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ASH 2024 | The SKylaRk trial: patients with multiple myeloma and high-risk cytogenetic abnormalities
Elizabeth O’Donnell, MD, Massachusetts General Hospital, Boston, MA, comments on the outcomes of patients with high-risk cytogenetic abnormalities in the SKylaRk trial (NCT04430894), which investigated isatuximab, carfilzomib, lenalidomide, and dexamethasone in newly diagnosed transplant-eligible multiple myeloma. Dr O’Donnell highlights that standard-risk patients did comparably well compared to other studies, but those with high-risk cytogenetics showed lower progression-free survival, suggesting consideration of alternative consolidation therapies such as CAR T-cell or adjunctive therapies. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
The SKylaRk trial was a Phase II study of isatuximab, carfilzomib, lenalidomide, dexamethasone, in newly diagnosed transplant-eligible patients with multiple myeloma. That data was published earlier this year in Lancet Hematology. But the question that we wanted to answer for this ad hoc abstract was, you know, most of the patients in that study, 88% deferred transplant. All the patients collected, but a large percent deferred...
The SKylaRk trial was a Phase II study of isatuximab, carfilzomib, lenalidomide, dexamethasone, in newly diagnosed transplant-eligible patients with multiple myeloma. That data was published earlier this year in Lancet Hematology. But the question that we wanted to answer for this ad hoc abstract was, you know, most of the patients in that study, 88% deferred transplant. All the patients collected, but a large percent deferred. And one of the important questions in myeloma is whether or not to transplant. And so what we looked at now that we have a little bit more mature data was the outcomes of patients by cytogenetic risk. And what we saw is that the standard-risk patients did very comparably well to other trials that included transplant. But where there was a small population, and these were very small numbers, about five patients who had double hits, who had two high-risk cytogenetic abnormalities, we did see that the progression-free survival was lower than that, than what was seen in like the concept study that used the same regimen in high-risk patients but did incorporate transplant. And so we think it really begs the question of whether there may be some consideration of whether it be transplant or maybe CAR T-cell or adjunctive therapies in patients who do have high-risk disease to consolidate and ensure enhanced progression-free survival.
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Disclosures
Grail: Consultancy; Natera: Membership on an entity’s Board of Directors or advisory committees; Exact Sciences: Honoraria; Legend Pharmaceuticals: Membership on an entity’s Board of Directors or advisory committees; BMS: Consultancy; Sanofi: Consultancy, Honoraria; Pfizer: Consultancy.
