Elotuzumab in the treatment of patients with refractory and relapsed multiple myeloma Experience of the Lapino Clinical Hospital Oncohematology Department

Abstract

Despite the therapy advances, largely due to the study of molecular biology, multiple myeloma remains an incurable disease, and refractory course or relapses significantly worsen the prognosis. In this regard, the development of effective therapeutic agents with fundamentally new mechanisms of action that provide increased survival is currently an urgent task. One potential immunotherapeutic target is signaling lymphocyte activation molecules (SLAMs), and the anti-SLAMF7 monoclonal antibody elotuzumab is used in combination with either lenalidomide and dexamethasone (Elo-Rd regimen) after 1 prior line of therapy, or with pomalidomide and dexamethasone (Elo-Pd regimen) after 2 or more lines of therapy. The results of studies demonstrated a survival benefit in all subgroups of patients with refractory or relapsed multiple myeloma when using elotuzumab. A manageable safety profile and a low frequency of grade III–IV induced myelosuppression were noted, which allows the use of elotuzumab in combination with lenalidomide or pomalidomide and dexamethasone in elderly and debilitated patients. We present our own experience of using elotuzumab in the treatment of patients with refractory/recurrent multiple myeloma. A clinical case of a patient in whom treatment with elotuzumab was initiated at an early stage (after 1 line of previous therapy) is presented; the effectiveness and safety of using the monoclonal antibody are assessed. A significant improvement in the patient’s clinical condition and positive dynamics according to laboratory data were noted already during the 1st cycle of Elo-Rd regimen with a further progressive deepening of the antitumor response along with satisfactory tolerability and the absence of significant adverse events.