BMS and AbbVie's elotuzumab could be game changer in myeloma

A phase III trial of Bristol-Myers Squibb's (BMS) and AbbVie's multiple myeloma therapy elotuzumab has been flagged by the American Society of Clinical Oncology (ASCO) as a highlight of its annual meeting later this week.

The 646-patient ELOQUENT-2 study showed that adding elotuzumab to the conventional myeloma therapies Revlimid (lenalidomide) from Celgene and dexamethasone extended the duration of remissions by around 4.5 months on average.

BMS and AbbVie's drug also reduced the risk of disease progression by 30 per cent, and it seemed equally effective in patients with a genetic profile that made them less likely to respond to conventional small-molecule therapies.

"This study is an innovative approach – one that combines the precision of a targeted, immune-based therapy with traditional myeloma therapy," commented ASCO President-Elect Julie Vose.

"The results are very encouraging, giving renewed hope to patients who have relapsed," she added, telling Reuters that BMS and AbbVie's drug could potentially be "practice-changing" and that the data put elotuzumab on course for approval.

The results suggest elotuzumab could be able to piggy-back on the extraordinary success of Revlimid, which achieved sales of just under $5 billion last year and is comfortably leading the myeloma market.

Elotuzumab binds to a cell surface protein, called SLAMF7, which is found on myeloma cells and on a type of immune cell known as the natural killer (NK) cell. It is thought that elotuzumab mounts a dual attack on cancer by targeting myeloma cells directly and by enhancing the NK cells' ability to kill them.

The antibody was awarded breakthrough therapy status by the US FDA last year for use alongside Revlimid and dexamethasone in multiple myeloma patients who have received one or more prior therapies.

The lead investigator in ELOQUENT-2, Sagar Lonial of Emory University's Winship Cancer Institute, said the study should be able to provide a view on whether adding elotuzumab to the standard treatment regimen will boost overall survival after another few months.

With increasing concern about the costs of cancer therapy, BMS and AbbVie will need to show a positive impact on survival in order to justify the increased cost of adding elotuzumab to Revlimid therapy, which costs upwards of $160,000 a year.

"Revlimid is already an expensive drug, and the financial cost of adding elotuzumab, an antibody, on top of it could become as prominent an issue as the results themselves," said EP Vantage in a commentary on the data.

Elotuzumab is one of three cancer candidates in late-stage development at AbbVie, along with ABT-199 for chronic lymphocytic leukaemia (CLL) and veliparib for BRCA-deficient breast cancer and non-small cell lung cancer (NSCLC).