Overall survival with daratumumab, lenalidomide, and dexamethasone in previously treated multiple myeloma (POLLUX): a randomized, open-label, phase III trial

PURPOSE - - With the initial analysis of POLLUX at a median follow-up of 13.5 months, daratumumab in combination with lenalidomide and dexamethasone (D-Rd) significantly prolonged progression-free survival versus lenalidomide and dexamethasone (Rd) alone in patients with relapsed or refractory mult...

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Hauptverfasser: Dimopoulos, Meletios A. (VerfasserIn) , Oriol, Albert (VerfasserIn) , Nahi, Hareth (VerfasserIn) , San-Miguel, Jesus (VerfasserIn) , Bahlis, Nizar J. (VerfasserIn) , Usmani, Saad Z. (VerfasserIn) , Rabin, Neil (VerfasserIn) , Orlowski, Robert Z. (VerfasserIn) , Suzuki, Kenshi (VerfasserIn) , Plesner, Torben (VerfasserIn) , Yoon, Sung-Soo (VerfasserIn) , Ben Yehuda, Dina (VerfasserIn) , Richardson, Paul G. (VerfasserIn) , Goldschmidt, Hartmut (VerfasserIn) , Reece, Donna (VerfasserIn) , Ahmadi, Tahamtan (VerfasserIn) , Qin, Xiang (VerfasserIn) , Garvin Mayo, Wendy (VerfasserIn) , Gai, Xue (VerfasserIn) , Carey, Jodi (VerfasserIn) , Carson, Robin (VerfasserIn) , Moreau, Philippe (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: January 04, 2023
In: Journal of clinical oncology
Year: 2023, Jahrgang: 41, Heft: 8, Pages: 1590-1599
ISSN:1527-7755
DOI:10.1200/JCO.22.00940
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1200/JCO.22.00940
Verlag, lizenzpflichtig, Volltext: https://ascopubs.org/doi/10.1200/JCO.22.00940
Volltext
Verfasserangaben:Meletios A. Dimopoulos, MD; Albert Oriol, MD; Hareth Nahi, MD, PhD; Jesus San-Miguel, MD, PhD ; Nizar J. Bahlis, MD; Saad Z. Usmani, MD, MBA; Neil Rabin, MBBS, PhD; Robert Z. Orlowski, MD, PhD; Kenshi Suzuki, MD, PhD; Torben Plesner, MD; Sung-Soo Yoon, MD, PhD; Dina Ben Yehuda, MD; Paul G. Richardson, MD; Hartmut Goldschmidt, MD; Donna Reece, MD; Tahamtan Ahmadi, MD, PhD; Xiang Qin, MS; Wendy Garvin Mayo, APRN, ANP-BC, MSN; Lue Gai, MMed; Jodi Carey, BSN; Robin Carson, MD; and Philippe Moreau, MD
Beschreibung
Zusammenfassung:PURPOSE - - With the initial analysis of POLLUX at a median follow-up of 13.5 months, daratumumab in combination with lenalidomide and dexamethasone (D-Rd) significantly prolonged progression-free survival versus lenalidomide and dexamethasone (Rd) alone in patients with relapsed or refractory multiple myeloma (RRMM). We report updated efficacy and safety results at the time of final analysis for overall survival (OS). - - METHODS - - POLLUX was a multicenter, randomized, open-label, phase III study during which eligible patients with ≥ 1 line of prior therapy were randomly assigned 1:1 to D-Rd or Rd until disease progression or unacceptable toxicity. After positive primary analysis and protocol amendment, patients receiving Rd were offered daratumumab monotherapy after disease progression. - - RESULTS - - Significant OS benefit was observed with D-Rd (hazard ratio, 0.73; 95% CI, 0.58 to 0.91; P = .0044) at a median (range) follow-up of 79.7 months (0.0-86.5). The median OS was 67.6 months for D-Rd compared with 51.8 months for Rd. Prespecified analyses demonstrated an improved OS with D-Rd versus Rd in most subgroups, including patients age ≥ 65 years and patients with one, two, or three prior lines of therapy, International Staging System stage III disease, high-risk cytogenetic abnormalities, and refractoriness to their last prior line of therapy or a proteasome inhibitor. The most common (≥ 10%) grade 3/4 treatment-emergent adverse events with D-Rd versus Rd were neutropenia (57.6% v 41.6%), anemia (19.8% v 22.4%), pneumonia (17.3% v 11.0%), thrombocytopenia (15.5% v 15.7%), and diarrhea (10.2% v 3.9%). - - CONCLUSION - - D-Rd significantly extended OS versus Rd alone in patients with RRMM. To our knowledge, for the first time, our findings, together with the OS benefit observed with daratumumab plus bortezomib and dexamethasone in the phase III CASTOR trial, demonstrate OS improvement with daratumumab-containing regimens in RRMM (ClinicalTrials.gov identifier: NCT02076009 [POLLUX]).
Beschreibung:Gesehen am 04.09.2023
Beschreibung:Online Resource
ISSN:1527-7755
DOI:10.1200/JCO.22.00940