CLO20-062: Comparative Efficacy of Elotozumab With Panobinostat and Ixazomib in Multiple Myeloma; A Meta-Analysis

Background: Multiple Myeloma(MM) has a variable response rate to different chemotherapies. We sought to determine Elotuzumab efficacy by assessing 50%, 90%, and 100% decrease in the M protein levels termed as partial response (PR), very good partial response (VGPR), and complete response (CR) respectively, in MM patients. Methods: A comprehensive literature search on MedLine and Cochrane databases identified five relevant clinical trials (984 patients). The response rate was analyzed on a fixed-effect model using an unadjusted odds ratio (OR) on RevMan 5.3. Results: Elotuzumab was associated with a net 58% higher odds to achieve VGPR against panobinostat and Ixazomib combined (OR 2.39, 95% CI 1.83-3.13, p<0.01). (Figure 1) Compared to panobinostat, Elotozumab had a 66% higher chance to achieve VGPR (OR 2.87, 95% CI 2.09-3.95, p <0.01). Subgroup analysis of three studies comprising of 245 patients showed that Elotozumab had a 32% higher but non-significant VGPR rate compared to Ixazomib alone (OR 1.47, 95% CI 0.88-2.45, p=0.14). Elotuzumab was also shown to achieve significantly higher rates of partial response (PR) (OR 1.33, 95% CI 1.03-1.71, p=0.03) compared to other medications. (Figure 2) However, the complete response rates were significantly lower in Elotuzumab compared to other medications (OR 0.29, 95% CI 0.19-0.45, p=<0.00001). (Figure 3) Conclusion: Elotuzumab is associated with a substantially higher rate of achieving VGPR and PR rates. However, the complete response rate was 70% lower compared to Panobinostat and Ixazomib.

Figure 1
Figure 1

Odds ratio of VGPR rates between Elotuzumab and Other multiple myeloma medications.

Citation: Journal of the National Comprehensive Cancer Network J Natl Compr Canc Netw 18, 3.5; 10.6004/jnccn.2019.7495

Figure 2
Figure 2

Odds ratio of PR rates between Elotuzumab and Other multiple myeloma medications.

Citation: Journal of the National Comprehensive Cancer Network J Natl Compr Canc Netw 18, 3.5; 10.6004/jnccn.2019.7495

Figure 3
Figure 3

Odds ratio of CR rates between Elotuzumab and Other multiple myeloma medications.

Citation: Journal of the National Comprehensive Cancer Network J Natl Compr Canc Netw 18, 3.5; 10.6004/jnccn.2019.7495

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Corresponding Author: Nishanth Thalambedu, MD
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    Odds ratio of VGPR rates between Elotuzumab and Other multiple myeloma medications.

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    Odds ratio of PR rates between Elotuzumab and Other multiple myeloma medications.

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    Odds ratio of CR rates between Elotuzumab and Other multiple myeloma medications.

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