How Do CELMoDs Impact Patient Outcomes in Myeloma?

By Patrick Daly - Last Updated: September 13, 2024

Treatment with cereblon E3 ligase modulatory drugs (CELMoDs) showed promising efficacy but high rates of neutropenia in patients with multiple myeloma, according to a meta-analysis led by Moazzam Shahzad, MD, of the H. Lee Moffitt Cancer Center.

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“This study indicates favorable outcomes with CELMoDs in the treatment of multiple myeloma; however, treatment-related adverse effects remain a major limitation,” said Dr. Shahzad in the presentation of the analysis’ findings at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

The analysis included eight articles with a combined total of 350 patients. One study was phase I, six were phase I/II, and one was phase II. The combined cohort had a median age of 66 years (range, 57-67) and was 55% male. Treatments included mezigdomide (n=176), iberdomide (n=172), and avadomide (n=2).

The pooled overall response rate was 63% (95% CI, 0.38-0.83; I2=88%; P<.01). In subsequent analyses of evaluable patients, the researchers calculated pooled rates for the following outcomes:

  • Partial response, 21% (95% CI, 0.15-0.29; I2=51%; P=.06; n=331)
  • Very good partial response, 22% (95% CI, 0.13-0.34; I2=69%; P<.01; n=331)
  • Complete response, 7% (95% CI, 0.03-0.13; I2=87%; P=.13; n=350)
  • Stringent complete response, 7% (95% CI, 0.02-0.20; I2=87%; P<.01; n=350)
  • Minimal response rate, 8% (95% CI, 0.05-0.14; I2=22%; P=.26; n=208)
  • Progressive disease, 13% (95% CI, 0.09-0.19; I2=37%; P=.79; n=285)
  • Stable disease rate, 41% (95% CI, 0.35-0.48; I2=0%; P=.79; n=210)
  • Incidence of neutropenia, 45% (95% CI, 0.31-0.60; I2=83; P<.01; n=348)

Ultimately, “further clinical trials are essential to determine the effectiveness and safety of this promising class of drugs for managing multiple myeloma,” suggested Dr. Shahzad.

Reference

Shahzad M, Basharat A, Irfan S, et al. Advancing multiple myeloma treatment: a systematic review and meta-analysis of cereblon E3 ligase modulatory drugs (CELMoDs) impact on patient outcomes. Abstract #MM-084. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.

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