IMS 2025 | Ongoing trials for newly diagnosed myeloma in the UK: FiTNESS and iFit

Within the UK we have a tradition of having academic trials for newly diagnosed as well as relapsed patients with multiple myeloma and I’ve been fortunate to be part of a number of the newly diagnosed trials over the last few years, particularly the FiTNESS trial or Myeloma XIV, which is a trial looking at frailty-adapted dosing for newly diagnosed transplant-ineligible myeloma patients. This is a trial that we initially reported, or Gordon Cook, the chief investigator, initially reported at ASH last year, reporting the outcome of frailty-adapted dosing in older patients and how that impacted both event-free, progression-free and overall survival outcomes for patients. Moving on from FiTNESS, we are in the process of setting up the iFit clinical trial, which we hope will open in the UK within the next few months. And this is taking one step further and looking at the use of immunotherapy approaches for older patients with myeloma adapted based both on their frailty, but also on their response to initial therapy with daratumumab, lenalidomide, and dexamethasone, which is our standard of care treatment for newly diagnosed transplant-ineligible patients. So we’ll be assessing their degree of response to that using minimal residual disease testing and also looking at their dynamic frailty during the first portion of induction therapy and then adapting therapy or looking at understanding whether adapting therapy with immunotherapeutic approaches, T-cell engager therapies can improve outcomes for patients with the less deep responses after that initial period of treatment.

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