Dose-escalation study of tabalumab with bortezomib and dexamethasone in Japanese patients with multiple myeloma

Abstract

B-cell activating factor (BAFF) promotes the survival and adhesion of multiple myeloma (MM) cells. Tabalumab (LY2127399) is an anti-BAFF monoclonal antibody. This phase 1, multicenter, open-label, nonrandomized, dose-escalation study evaluated the safety, tolerability, pharmacokinetics, pharmacodynamics, and efficacy of tabalumab in combination with bortezomib and dexamethasone in Japanese patients with relapsed or refractory MM (RRMM). Sixteen patients received intravenous (IV) tabalumab 100 mg (Cohort 1, n=4) or IV tabalumab 300 mg (Cohort 2, n=12) in combination with oral dexamethasone 20 mg/day and IV or subcutaneous (SC) bortezomib 1.3 mg/m². All patients had treatment-emergent adverse events (TEAEs) possibly related to study treatment; the most common TEAEs were thrombocytopenia (81.3%), lymphopenia (43.8%), and increased alanine aminotransferase (43.8%). Two (20.0%) dose-limiting toxicities were observed, both in Cohort 2 (tabalumab 300 mg), which was below the predefined cutoff for tolerability (< 33%). The pharmacokinetics of tabalumab were similar when bortezomib was coadministered IV vs SC. The overall response rate was 56.3%, suggesting that the combined treatment was effective. In conclusion, combined treatment with these 3 agents was well tolerated in this population of Japanese patients with RRMM. The study was registered at http://ift.tt/PmpYKN (NCT01556438).

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