ONCAlert | Upfront Therapy for mRCC

Melflufen Plus Dexamethasone Safe and Effective For R/R Multiple Myeloma

Paul G. Richardson, MD
Published Online: 12:21 AM, Sun September 15, 2019

Paul G. Richardson, MD, clinical program leader and director of clinical research of the Jerome Lipper Multiple Myeloma Center, Dana Farber Cancer Institute and RJ Corman Professor of Medicine, Harvard School of Medicine, discusses the interesting safety and efficacy profiles of the HORIZON trial.
The phase II, multicenter study looked at the combination of melflufen and Dexamethasone (Ozurdex) in patients with relapsed/refractory multiple myeloma who were refractory to pomalidomide (Pomalyst), daratumumab (Darzalex), or both.
The safety profiles showed that most toxicities were grades 1 and 2. Expected adverse events like suppression of blood counts, hair loss, mucositis, and peripheral neuropathy were either manageable or did not occur. 
Richardson notes that the efficacy signals were impressive. These heavily pretreated patients had a 30% response rate to the combination and the significant number of patients with extramedullary disease had a higher response rate than other patients. Another interesting finding in this trial was that among the patients who had an anti-monoclonal anti-body before trial, there were more occurrences of extramedullary disease. Richardson believes that this indicates that patients who relapse after being treated with agents like daratumumab or Isatuximab, extramedullary disease emerges.

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