LocoMMotion: Final analysis at 2-year follow up

The multiple myeloma (MM) treatment landscape is continually evolving, with several novel therapies under clinical trial. Most patients with MM experience treatment failure on initial therapy and require several further lines of therapy (LOTs), resulting in significant treatment combination heterogeneity in the real-world setting.

Here, we summarize key findings from the final analysis of the LocoMMotion study, presented by Moreau et al.¹ at the 50th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), which assessed the efficacy and safety of real-life standard of care treatments for triple-class-exposed patients with relapsed/refractory MM (RRMM).

Study design

• LocoMMotion (NCT04035226) is a prospective, observational study conducted across multinational centers.
• Data were collected on initial treatment, outcomes 30 days post-initial treatment, following subsequent LOT, and at a median follow-up of 26.4 months.
• The primary focus was efficacy and safety of follow-up treatments.

Key findings

• A total of 248 patients with heavily pre-treated RRMM were enrolled between 2019 and 2020.
• The study identified 91 unique initial treatment regimens.
• An overall response rate of 31.9%, with a median duration of response of 7.4 months, was observed across the entire cohort.
• Both progression-free (PFS) and overall survival (OS) were markedly poor (Figure 1).

• Following initial therapy, 61.3% of patients went on to receive a subsequent LOT.
  • 79 unique treatment regimens were identified amongst subsequent LOTs.
• Disease progression was notably rapid, with a median time from initial study randomization to second disease progression or death from any cause (PFS2) of 10.8 months following subsequent treatment.
• Adverse events occurred in 86.7% of patients following initial therapy, with cytopenias being the most common.
• The most common cause of death was disease progression, regardless of the treatment stage.

OS, overall survival; PFS, progression-free survival.
*Data from Moreau, et al.¹

Key learnings
Overall, the data suggest a lack of standardized care for RRMM patients, with 91 initial and 79 subsequent treatment regimens identified. Survival outcomes were poor, with a 24-month PFS rate of 10.5% and OS rate of 33.7%. Disease progression is often rapid and is the primary cause of death in patients with RRMM, highlighting a distinct need for improved care for heavily pretreated patients.