Dr. Shaji Kumar on the ENDURANCE Trial
What is the ENDURANCE trial?
The ENDURANCE (E1A11) phase III trial compares the combination of the drugs bortezomib, lenalidomide, and dexamethasone to see how well they work compared to carfilzomib, lenalidomide, and dexamethasone when treating patients with newly diagnosed multiple myeloma.
In this video:
Dr. Shaji Kumar (Mayo Clinic - Rochester, Minnesota) provides the results of the phase III ENDURANCE trial (E1A11). He explains that previous phase III trials proved that triple drug combinations (triplets) improved overall survival for newly diagnosed multiple myeloma patients as opposed to double drug combinations (doublets). For this reason, the ENDURANCE trial compared the efficacy and toxicity of two triplet drug regimens for newly diagnosed multiple myeloma patients who may or may have not undergone autologous stem cell transplant. The two triplet combinations that were compared were Kyprolis (carfilzomib), Revlimid (lenalidomide), and dexamethasone (KRd) versus Velcade (bortezomib), Revlimid (lenalidomide), and dexamethasone (VRd).
In phase II trials, bortezomib combined with lenalidomide and dexamethasone had a higher efficacy. The ENDURANCE trial, a randomized phase III study, also examined if KRd improves progression free survival (PFS) compared to VRd in NDMM (current results), and whether indefinite maintenance with lenalidomide improves overall survival compared with two-year maintenance.
The results:
The trial demonstrated that KRd did not improve PFS compared with VRd in NDMM. A significantly higher rate of cardiopulmonary and renal toxicity was observed with KRd, while neuropathy rates were higher with VRd.
Conclusion:
In conclusion, VRd remains the standard triplet induction regimen in standard- and intermediate-risk newly diagnosed multiple myeloma, and a suitable backbone for four-drug combinations.
Clinical trial information: NCT01863550
SHAJI K. KUMAR, MD
Dr. Shaji Kumar is the Medical Director for the Cancer Center Clinical Research Office at the Mayo Clinic Cancer Center in Rochester, Minnesota. Dr. Kumar holds membership in several professional organizations including the American Society of Hematology, American Society of Clinical Oncology, American Association for Cancer Research, American Society of Blood and Marrow Transplantation, the Association of Physicians of India, and the European Hematology Association. He has published numerous articles, abstracts, editorials, and letters in the peer-reviewed literature, including Blood, Journal of Clinical Oncology, Leukemia, American Journal of Hematology, British Journal of Haematology, and Bone Marrow Transplantation. Visit Dr. Shaji Kumar’s full biography.
