Dr Biran on the IMROZ Trial in Newly Diagnosed, Transplant-Ineligible Multiple Myeloma

Noa Biran, MD, associate professor, medicine, Hackensack Meridian School of Medicine, physician, Division of Multiple Myeloma, John Theurer Cancer Center, Hackensack Meridian Health, discusses the impact of the phase 3 IMROZ trial (NCT03319667) in the treatment of patients with newly diagnosed, transplant-ineligible multiple myeloma.

The findings from the IMROZ trial have the potential to significantly alter the standard treatment approach for patients with newly diagnosed, transplant-ineligible multiple myeloma, Biran begins. Traditionally, the standard of care (SOC) for these patients has been the combination of daratumumab (Darzalex), lenalidomide (Revlimid), and dexamethasone, she explains. However, the IMROZ study introduced a new combination by comparing isatuximab-irfc (Sarclisa) plus bortezomib, lenalidomide, and dexamethasone (VRd) with VRd alone in this patient population, Biran states. This trial marks the first instance of incorporating a proteasome inhibitor into the frontline treatment regimen for patients with transplant-ineligible multiple myeloma, she notes.

The findings from the IMROZ study demonstrated both the efficacy and the feasibility of delivering a quadruplet regimen to these patients, Biran continues. Incorporating a proteasome inhibitor is particularly significant for high-risk patients who are not eligible for transplant, she says. The addition of isatuximab to the VRd regimen showed promising results, indicating that this combination could improve outcomes for this subset of patients, Biran elucidates.

This trial’s results may lead to a shift in how newly diagnosed, transplant-ineligible patients with multiple myeloma are treated, potentially setting a new SOC for this population that includes a quadruplet regimen containing a proteasome inhibitor, she expands. This approach could enhance treatment efficacy and offer a better prognosis for high-risk patients, who traditionally have fewtherapeutic options, Biran says. As the medical community evaluates the full impact of the IMROZ study, it is likely that its findings will influence future treatment protocols and guidelines, providing a more effective and comprehensive strategy for the management of multiple myeloma in transplant-ineligible patients, Biran concludes.