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Verfasst von:Mai, Elias K. [VerfasserIn]   i
 Goldschmidt, Hartmut [VerfasserIn]   i
 Miah, Kaya [VerfasserIn]   i
 Bertsch, Uta [VerfasserIn]   i
 Besemer, Britta [VerfasserIn]   i
 Hänel, Mathias [VerfasserIn]   i
 Krzykalla, Julia [VerfasserIn]   i
 Fenk, Roland [VerfasserIn]   i
 Schlenzka, Jana [VerfasserIn]   i
 Munder, Markus [VerfasserIn]   i
 Dürig, Jan [VerfasserIn]   i
 Blau, Igor W [VerfasserIn]   i
 Huhn, Stefanie [VerfasserIn]   i
 Hose, Dirk [VerfasserIn]   i
 Jauch, Anna [VerfasserIn]   i
 Kunz, Christina [VerfasserIn]   i
 Mann, Christoph [VerfasserIn]   i
 Weinhold, Niels [VerfasserIn]   i
 Scheid, Christof [VerfasserIn]   i
 Schroers, Roland [VerfasserIn]   i
 von Metzler, Ivana [VerfasserIn]   i
 Schieferdecker, Aneta [VerfasserIn]   i
 Thomalla, Jörg [VerfasserIn]   i
 Reimer, Peter [VerfasserIn]   i
 Mahlberg, Rolf [VerfasserIn]   i
 Graeven, Ullrich [VerfasserIn]   i
 Kremers, Stephan [VerfasserIn]   i
 Martens, Uwe M [VerfasserIn]   i
 Kunz, Christian [VerfasserIn]   i
 Hensel, Manfred [VerfasserIn]   i
 Benner, Axel [VerfasserIn]   i
 Seidel-Glätzer, Andrea [VerfasserIn]   i
 Weisel, Katja C [VerfasserIn]   i
 Raab, Marc-Steffen [VerfasserIn]   i
 Salwender, Hans [VerfasserIn]   i
Titel:Elotuzumab, lenalidomide, bortezomib, dexamethasone, and autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GMMG-HD6)
Titelzusatz:results from a randomised, phase 3 trial
Verf.angabe:Elias K Mai, Hartmut Goldschmidt, Kaya Miah, Uta Bertsch, Britta Besemer, Mathias Hänel, Julia Krzykalla, Roland Fenk, Jana Schlenzka, Markus Munder, Jan Dürig, Igor W Blau, Stefanie Huhn, Dirk Hose, Anna Jauch, Christina Kunz, Christoph Mann, Niels Weinhold, Christof Scheid, Roland Schroers, Ivana von Metzler, Aneta Schieferdecker, Jörg Thomalla, Peter Reimer, Rolf Mahlberg, Ullrich Graeven, Stephan Kremers, Uwe M Martens, Christian Kunz, Manfred Hensel, Axel Benner, Andrea Seidel-Glätzer, Katja C Weisel, Marc S Raab, Hans J Salwender, for the German-speaking Myeloma Multicenter Group (GMMG) HD6 investigators
E-Jahr:2024
Jahr:February 2024
Umfang:13 S.
