Because most multiple myeloma patients are 65 or older, including some who are frail, successive lines of therapy to address relapsed disease often take their toll — so keeping patients in deep remission after frontline treatment is highly desirable. Clinical trials of the immunomodulatory drug iberdomide — which works by both killing tumor cells directly and stimulating the immune system — have demonstrated that when it is combined with the steroid dexamethasone, it can trigger responses even in patients with disease that is heavily refractory to other treatments, including immunomodulatory drugs, proteasome inhibitors and monoclonal antibodies.
Roswell Park Comprehensive Cancer Center is one of only two sites in the country offering a new approach to an application of iberdomide with a phase 2 clinical trial to determine the feasibility, safety and efficacy of iberdomide maintenance therapy after autologous stem cell transplant (ASCT) in patients with multiple myeloma. Results of the single-arm study will inform the feasibility of a phase 3 study comparing the efficacy of maintenance therapy with iberdomide vs. lenalidomide (brand name Revlimid), the current standard of care, after ASCT. “We expect that iberdomide is more effective than lenalidomide, and on top of that, potentially even better tolerated, based on prior experience,” says Jens Hillengass MD, PhD, Chief of Myeloma and site principal investigator for the clinical trial at Roswell Park.
“Iberdomide Maintenance Therapy in Patients with Multiple Myeloma” (NCT05177536) will enroll 38 patients. The clinical trial is sponsored by the University of Nebraska, where patients are also being enrolled by Sarah Holstein, MD, PhD, Professor of Oncology and Hematology, who designed the trial and wrote the protocol.
Following ASCT, participants will receive 1.0 mg iberdomide, taken orally, for 21 consecutive days in a 28-day cycle. Treatment will continue until disease progression or toxicity.
“Iberdomide has the potential to become a new standard-of-care maintenance therapy in multiple myeloma,” says Dr. Hillengass.