Dr. Kumar on Takeaways From the ENDURANCE Trial in Multiple Myeloma

Shaji K. Kumar, MD, professor of medicine, Mayo Clinic, discusses key takeaways from the phase 3 ENDURANCE trial in newly diagnosed multiple myeloma.

The results from the trial showed similar progression-free survival and overall survival (OS) with bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd) versus carfilzomib (Kyprolis), lenalidomide, and dexamethasone (KRd) in this setting, says Kumar. The estimated 3-year OS rates were approximately 85% in both arms. Additionally, the overall response rates were comparable between arms. Notably, deeper responses such as the rate of very good partial response, was more common among patients in the KRd arm, says Kumar.

In terms of safety, a higher incidence of grade 3 or higher non-hematological adverse effects was seen in the KRd arm, particularly cardiac, pulmonary, and renal toxicities. However, patients in the VRd arm had a higher risk of peripheral neuropathy. Taken collectively, the results do not provide sufficient evidence that KRd should replace VRd as the current frontline standard of care in newly diagnosed patients with transplant-eligible myeloma. Trials evaluating the addition of monoclonal antibodies to VRd or replacing bortezomib are ongoing, concludes Kumar.