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Patients with newly diagnosed high-risk multiple myeloma have poor survival outcomes and few prospective trials aiming to determine the optimal treatment strategy. Measurable residual disease (MRD) negativity is the strongest predictor of survival; therefore, is crucial for this patient population.
Leypoldt et al.1 recently published results from the phase II GMMG-CONCEPT trial (NCT03104842) in Journal of Clinical Oncology investigating transplant-eligible (TE) and transplant-non-eligible (TNE) patients with newly diagnosed high-risk multiple myeloma treated with isatuximab, carfilzomib, lenalidomide, and dexamethasone (Isa-KRd), followed by triplet maintenance. We summarize the key points below.
Figure 1. Response rates of TE and TNE patients treated with Isa-KRd*
CR, complete response; ORR, overall response rate; PD, progressive disease; PR, partial response; TE, transplant-eligible; TNE, transplant-non-eligible; VGPR, very good PR.
*Adapted from Leypoldt, et al.1
Figure 2. Rates of sustained MRD negativity at ≥6 months and ≥12 months in TE and TNE patients treated with Isa-KRd*
MRD, measurable residual disease; TE, transplant-eligible; TNE, transplant-non-eligible.
*Adapted from Leypoldt, et al.1
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What is the most significant limitation you have identified when using lenalidomide or pomalidomide for the treatment of patients with multiple myeloma?