-negative, respectively (<0.0001). analyses of clinically relevant patient subgroups demonstrated that progression-free survival was significantly prolonged for daratumumab plus lenalidomide/dexamethasone lenalidomide/dexamethasone regardless of number of prior lines of therapy. Patients previously treated with lenalidomide or thalidomide and those refractory to bortezomib received similar benefits (all <0.01). Treatment benefit with daratumumab plus lenalidomide/dexamethasone was maintained in high-risk patients (median progression-free survival 22.6 10.2 months; hazard ratio, 0.53; 95% confidence interval, 0.25-1.13; =0.0921) and patients with treatment-free intervals of >12 and ≤12 months and >6 and ≤6 months. No new safety signals were observed. In relapsed/refractory multiple myeloma patients, daratumumab plus lenalidomide/dexamethasone continued to improve progression-free survival and deepen responses lenalidomide/dexamethasone. Trial Registration: .
在 POLLUX 研究中,与单独使用来那度胺/地塞米松相比,达雷妥尤单抗联合来那度胺/地塞米松显著降低了复发/难治性多发性骨髓瘤患者的进展/死亡风险。我们提供了额外一年的随访结果,并纳入了微小残留病灶和临床相关亚组的影响。在 25.4 个月的随访后,与来那度胺/地塞米松相比,达雷妥尤单抗联合来那度胺/地塞米松延长了无进展生存期(中位未达到 17.5 个月;风险比,0.41;95%置信区间,0.31-0.53;<0.0001)。总缓解率分别为 92.9%和 76.4%,51.2%和 21.0%分别达到完全缓解或更好(均<0.0001)。在 10%的敏感性阈值下,分别有 26.2%和 6.4%的患者达到微小残留病灶阴性(均<0.0001)。对临床相关患者亚组的分析表明,与来那度胺/地塞米松相比,达雷妥尤单抗联合来那度胺/地塞米松显著延长了无进展生存期,无论患者接受的治疗线数如何。先前接受过来那度胺或沙利度胺治疗和对硼替佐米耐药的患者也获得了相似的获益(均<0.01)。达雷妥尤单抗联合来那度胺/地塞米松的治疗获益在高危患者(中位无进展生存期 22.6 个月与 10.2 个月;风险比,0.53;95%置信区间,0.25-1.13;=0.0921)和治疗间隔>12 个月和≤12 个月以及>6 个月和≤6 个月的患者中得以维持。未观察到新的安全性信号。在复发/难治性多发性骨髓瘤患者中,与来那度胺/地塞米松相比,达雷妥尤单抗联合来那度胺/地塞米松继续改善无进展生存期并加深缓解。试验注册:NCT01772724。