An interesting study for the frail myeloma patients who are not eligible for ASCT is the phase II, Hovon 143 Study, which was published in Journal of Clinical Oncology in September. Frail patients with newly diagnosed multiple myeloma have an inferior outcome, mainly because of a high discontinuation rate due to toxicity. In this phase II trial 65 frail patients, according to IMWG frailty index, received the nine induction cycles of the combination of ixazomib-daratumumab-low dose dexamethasone (Ixa-Dara-dex) followed by maintenance with Ixa-Dara for a maximum of 2 years.
The overall response rate on induction therapy was 78%. After a median follow-up of 22.9 months, the median PFS was 13.8 months, and the 12-month OS rate was 78%. Median PFS and 12-month OS were 21.6 months and 92% in patients who were frail based on age >80 years alone, versus 13.8 months and 78%, and 10.1 months and 70% in patients who were frail based on additional frailty parameters either ≤ 80 or > 80 years of age, respectively. In 51% of patients, induction therapy had to be discontinued prematurely, of which 6% because of noncompliance to study treatment, 9% because of toxicity, and 9% because of death.
Professor Sonja Zweegman, who is the last author of the publication, talks to IMS Newsletter for these results in NDMM frail patients and the implications they have in everyday clinical practice.
