Dr. Kumar on Treatment Discontinuation in the ENDURANCE Trial in Multiple Myeloma

Shaji K. Kumar, MD, professor of medicine, Mayo Clinic, discusses the rate of treatment discontinuation in the phase 3 ENDURANCE (E1A11) trial in newly diagnosed multiple myeloma.

Patients with newly diagnosed multiple myeloma were randomized to received bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd) or carfilzomib (Kyprolis), lenalidomide, and dexamethasone (KRd).

Findings from the study showed that KRd did not improve progression-free survival compared with VRd in this patient population.

Early discontinuation of treatment was relatively common among patients treated in both arms of the ENDURANCE study, says Kumar. About 43% of patients completed the full 12 cycles of VRd and 61.6% of patients completed the full 9 cycles of KRd.

Treatment discontinuation can be attributed to adverse effects, emergence of alterative therapy like stem cell transplant, or patient withdrawal/refusal, says Kumar.

Although the trial was not intended to enroll patients who would eventually go on to receive transplant, around 28% of patients in both arms went on to transplant before or shortly after completing induction therapy, concludes Kumar.