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Efficacy of elotuzumab for multiple myeloma deteriorates after daratumumab: a multicenter retrospective study

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Abstract

Elotuzumab-based regimens are sometimes selected for multiple myeloma treatment after daratumumab-based regimens. However, there has been insufficient discussion on the efficacy of elotuzumab after daratumumab. We used Kansai Myeloma Forum registration data in a multicenter retrospective evaluation of the efficacy of elotuzumab after daratumumab. Overall survival (OS) rate and time to next treatment (TTNT) were significantly worse in the cohort given elotuzumab after daratumumab (Dara cohort, n = 47) than in the cohort with no history of daratumumab administration before elotuzumab (No-Dara cohort, n = 80, OS: P = 0.03; TTNT: P = 0.02; best response: P < 0.01). In the Dara cohort, OS and TTNT rates were worse with sequential elotuzumab use after daratumumab than with non-sequential (OS: P = 0.02; TTNT: P = 0.03). In patients given elotuzumab < 180 days after daratumumab, OS (P = 0.08) and best response (P = 0.21) tended to be worse, and TTNT was significantly worse (P = 0.01), than in those given elotuzumab after ≥ 180 days. These findings were confirmed by subgroup analyses and multivariate analyses. Monoclonal-antibody-free treatment might be preferable after daratumumab-based regimens. If possible, elotuzumab-based regimens should be considered only ≥ 180 days after daratumumab use.

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Data availability

The data of this study are available from the first and corresponding author, NN, upon reasonable request.

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Acknowledgements

We thank the staff of KMF for their dedicated support

Funding

This study was supported by Management Expenses Grants from the Shinko Hospital Hematologic Disease Center.

Author information

Authors and Affiliations

  1. Department of Hematology, Shinko Hospital, 1-4-47, Wakihamacho, Chuo-Ku, Kobe, Hyogo, 651-0072, Japan

    Naokazu Nakamura & Nobuyoshi Arima

  2. Department of Hematology and Oncology Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Naokazu Nakamura, Junya Kanda & Akifumi Takaori-Kondo

  3. Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

    Teruhito Takakuwa & Masayuki Hino

  4. Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan

    Satoshi Yoshioka & Kazunori Imada

  5. Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan

    Kentaro Fukushima & Naoki Hosen

  6. First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan

    Masaaki Hotta & Tomoki Ito

  7. Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan

    Shin-ichi Fuchida & Chihiro Shimazaki

  8. Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan

    Nobuhiko Uoshima

  9. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Yuji Shimura & Junya Kuroda

  10. Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osakasayama, Japan

    Hirokazu Tanaka & Itaru Matsumura

  11. Hematology Ohta Clinic, Shinsaibashi, Japan

    Kensuke Ohta

  12. Department of Internal Medicine (Hematology), Toyonaka Municipal Hospital, Toyonaka, Japan

    Satoru Kosugi

  13. Department of Hematology and Oncology, Nara Prefecture General Medical Center, Nara, Japan

    Hideo Yagi

  14. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Satoshi Yoshihara

  15. Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Nakatsu, Japan

    Ryosuke Yamamura

  16. Department of Internal Medicine, JCHO Kobe Central Hospital, Kobe, Japan

    Yoko Adachi

  17. Department of Hematology, Kindai University Nara Hospital, Nara, Japan

    Hitoshi Hanamoto

  18. Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan

    Hirohiko Shibayama

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  1. Naokazu Nakamura
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the Kansai Myeloma Forum

Contributions

NN designed the research. NN organized the project. NN performed the statistical analysis. The remaining authors, NA, TT, SY, KI, KF, MH, SF, JK, NU, YS, HT, KO, SK, HY, SY, RY, YA, HH, HS, NH, TI, CS, ATK, JK, IM, and MH, interpreted the data. NN wrote the first draft. All other authors critically reviewed the draft and approved the final version of the manuscript.

Corresponding author

Correspondence to Naokazu Nakamura.

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Ethical Approval

The study was conducted in accordance with the Declaration of Helsinki and was approved by the ethics committee of the KMF and Shinko Hospital.

