MyDrug Platform Trial Addresses Mutation Challenges to Multiple Myeloma Clinical Trial Enrollment

John Theurer Cancer Center study measures efficacy and safety of daratumumab, ixazomib, pomalidomide, and dexamethasone in patients with functionally high-risk multiple myeloma

To overcome the challenges of multiple mutations and increased mutations’ frequency with disease progression, and better understand the role of novel therapies in precision medicine, the MMRF launched MyDRUG, a platform trial of patients with select actionable genetic mutations.

• The trial measured the efficacy and safety of daratumumab, ixazomib, pomalidomide, and dexamethasone in patients with functionally high-risk multiple myeloma.
• Through different subprotocols, patients received targeted agents or immunotherapy/novel agents in combination with a backbone regimen of ixazomib, pomalidomide, and dexamethasone (IPd).
• Patients who received daratumumab plus IPd exhibited significant efficacy and a manageable AE profile.

Many different mutations occur in multiple myeloma, and mutation frequency increases with disease progression and relapse, making it difficult to determine dominant genetic abnormalities and assess their relevance to a particular patient. In addition, a substantial subset of patients appear to lack actionable mutations or have low allelic burden, making recruitment to clinical trials studying one specific mutation operationally difficult.

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