Dr. Kumar on Treatment Discontinuation in the ENDURANCE Myeloma Trial

Shaji K. Kumar, MD, a consultant in the Division of Hematology and a professor of medicine with Mayo Clinic, discusses treatment discontinuation in the phase 3 ENDURANCE trial in newly diagnosed multiple myeloma.

The ENDURANCE trial saw quite a few early discontinuations of treatment, says Kumar. Patients went off of therapy without completing the full 9 to 12 cycles of bortezomib (Velcade) plus lenalidomide (Revlimid) and dexamethasone (Ozurdex; VRd) or carfilzomib (Kyprolis) plus lenalidomide and dexamethasone (KRd).

Only 43.3% of patients who received VRd and 61.6% of those who received KRd completed all cycles of treatment as planned; this was because of several reasons, including patient withdrawal/refusal or switching to an alternative therapy, such as stem cell transplant, adds Kumar.

Even though the trial was intended for patients who were not going to an early transplant, 28.0% of patients on the VRd arm and 26.8% on the KRd arm received a stem cell transplant either before they completed induction therapy or soon after completing induction therapy, concludes Kumar.