Accelerated elozutumab infusion safe for multiple myeloma
Accelerated administration of elotuzumab for multiple myeloma (MM) or relapsed/refractory MM (RRMM) is safe and produces no grade 3 or 4 infusion reactions (IRs), a phase 2 study shows.
Investigators involved 70 adults with active and newly diagnosed MM or RRMM (median age 67.5 years). Of these, 47 percent (n=33) had received prior treatments for MM, the most common of which was bortezomib (41 percent).
Infusion rate of the first dose of elotuzumab during cycle 1 was increased from 0.5 to 2 mL/min in the absence of IRs. Rates were increased from 3 to 4 mL/min during dose 2 and to mL/min for all succeeding doses. Of all infusions, 87 percent (n=968) were delivered at the maximum rate of 5 mL/min.
There were no reported cases of the primary outcome of grade 3 or 4 IRs by the end of cycle 2. Only two IRs were reported, both of which manifested during the 2 mL/min infusion rate. One patient experienced a nonspecific grade 2 infusion-related reaction, while the other had a grade 1 pyrexia.
Infusion was interrupted only in the case of the grade 2 IR but was resumed after resolution. No treatments were discontinued due to IRs.
The most common adverse event (AE) was infection which was observed in 60 percent (n=42) of the participants. This was followed by fatigue (50 percent; n=35) and diarrhoea (31 percent; n=22). Eight cases of grade 4 AEs were reported and 13 patients discontinued treatment because of AEs.
A total of 27 patients experienced severe AEs, the most common of which were pneumonia and atrial fibrillation which were observed in three patients each. There was a total of five deaths caused by disease progression, fatal bleeding, respiratory failure and ischaemic bowel syndrome.