OAB-013: Iberdomide (IBER) in combination with dexamethasone (DEX) and daratumumab (DARA), bortezomib (BORT), or carfilzomib (CFZ) in patients (pts) with relapsed/refractory multiple myeloma (RRMM).

Lonial, Sagar; Richardson, Paul G.; Popat, Rakesh; Stadtmauer, Edward A.; Larsen, Jeremy T.; Oriol, A.; Knop, Stefan; Jagannath, Sundar; Cook, Gordon; Badros, Ashraf Z.; Rodríguez-Otero, Paula; Siegel, David S.; Tuong Vi Nguyen; Micco, Antonia Di; Amin, Alpesh; Min Chen; Kueenburg, Elisabeth; van de Donk, Niels W.C.J.

CC-220-MM-001 (NCT02773030) is an ongoing phase 1/2 study evaluating the maximum tolerated dose, recommended phase 2 dose (RP2D), safety, and preliminary efficacy of IBER, an oral, novel cereblon E3 ligase modulator (CELMoD®) compound, with different treatment combinations in independent cohorts, in pts with MM. Here we report results from the IBER+DARA+DEX (IberDd), IBER+BORT+DEX (IberVd), and IBER+CFZ+DEX (IberKd) cohorts in RRMM. Eligible pts received ≥2 (IberDd and IberKd cohorts) or ≥1 prior regimens (IberVd cohort), containing lenalidomide or pomalidomide, and a proteasome inhibitor. All pts had progressed ≤60 days from last therapy. Escalating oral doses of IBER were given on day (D)1–21 of each 28-D cycle in the IberDd cohort and in the IberKd cohort with weekly CFZ, and on D1–14 of each 21-D cycle in the IberVd cohort. DEX was given weekly in all 3 cohorts. As of April 8, 2021, 43 pts had received IberDd, 25 IberVd, and 9 IberKd. Median age was 67, 64, and 61 years, and median time since diagnosis was 7.35, 7.1, and 6.7 years in the IberDd, IberVd, and IberKd cohorts, respectively. Extramedullary plasmacytomas were present in 7 (16%), 4 (16%), and 2 (22%) pts in the IberDd, IberVd, and IberKd cohorts, respectively. Exposure to prior regimens was heterogeneous; all pts were refractory to their last prior regimen and ≥33% pts in the 3 cohorts were triple-class refractory. IBER doses ranged from 1.0 to 1.6 mg. Median follow-up was 4.17, 4.86, and 5.03 months, 22 (51%), 6 (24%), and 5 (56%) pts continue on treatment, and median cycles received were 4, 6, and 5 with IberDd, IberVd, and IberKd, respectively. Hematologic grade (G) 3–4 treatment-emergent adverse events (TEAEs) of interest included neutropenia (67%), leukopenia (23%), anemia (21%), and febrile neutropenia (5%) with IberDd; neutropenia (28%) and thrombocytopenia (24%) with IberVd; and lymphopenia (44%) and neutropenia (33%) with IberKd. Neutropenia was manageable with G-CSF. Occurrence of non-hematologic TEAEs was low, with very few G3–4 fatigue, rash, and gastrointestinal disorders. The overall response rate was 46% with IberDd, 56% with IberVd, and 50% with IberKd, including a VGPR or better of 24%, 28%, and 38%, respectively. Median time to response was 4.1 (4.0–12.0), 3.6 (3.0–13.1), and 4.1 (4.1–8.1) weeks, in the IberDd, IberVd, and IberKd cohorts, respectively. Median duration of response is 35.7 weeks in the IberVd cohort (not reached in the other cohorts). RP2D was determined at 1.6 mg in the IberDd cohort; dose evaluation continues in the other cohorts. In pts with heavily pretreated RRMM, IberDd, IberVd, and IberKd showed a tolerable safety profile and promising efficacy. These results support further development of IBER-based regimens in MM, including the initiation of phase 3 combination studies. Previously published in Lonial S, et al. HemaSphere 2021;5(S2):49.

Clinical Lymphoma, Myeloma & Leukemia, 2021, Vol 21, pS9

2152-2650

Academic Journal

10.1016/S2152-2650(21)02087-5