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IMS 2025 | A Phase III trial comparing KRd with Rd in patients with transplant-ineligible NDMM
Mattia D’Agostino, MD, University of Turin, Turin, Italy, discusses a Phase III trial (NCT04096066) investigating carfilzomib-lenalidomide-dexamethasone (KRd) versus lenalidomide-dexamethasone (Rd) in patients with newly diagnosed multiple myeloma (NDMM) ineligible for transplantation. Dr D’Agostino reports promising findings, highlighting that KRd is an effective backbone in these patients. This interview took place at the 22nd International Myeloma Society (IMS) Annual Meeting in Toronto, Canada.
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Transcript
So for many years in transplant-ineligible trials, carfilzomib treatment has been questioned because of negative Phase III trials investigating the carfilzomib melphalan-prednisone versus velcade melphalan-prednisone. In this trial we use carfilzomib weekly in addition to lenalidomide, dexamethasone backbone, and we compared it prospectively in a cohort of fit or intermediate fit transplant-ineligible newly diagnosed patients...
So for many years in transplant-ineligible trials, carfilzomib treatment has been questioned because of negative Phase III trials investigating the carfilzomib melphalan-prednisone versus velcade melphalan-prednisone. In this trial we use carfilzomib weekly in addition to lenalidomide, dexamethasone backbone, and we compared it prospectively in a cohort of fit or intermediate fit transplant-ineligible newly diagnosed patients. And the combination was indeed very good. It prolonged progression-free survival and it doesn’t add toxicity to our patients. Carfilzomib was conveniently administered to our patients with a weekly schedule and after two years, patients that were sustained MRD negativity suspended carfilzomib. So we think that KRd may be a very good backbone also in the elderly and the addition of an anti-CD38 should be explored in next trials.
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Disclosures
M.D. has received honoraria from GlaxoSmithKline, Sanofi, and Janssen; and has served on the advisory boards for GlaxoSmithKline, Sanofi, and Bristol Myers Squibb.
