Hovon 143 Study reported that the use of Ixazomib-daratumumab-low-dose-dexamethasone (Ixa-Dara-dex) combination results in higher response rate and better quality of life (QoL) in frail patients with newly diagnosed multiple myeloma.
The present study conducted by Claudia A. M. Stege et al., aimed to d the efficacy and tolerability of Ixa-Dara-dex specifically in frail patients. Based on the International Myeloma Working Group frailty index, 65 patients with multiple myeloma were treated with 9 induction cycles of the combination Ixa-Dara-dex and later maintenance therapy with only Ixa-Dara for up to 2 years.
Generally, the induction therapy had a response rate of 78%. The median progression-free survival (PFS) was 13.8 months and 12-month overall survival (OS) was 78% after mean follow-up of 22.9 months. The change in median PFS and 12-month OS in frail patients has been portrayed in the following table:
|Frail patients aged > 80 years alone||Frail patients based on additional parameters aged ≤ 80 alone||Frail patients based on additional parameters aged > 80 years|
|Median PFS||21.6 months||13.8 months||10.1 months|
The induction treatment had to be withdrawn early in 51% of the patients (6% due to non-compliance, 9% due to toxicity, and 9% due to mortality). An improvement in the QoL was also observed which was clinically significant following 3 cycles. Discontinuation of the therapy due to toxicity and early mortality, adversely affecting the PFS and OS still remains challenging in frail patients.
All in all, the study outcome varied amongst frail subpopulations. This should be of particular interest while designing and clarification of future studies in frail or weak patients for more precise treatment.
|Source:||Journal of Clinical Oncology|
|Original title of the article:||Ixazomib, Daratumumab, and Low-Dose Dexamethasone in Frail Patients With Newly Diagnosed Multiple Myeloma: The Hovon 143 Study|