Fussnoten:Gesehen am 28.03.2024
Titel Quelle:Enthalten in: The lancet <London> / Haematology
Ort Quelle:London [u.a.] : Elsevier, 2014
Jahr Quelle:2024
Band/Heft Quelle:11(2024), 2, Seite e101-e113
ISSN Quelle:2352-3026
Abstract:Background - The aim of this trial was to investigate the addition of the anti-SLAMF7 monoclonal antibody elotuzumab to lenalidomide, bortezomib, and dexamethasone (RVd) in induction and consolidation therapy as well as to lenalidomide maintenance treatment in transplant-eligible patients with newly diagnosed multiple myeloma. - Methods - GMMG-HD6 was a phase 3, randomised trial conducted at 43 main trial sites and 26 associated trial sites throughout Germany. Adult patients (aged 18-70 years) with previously untreated, symptomatic multiple myeloma, and a WHO performance status of 0-3, with 3 being allowed only if caused by myeloma disease and not by comorbid conditions, were randomly assigned 1:1:1:1 to four treatment groups. Induction therapy consisted of four 21-day cycles of RVd (lenalidomide 25 mg orally on days 1-14; bortezomib 1·3 mg/m2 subcutaneously on days 1, 4, 8, and 11]; and dexamethasone 20 mg orally on days 1, 2, 4, 5, 8, 9, 11, 12, and 15 for cycles 1-2) or, RVd induction plus elotuzumab (10 mg/kg intravenously on days 1, 8, and 15 for cycles 1-2, and on days 1 and 11 for cycles 3-4; E-RVd). Autologous haematopoietic stem-cell transplantation was followed by two 21-day cycles of either RVd consolidation (lenalidomide 25 mg orally on days 1-14; bortezomib 1·3 mg/m2 subcutaneously on days 1, 8, and 15; and dexamethasone 20 mg orally on days 1, 2, 8, 9, 15, and 16) or elotuzumab plus RVd consolidation (with elotuzumab 10 mg/kg intravenously on days 1, 8, and 15) followed by maintenance with either lenalidomide (10 mg orally on days 1-28 for cycles 1-3; thereafter, up to 15 mg orally on days 1-28; RVd/R or E-RVd/R group) or lenalidomide plus elotuzumab (10 mg/kg intravenously on days 1 and 15 for cycles 1-6, and on day 1 for cycles 7-26; RVd/E-R or E-RVd/E-R group) for 2 years. The primary endpoint was progression-free survival analysed in a modified intention-to-treat (ITT) population. Safety was analysed in all patients who received at least one dose of trial medication. This trial is registered with ClinicalTrials.gov, NCT02495922, and is completed. - Findings - Between June 29, 2015, and on Sept 11, 2017, 564 patients were included in the trial. The modified ITT population comprised 559 (243 [43%] females and 316 [57%] males) patients and the safety population 555 patients. After a median follow-up of 49·8 months (IQR 43·7-55·5), there was no difference in progression-free survival between the four treatment groups (adjusted log-rank p value, p=0·86), and 3-year progression-free survival rates were 69% (95% CI 61-77), 69% (61-76), 66% (58-74), and 67% (59-75) for patients treated with RVd/R, RVd/E-R, E-RVd/R, and E-RVd/E-R, respectively. Infections (grade 3 or worse) were the most frequently observed adverse event in all treatment groups (28 [20%] of 137 for RVd/R; 32 [23%] of 138 for RVd/E-R; 35 [25%] of 138 for E-RVd/R; and 48 [34%] of 142 for E-RVd/E-R). Serious adverse events (grade 3 or worse) were observed in 68 (48%) of 142 participants in the E-RVd/E-R group, 53 (39%) of 137 in the RVd/R, 53 (38%) of 138 in the RVd/E-R, and 50 (36%) of 138 in the E-RVd/R (36%) group. There were nine treatment-related deaths during the study. Two deaths (one sepsis and one toxic colitis) in the RVd/R group were considered lenalidomide-related. One death in the RVd/E-R group due to meningoencephalitis was considered lenalidomide and elotuzumab-related. Four deaths (one pulmonary embolism, one septic shock, one atypical pneumonia, and one cardiovascular failure) in the E-RVd/R group and two deaths (one sepsis and one pneumonia and pulmonary fibrosis) in the E-RVd/E-R group were considered related to lenalidomide or elotuzumab, or both. - Interpretation - Addition of elotuzumab to RVd induction or consolidation and lenalidomide maintenance in patients with transplant-eligible newly diagnosed multiple myeloma did not provide clinical benefit. Elotuzumab-containing therapies might be reserved for patients with relapsed or refractory multiple myeloma. - Funding - Bristol Myers Squibb/Celgene and Chugai.
DOI:doi:10.1016/S2352-3026(23)00366-6
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1016/S2352-3026(23)00366-6
 Volltext: https://www.sciencedirect.com/science/article/pii/S2352302623003666
 DOI: https://doi.org/10.1016/S2352-3026(23)00366-6
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1884553737
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