Competing interests

TT received honoraria from Sanofi K.K. and Janssen Pharmaceutical K.K. and grants from Bristol-Myers Squibb Co., Incyte Biosciences Japan G.K., GSK Corp. and Pfizer Japan Inc. SF received personal fees from Takeda Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K. and Sanofi K.K. JK received honoraria from Bristol-Myers Squibb Co., Janssen Pharmaceutical K.K., Takeda Pharmaceutical Co., Ltd., Sanofi K.K. and Ono Pharmaceutical Co., Ltd. and is in advisory roles at Janssen Pharmaceutical K.K, and Novartis Pharma K.K. NU received honoraria from Nippon Shinyaku Co., Ltd., Bristol-Myers Squibb Co. and Janssen Pharmaceutical K.K. KO received an honorarium from Takeda Pharmaceutical Co., Ltd. SY received honoraria from Janssen Pharmaceutical K.K. and Bristol-Myers Squibb Co. HH received honoraria from CLS Behring K.K. and Takeda Pharmaceutical Co., Ltd. HS received honoraria from Takeda Pharmaceutical Co., Ltd., Fujimoto Pharmaceutical Corp., Eisai Co., Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Ono Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Sanofi K.K., AbbVie G.K. and Novartis Pharma K.K., as well as grants from Bristol-Myers Squibb Co., Ono Pharmaceutical Co., Ltd. and AbbVie G.K. NH received personal fees from Otsuka Pharmaceutical K.K. and Chugai Pharmaceutical Co., Ltd. and grants from Chugai Pharmaceutical Co., Ltd., Teijin Pharma Corp., Kyowa Kirin Co., Eisai Co., Ltd., Ono Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd., AbbVie G.K., Shionogi Pharma and Asahi Kasei Pharma Corp. TI received honoraria from Bristol-Myers Squibb Co., CSL Behring, Janssen Pharmaceutical, Novartis Pharma, Takeda Pharmaceutical Co and AbbVie G.K. CS received honoraria from Janssen Pharmaceutical K.K., Bristol-Myers Squibb Co. and Sanofi K.K. AT-K received honoraria from Nippon Shinyaku Co., Ltd., Bristol-Myers Squibb Co., Janssen Pharmaceutical K.K., Otsuka Pharmaceutical K.K. and Megakaryon Corp., as well as personal fees from Ono Pharmaceutical Co., Ltd., COGNOA Corp., and PharmaEssentia Corp. JK is a consultant for Janssen Pharmaceutical, Pfizer, AbbVie and Bristol Myers Squibb; has received research funding from Kyowa Kirin, Chugai Pharmaceutical, Asahi Kasei, Sumitomo Pharma, Otsuka Pharmaceutical, Mochida Pharmaceutical and the Japan Blood Products Organization; and has received honoraria from Janssen Pharmaceutical, Kyowa Kirin, Chugai Pharmaceutical, Ono Pharmaceutical Co., Ltd. , Sanofi. K.K., Astra Zeneca. K.K., Astellas. K.K., Eisai Co. Ltd., AbbVie G.K., Novartis, Daiichi Sankyo, Amgen, Otsuka Pharmaceutical and BMS. IM received honoraria from AstraZeneca K.K., AbbVie G.K., Otsuka Pharmaceutical K.K., Novartis Pharma K.K., Pfizer Japan Inc., Janssen Pharmaceutical K.K., Ono Pharmaceutical Co., Ltd. and Bristol-Myers Squibb Co., as well as grants from Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Taiho Pharmaceutical, AbbVie GK., Otsuka Pharmaceutical K.K., Asahi Kasei Pharma Corporation, Sumitomo Pharma Co., Ltd. and Kyowa Kirin Co. MH received honoraria from Novartis Pharma K.K., Bristol-Myers Squibb Co., Otsuka Pharmaceutical K.K. and Kyowa Kirin Co.; personal fees from LabCorp Drug Development Japan Co., Ltd.; and grants from Otsuka Pharmaceutical K.K., Kyowa Kirin Co., Sekisui Medical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd. and Taiho Pharmaceutical. The other authors have no conflicts of interest.

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Nakamura, N., Arima, N., Takakuwa, T. et al. Efficacy of elotuzumab for multiple myeloma deteriorates after daratumumab: a multicenter retrospective study. Ann Hematol (2024). https://doi.org/10.1007/s00277-024-05705-z

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