Multiple Myeloma
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Research in Context
Research in Context is a structured summary that editors at The Lancet’s journals ask all authors to provide when submitting an original research article. Read more
Featured Article
Investigational mezigdomide triplet evaluated in phase 3 SUCCESSOR-2 trial for relapsed or refractory multiple myeloma.
In patients exposed to anti-CD38 antibodies and lenalidomide, investigators reported improved progression-free survival and deeper responses versus carfilzomib–dexamethasone, with safety consistent with prior mezigdomide studies and known carfilzomib toxicity.
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ATLAS: intensified maintenance strategy after autologous HSCT in multiple myeloma.
In this phase 3 trial, carfilzomib–lenalidomide–dexamethasone maintenance prolonged progression-free survival versus lenalidomide alone; the authors describe evidence for improved overall survival and note subgroup benefit in MRD-positive and high-risk-cytogenetics patients that may inform future risk-adapted approaches.
Phase 3 DREAMM-8 Trial Reports Progression-Free Survival Benefit With Belantamab Mafodotin Combination in Relapsed or Refractory Multiple Myeloma
In a head-to-head comparison against a bortezomib-based triplet, researchers reported a progression-free survival benefit in patients with at least one previous line of therapy including lenalidomide, though self-reported ocular side-effects were more common with belantamab mafodotin, with minimal overall quality-of-life impact reported in post-hoc analysis.
First phase 3 trial of dexamethasone-sparing regimen in frail older patients with myeloma.
IFM2017-03 reports that lenalidomide plus daratumumab improved progression-free survival versus lenalidomide plus dexamethasone in this frailty-specific population, without increased infection risk; the strategy is now part of EHA–EMN myeloma guidelines.
Phase 3 trial: Investigators report higher MRD-negativity with KRd, daratumumab-KRd versus VMP-Rd in transplant-ineligible myeloma
Investigators reported higher rates of undetectable measurable residual disease after 18 induction cycles with these regimens, and describe frailty assessment as a tool to help guide regimen selection.
Weekly carfilzomib regimen evaluated in transplant-ineligible multiple myeloma
In the under-enrolled EMN20 randomised phase 3 trial, adding weekly carfilzomib to lenalidomide–dexamethasone improved MRD negativity and progression-free survival in fit or intermediate-fit patients with newly diagnosed, transplantation-ineligible multiple myeloma.
DREAMM-7 extended follow-up: BVd versus DVd in relapsed or refractory multiple myeloma after ≥1 prior line
Investigators reported that ocular events were managed with dose modifications and were generally reversible, alongside significant and clinically meaningful progression-free and overall survival benefits with BVd versus DVd; the authors describe BVd as a potential new standard of care in this setting.
DREAMM-7: exploratory patient-reported outcomes in relapsed or refractory multiple myeloma
In this ongoing phase 3 study, secondary/exploratory PRO analyses showed quality of life was generally maintained or improved with both treatment regimens; post-hoc analyses suggested ocular side-effects had only a minor effect on quality of life.
BELLINI update: overall survival unfavourable for venetoclax overall
Researchers report that in the phase 3 BELLINI study, updated overall survival favored placebo over venetoclax (each with bortezomib and dexamethasone) in the overall population.
Pilot study explores radiotherapy plus anti-PD1 in relapsed/refractory multiple myeloma
In this small, exploratory study of heavily pre-treated patients, investigators reported safety and response findings, but say further trials are needed before this approach could inform clinical practice.