LocoMMotion: a prospective, non-interventional, multinational study of real-life current standards of care in patients with relapsed and/or refractory multiple myeloma

• Published in: Leukemia Vol. 36; no. 5; pp. 1371 - 1376
• Main Authors: Mateos, Maria-Victoria, Weisel, Katja, De Stefano, Valerio, Goldschmidt, Hartmut, Delforge, Michel, Mohty, Mohamad, Cavo, Michele, Vij, Ravi, Lindsey-Hill, Joanne, Dytfeld, Dominik, Angelucci, Emanuele, Perrot, Aurore, Benjamin, Reuben, van de Donk, Niels W C J, Ocio, Enrique M, Scheid, Christof, Gay, Francesca, Roeloffzen, Wilfried, Rodriguez-Otero, Paula, Broijl, Annemiek, Potamianou, Anna, Sakabedoyan, Caline, Semerjian, Maria, Keim, Sofia, Strulev, Vadim, Schecter, Jordan M, Vogel, Martin, Wapenaar, Robert, Nesheiwat, Tonia, San-Miguel, Jesus, Sonneveld, Pieter, Einsele, Hermann, Moreau, Philippe
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.05.2022; Nature Publishing Group UK
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; CD38 antigen; Dexamethasone - therapeutic use; Humans; Immunomodulation; Monoclonal antibodies; Multiple myeloma; Multiple Myeloma - drug therapy; Patients; Prospective Studies; Proteasome inhibitors; Proteasome Inhibitors - therapeutic use; Standard of Care; Survival
• ISSN: 0887-6924; 1476-5551; 1476-5551
• DOI: 10.1038/s41375-022-01531-2

Despite treatment advances, patients with multiple myeloma (MM) often progress through standard drug classes including proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and anti-CD38 monoclonal antibodies (mAbs). LocoMMotion (ClinicalTrials.gov identifier: NCT04035226) is the first prospective study of real-life standard of care (SOC) in triple-class exposed (received at least a PI, IMiD, and anti-CD38 mAb) patients with relapsed/refractory MM (RRMM). Patients (N = 248; ECOG performance status of 0-1, ≥3 prior lines of therapy or double refractory to a PI and IMiD) were treated with median 4.0 (range, 1-20) cycles of SOC therapy. Overall response rate was 29.8% (95% CI: 24.2-36.0). Median progression-free survival (PFS) and median overall survival (OS) were 4.6 (95% CI: 3.9-5.6) and 12.4 months (95% CI: 10.3-NE). Treatment-emergent adverse events (TEAEs) were reported in 83.5% of patients (52.8% grade 3/4). Altogether, 107 deaths occurred, due to progressive disease (n = 74), TEAEs (n = 19), and other reasons (n = 14). The 92 varied regimens utilized demonstrate a lack of clear SOC for heavily pretreated, triple-class exposed patients with RRMM in real-world practice and result in poor outcomes. This supports a need for new treatments with novel mechanisms of action.