Dr. Biran on Post-ASCT Consolidation in Multiple Myeloma

Noa Biran, MD, physician, John Theuer Cancer Center, Hackensack University Medical Center, discusses elotuzumab (Empliciti) as post-autologous stem cell transplant consolidation in patients with high-risk myeloma.

Patients with high-risk myeloma have very short remissions posttransplant, says Biran. Therefore, researchers hypothesized that they could take multiple myeloma at the lowest burden of disease state and, at a time of immune recovery, harvest the immune recovery posttransplant. Elotuzumab is utilized because it is a therapy option that can increase the natural killer and T-cell activity in combination with an immunomodulatory agent plus steroids to help reduce disease burden and prolong progression-free survival posttransplant.

In a retrospective, single-institution study that treated 31 patients who have high-risk multiple myeloma. Patients were treated with a fixed number of 4 cycles of lenalidomide (Revlimid), dexamethasone, and elotuzumab. Steroids were then reduced after the first 2 cycles or discontinued in most cases.

The median PFS was 31.5 months. While promising, physicians need to take this study in perspective and perhaps use it as a basis for future prospective studies, concludes Biran.