Lenalidomide based triplets in relapsed/refractory multiple myeloma: analysis of the Czech Myeloma Group

Lenalidomide based triplets in relapsed/refractory multiple myeloma: analysis of the Czech Myeloma Group

Abstract Despite significant advancements in therapy of multiple myeloma (MM) over the past 20 years, most patients experience relapse, necessitating new treatment approaches. This study aims to compare the real-world effectiveness of lenalidomide (LEN)-based triplet therapies, specifically daratumu...

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Main Authors: Jiri Minarik, Ludek Pour, Vojtech Latal, Tomas Jelinek, Jan Straub, Alexandra Jungova, Jakub Radocha, Petr Pavlicek, Martin Stork, Tomas Pika, Petra Krhovska, Tereza Popkova, Frantisek Sedlak, Ivan Spicka, Pavel Jindra, Vladimira Capounova, Vladimir Maisnar, Roman Hajek
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cancer
Subjects:
Multiple myeloma
Relapsed/refractory
Lenalidomide triplets
Risk groups
Online Access:https://doi.org/10.1186/s12885-025-14087-y
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Summary:Abstract Despite significant advancements in therapy of multiple myeloma (MM) over the past 20 years, most patients experience relapse, necessitating new treatment approaches. This study aims to compare the real-world effectiveness of lenalidomide (LEN)-based triplet therapies, specifically daratumumab (DRD), carfilzomib (KRD), and ixazomib (IRD), in relapsed/refractory multiple myeloma (RRMM). A retrospective registry-based study analyzed 538 RRMM patients undergoing therapy for their first to third relapse. The primary endpoints were overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), with a matching-adjusted indirect comparisons (MAIC) employed to address cohort differences. ORR was highest for DRD at 91.4%, followed by KRD (89.6%) and IRD cohorts (Early-IRD: 79.6%, Late-IRD: 70.8%). Median PFS for DRD was greater at 23.64 months compared to KRD (16.52 months) and IRD groups (Early-IRD: 19.97 months, Late-IRD: 11.57 months). The MAIC confirmed better outcomes for the DRD regimen. High-risk features were not overcome by any of the LEN-based regimens. The findings underscore the superior efficacy of DRD in achieving sustained responses in RRMM patients. The composition of the cohort is a crucial factor, extending beyond selection criteria. This study highlights the importance of real-world evidence in assessing treatment modalities in clinical settings.
ISSN:1471-2407

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