. 2021 Dec 10;2021(1):30-36. doi: 10.1182/hematology.2021000229

Table 3.

Efficacy of current treatment approaches for patients with NDMM with high-risk features (defined as del(17p), t(4;14), or t(14;16))

Clinical trial	Transplant-eligible NDMM
Clinical trial	SWOG-1211	Cassiopeia		Forte		Griffin
Population	High risk^*	ITT	High risk	ITT	High risk	ITT			High risk
Treatment	EloVRd vs VRd	DVTd vs VTD	DVTd vs VTD	KRd-T/KRd12	KRd-T/KRd12	DRVd vs RVd			DRVd vs RVd
PFS (m)/HR	31 vs 34/0.96	NR/0.47	NR/0.67	NR/0.64	NR/0.51	NR/NA			NR/NA
Clinical trial	Transplant-ineligible NDMM
Clinical trial	SWOG		ALCYONE			MAIA
Population	ITT	High risk	ITT	High risk	Frail patients	ITT	High risk		Frail patients
Treatment	VRd- > Rd vs Rd	VRd- > Rd vs Rd	DVMP vs VMP	DVMP vs VMP	DVMP vs VMP	DRd vs Rd	DRd vs Rd		DRd vs Rd
PFS (m)/HR	43 vs 30/0.74	38 vs 16/NA	36 vs 18/0.50	18 vs 18/0.78	33 vs 19/0.51	NR vs 34/0.54	45 vs 29/0.57		NR vs 30/0.62
Clinical trial	Relapsed-refractory MM
Clinical trial	POLLUX			ASPIRE			ELOQUENT-2		TOURMALINE-MM1
Population	ITT	High risk	Early relapse	ITT	High risk	Early relapse	ITT	High risk	ITT	High risk
Treatment	DRd vs Rd	DRd vs Rd		KRd vs Rd	KRd vs Rd		EloRd vs Rd	EloRd vs Rd	IRd vs Rd	IRd vs Rd
PFS (m)/HR	44.5 vs 17.5/0.44	26.8 vs 8.3/0.37	0.38	26.3 vs 17.3/0.69	23 vs 13.9/0.7	21.4 vs 10.7/0.7	19.4 vs 14.9/0.70	NA/0.72(del17p) NA/0.56 (t(4;14)	20.6 vs 14.7/0.74	21.4 vs 9.7/0.54
Clinical trial	CASTOR		ENDEAVOR		CANDOR			IKEMA
Population	ITT	High risk	ITT	High risk	ITT	High risk	Early relapse	ITT		High risk
Treatment	DVd vs Vd	DVd vs Vd	Kd vs Vd	Kd vs Vd	DKd vs Kd	DKd vs Kd		IsaKd vs Kd		IsaKd vs Kd
PFS (m)/HR	16.7 vs 7.1/0.31	12.6 vs 6.2/0.41	18.7 vs 9.4/0.53	8.8 vs 6.0/0.7	28.6 vs 15.9/0.59	15.6 vs 5.6/0.49	CRrate 28 vs 3%	NR vs 19.1/0.53		NA/0.72
Clinical trial	OPTIMISMM		BOSTON		ICARIA		ELOQUENT-3
Population	ITT	High risk	ITT	High risk	ITT	High risk	ITT		High risk
Treatment	PVd vs Vd	PVd vs Vd	SVd vs Vd	SVd vs Vd	IsaPd vs Pd	IsaPd vs Pd	EloPd vs Pd		EloPd vs Pd
PFS (m)/HR	11.2 vs 7.1/0.61	NA/0.56	11.2 vs 5.8/0.61	NA/0.67	11.5 vs 6.4/0.59	NA/0.66	10.3 vs 4.7/0.54		0.52
Clinical trial	STORM		HORIZON		DREAMM-2		KARMMA-1
Population	ITT	High risk	ITT	High risk	ITT	High risk	ITT		High risk
Treatment	Sd	Sd	Melflufen-dex	Melflufen-dex	Belamaf	Belamaf	Ide-cel		Ide-cel
PFS (m)/HR	3.7	3.3^* and 4.6^*	4.2	3.0	3.9	2.1	8.8		10.4

^{^*}

High-risk definition: gene expression profiling high risk, t(14;16), t(14;20), del(17p), amp1q21, plasma cell leukemia, elevated serum LDH (2 × upper limit of normal).

Belamaf, belantamaf mafodotin; dex, dexamethasone; DKd, daratumumab, carfilzomib, and dexamethasone; DRd, daratumumab, lenalidomide, and dexamethasone; DRVd, daratumumab, lenalidomide, bortezomib, and dexamethasone; DVd, daratumumab, bortezomib, and dexamethasone; DVMP, daratumumab, bortezomib, melphalan, and prednisone; DVTd, daratumumab, bortezomib, thalidomide, and dexamethasone; Elo, elotuzumab; EloPd, elotuzumab, pomalidomide, and dexamethasone; EloRd, elotuzumab, lenalidomide, and dexamethasone; Ide-cel, idecabtagene vicleucel; IRd, ixazomib, lenalidomide, and dexamethasone; IsaKd, isatuximab, carfilzomib, and dexamethasone; IsaPd, isatuximab, pomalidomide, and dexamethasone; ITT, intention-to-treat population; Kd, carfilzomib and dexamethasone; KRd, carfilzomib, lenalidomide, and dexamethasone; KRd-T, carfilzomib, lenalidomide, and dexamethasone followed by transplant; KRd 12, KRd for 12 cycles; m, months; NA, not available; NR, not reached; PVd, pomalidomide, bortezomib, and dexamethasone; Rd, lenalidomide and dexamethasone; RVd, lenalidomide, bortezomib, and dexamethasone; Sd, selinexor and dexamethasone; SVd, selinexor, bortezomib, and dexamethasone; VTd, bortezomib, thalidomide, and dexamethasone.