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Iberdomide + dexamethasone in R/R multiple myeloma

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Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD, University College London Hospitals, London, UK, presents the results of a study evaluating iberdomide, a cereblon E3 ligase modulator (CELMoD) agent, in combination with dexamethasone in patients with triple-class refractory multiple myeloma or in patients who have been exposed to an anti-BCMA agent (NCT02773030). The overall response rate (ORR) reached 30% in both patient groups and the median progression-free survival (PFS) was three months. Dr Popat explains that in contrast to pomalidomide and lenalidomide, iberdomide is associated with significantly lower rates of non-hematological toxicity. In the future, iberdomide will be evaluated in combination with proteasome inhibitors, monoclonal antibodies and as a maintenance strategy post-transplantation. This interview took place at the 62nd Annual Scientific Meeting of the British Society for Haematology (BSH) 2022, in Manchester, UK.

Cc220 also known as iberdamide is a new immunomodulatory or cell mod agent essentially this compound targets cerebellon which leads to the degradation of ecoros and ileos via the protozoan this in itself leads to myelin cell death and immune modulatory effects such as t cell and nk cell activity we’ve previously reported the first in human study of viberdomide

And dexmethazone and what we’re reporting now are the expansion cohorts cohort d which is for patients who are triple class refactors so they are refracted to a protozoan inhibitor an immunomodulatory agent and a monoclonal cd38 antibody and the next cohort cohort eye which is ahead difficult to treat population of patients who’ve been exposed to a prior bcma

Agent and i would say that actually we have very little data on how patients have been exposed to bcma agent performed so this is the purpose of performing this study so patients received iberomide at a dose of 1.6 milligrams for three weeks on followed by one week off with dexamethasone weekly until disease progression or intolerance the overall response rate

For cohort d was approximately 30 percent and a similar sort of result was seen in cohort eye what we do see is our patients do deepen their responses as time goes on and unfortunately on some of this on this study we lost some of our patients through covid19 and therefore they weren’t able to deepen their response the median progression free survival data is

Approximately three months and the overall survival data is is not yet reached but when we look at the medium progression free survival for those responders they actually perform really well so again this is giving an indication that despite this being a heavily pretreated population triple class refractory many patients penta refraction i should add that the

Majority of patients were refractory to lenolidomide or pomalidomide to get activity of a doublet i think is meaningful and impressive in terms of the tolerability profile one of the key things about iberdamide is that it’s only present um as a pure form and what we find with the thalidomide and lenolidomide is that is that different enantiomers break up of that

Compound which leads to the sedative effects we don’t see that with iberomides when you look at the toxicity profile there is some hemological toxicity as we would expect but the non-hemogeological toxicity is very low there are hardly any great three or four events so overall i think iberomide and dexamethasone is a very well tolerated anti-myeloma drug it has

Activity as a doublet in the heart to treat triple class refractory populations and the post-bcma um patients and i’m really looking forward to the future studies which will be combinations with protozoan inhibitors monoclonal antibodies targeting cd38 and also as you say as a maintenance agent for post stem cell transplant

Transcribed from video
Iberdomide + dexamethasone in R/R multiple myeloma By VJHemOnc – Video Journal of Hematological Oncology