1. Filanesib plus bortezomib and dexamethasone in relapsed/refractory t(11;14) and 1q21 gain multiple myeloma.
- Author
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Pan, Darren, Kaufman, Jonathan, Htut, Myo, Agrawal, Manish, Mazumder, Amitabha, Cornell, Robert, Zonder, Jeffrey, Fay, Joseph, Modiano, Manuel, Moshier, Erin, Rush, Selena, Tunquist, Brian, and Chari, Ajai
- Subjects
chemotherapy ,clinical cancer research ,clinical trials ,experimental ,medical oncology ,multiple myeloma ,therapeutics ,Adult ,Aged ,Antineoplastic Combined Chemotherapy Protocols ,Bortezomib ,Chromosome Aberrations ,Chromosomes ,Human ,Pair 1 ,Dexamethasone ,Dose-Response Relationship ,Drug ,Female ,Humans ,Male ,Maximum Tolerated Dose ,Middle Aged ,Multiple Myeloma ,Neoplasm Recurrence ,Local ,Progression-Free Survival ,Thiadiazoles - Abstract
Filanesib is a first-in-class kinesin spindle protein inhibitor which demonstrated safety and encouraging activity in combination with bortezomib and dexamethasone in relapsed/refractory multiple myeloma in a preliminary analysis of dose-escalation phase results. This multicenter study included first a dose-escalation phase to determine maximum tolerated dose of two schedules of filanesib, bortezomib, and dexamethasone and a subsequent dose-expansion phase using the maximum tolerated doses. In the dose-expansion phase, 28 patients were evaluable for safety and efficacy. The most common grade ≥3 adverse events were neutropenia (21%) and anemia (18%), which were noncumulative and reversible, and hypertension (18%). The overall response rate was 43% with median duration of response not yet reached (range, 2.8-23.7+ months) with median follow-up of 6.3 months. A post hoc analysis incorporated 29 dose-escalation phase patients who received therapeutic filanesib doses, with an overall response rate of 39% and median duration of response of 18.0 months among the 57 total patients with median progression-free survival of 8.5 months. Notably, the PFS of high risk patients was comparable at 8.5 months, driven by the patients with 1q21 gain, characterized by increased MCL-1 expression, with a PFS of 9.1 months versus 3.5 months for the remainder of high risk patients. Patients with t(11;14) also had an encouraging PFS of 15.0 months. The combination of filanesib, bortezomib, and dexamethasone continues to show safety and encouraging activity in relapsed/refractory multiple myeloma, particularly in those patients with 1q21 gain and t(11;14).
- Published
- 2022