title: Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma.
abstract: BACKGROUND
  Elotuzumab, an immunostimulatory monoclonal antibody targeting signaling lymphocytic activation molecule F7 (SLAMF7), showed activity in combination with lenalidomide and dexamethasone in a phase 1b-2 study in patients with relapsed or refractory multiple myeloma.
  
  
  METHODS
  In this phase 3 study, we randomly assigned patients to receive either elotuzumab plus lenalidomide and dexamethasone (elotuzumab group) or lenalidomide and dexamethasone alone (control group). Coprimary end points were progression-free survival and the overall response rate. Final results for the coprimary end points are reported on the basis of a planned interim analysis of progression-free survival.
  
  
  RESULTS
  Overall, 321 patients were assigned to the elotuzumab group and 325 to the control group. After a median follow-up of 24.5 months, the rate of progression-free survival at 1 year in the elotuzumab group was 68%, as compared with 57% in the control group; at 2 years, the rates were 41% and 27%, respectively. Median progression-free survival in the elotuzumab group was 19.4 months, versus 14.9 months in the control group (hazard ratio for progression or death in the elotuzumab group, 0.70; 95% confidence interval, 0.57 to 0.85; P<0.001). The overall response rate in the elotuzumab group was 79%, versus 66% in the control group (P<0.001). Common grade 3 or 4 adverse events in the two groups were lymphocytopenia, neutropenia, fatigue, and pneumonia. Infusion reactions occurred in 33 patients (10%) in the elotuzumab group and were grade 1 or 2 in 29 patients.
  
  
  CONCLUSIONS
  Patients with relapsed or refractory multiple myeloma who received a combination of elotuzumab, lenalidomide, and dexamethasone had a significant relative reduction of 30% in the risk of disease progression or death. (Funded by Bristol-Myers Squibb and AbbVie Biotherapeutics; ELOQUENT-2 ClinicalTrials.gov number, NCT01239797.).
authors.affiliation: From Winship Cancer Institute, Emory University School of Medicine, Atlanta (S.L.); National and Kapodistrian University of Athens, Athens (M.D.); A.O.U. San Giovanni Battista di Torino-Ospedale Molinette, Turin, Italy (A.P.); QEII Health Science Center and Dalhousie University, Halifax, NS (D.W.), Cross Cancer Institute and University of Alberta, Edmonton (A.B.), and Princess Margaret Cancer Centre, Toronto (D.R.) - all in Canada; Silesian Medical University, Katowice (S.G.), and Medical University of Lublin, Lublin (A.W.-C.) - both in Poland; Charles University Hospital, Prague, Czech Republic (I.S.); University Hospital, Nantes, France (P.M.); Complejo Asistencial Universitario de Salamanca-Instituto de Investigación Biomédica de Salamanca, Salamanca (M.-V.M.), and Clinica Universidad de Navarra-Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, Pamplona (J.S.-M.) - both in Spain; Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, and Tel Aviv University, Ramat Aviv - both in Israel (H.M.); Ankara University, Ankara, Turkey (M.B.); Alfred Health-Monash University, Melbourne, VIC, Australia (A. Spencer); Barts and the London NHS Trust, London (H.O.); University of Texas M.D. Anderson Cancer Center, Houston (R.Z.O.); Kyoto Prefectural University of Medicine, Kyoto (M.T.), and Nishigunma National Hospital, Shibukawa (M.M.) - both in Japan; Universitätsklinikum der Technische Universität, Dresden (C.R.), and Universitätsklinikum Würzburg, Würzburg (H.E.) - both in Germany; Zeikenhuis Netwerk Antwerpen (ZNA) Stuivenberg, Antwerp, Belgium (K.L.W.); AbbVie Biotherapeutics, Redwood City, CA (A. Singhal); Bristol-Myers Squibb, Princeton, NJ (J.K.), Wallingford, CT (E.B.), and Braine-l'Alleud, Belgium (V.P.); and Dana-Farber Cancer Institute, Boston (K.C.A., P.R.).
authors.forename: Sagar
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authors.lastname: Lonial
authors.forename: Meletios
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authors.lastname: Dimopoulos
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authors.lastname: Palumbo
authors.forename: Darrell
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authors.lastname: White
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authors.lastname: Grosicki
authors.forename: Ivan
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authors.lastname: Spicka
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authors.forename: Philippe
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authors.lastname: Moreau
authors.forename: Maria-Victoria
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authors.forename: Hila
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authors.lastname: Magen
authors.forename: Andrew
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authors.lastname: Belch
authors.forename: Donna
authors.initials: D
authors.lastname: Reece
authors.forename: Meral
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authors.lastname: Beksac
authors.forename: Andrew
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authors.lastname: Spencer
authors.forename: Heather
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authors.lastname: Oakervee
authors.forename: Robert Z
authors.initials: RZ
authors.lastname: Orlowski
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authors.lastname: Taniwaki
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authors.lastname: Röllig
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authors.lastname: Einsele
authors.forename: Ka Lung
authors.initials: KL
authors.lastname: Wu
authors.forename: Anil
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authors.lastname: Singhal
authors.forename: Jesus
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authors.lastname: San-Miguel
authors.forename: Morio
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authors.lastname: Matsumoto
authors.forename: Jessica
authors.initials: J
authors.lastname: Katz
authors.forename: Eric
authors.initials: E
authors.lastname: Bleickardt
authors.forename: Valerie
authors.initials: V
authors.lastname: Poulart
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Anderson
authors.forename: Paul
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authors.lastname: Richardson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D018572:Disease-Free Survival; D006801:Humans; D000077269:Lenalidomide; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D011971:Receptors, Immunologic / Q000037:antagonists & inhibitors*; D012008:Recurrence; D000071176:Signaling Lymphocytic Activation Molecule Family; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D011971:Receptors, Immunologic; C448987:SLAMF7 protein, human; D000071176:Signaling Lymphocytic Activation Molecule Family; C546027:elotuzumab; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide