P-087: Real world efficacy and safety of venetoclax in t(11;14) multiple myeloma in Hungary

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2021-10, Vol.21, p.S86-S87
• Main Authors: Szita, Virág, Mikala, Gábor, Kozma, András, Fábián, János, Hardi, Apor, Alizadeh, Hussain, Rajnics, Péter, Váróczy, László, Rejtő, László, Szendrei, Tamás, Illés, Árpád, Vályi-Nagy, István, Masszi, Tamás, Varga, Gergely
• Format: Article
• Language: English
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(21)02221-7

Despite therapeutic advances, multiple myeloma remains incurable. Venetoclax, a selective bcl-2 inhibitor may be a step toward personalised therapy for t(11;14) patients, but questions remain about its optimal use. We retrospectively evaluated hematologic response, survival and safety after venetoclax treatment in t(11;14) myeloma patients in Hungary. Overall, 49 patients from seven clinical centers were reported. We divided patients into two groups based on the clinical setting: 32 relapsed/refractory patients, who received venetoclax after multiple lines of therapy, often in an ultimate effort; and 17 frontline patients, who achieved unsatisfactory response to standard first line therapy and were treated with venetoclax as reinduction before intended ASCT. We observed remarkably good hematological response rates (ORR): 94% in the relapsed/refractory group and 100% in the frontline setting. This translated into a median PFS of 9.6 months and a median OS of 14.6 months in the relapsed group; median PFS and OS were not reached in the reinduction group. Known adverse prognostic factors, such as 17p deletion, kidney failure or 1q21 amplification did not convey significantly worse prognosis in our study. Almost one third of patients had impaired kidney function during venetoclax therapy, including three patients requiring dialysis. Clinically relevant improvement was observed in 42% of these patients; dialysis could be stopped in all three cases. Notably, our study also included six plasma cell leukemia patients, with a remarkable median PFS of 10 months and over one year median OS in relapsed disease. Vulnerable patients with PCL, renal failure or refractory disease reported more adverse events, requiring supportive measures or dose adjustment, but cessation of venetoclax therapy did not become necessary. Venetoclax therapy is a promising option with few side effects and very good response rates for t(11;14) patients, both in the frontline and in the relapsed setting