Researchers from the LocoMMotion study examined real-world clinical practice treatments for patients with relapsed/refractory multiple myeloma (RRMM) exposed to proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies. This prospective, observational study across Europe and the United States revealed a lack of standardized treatment, with patients undergoing 91 unique regimens during their initial line of therapy. Outcomes showed a low response rate (31.9%), short progression-free survival of 4.6 months, and median overall survival of 13.8 months. Deeper responses (≥VGPR) correlated with better outcomes, but only 10% achieved this level. Adverse events, particularly hematologic toxicities, were common, and over 60% of patients died, mainly from disease progression.

The study highlights the difficulties in managing triple-class exposed patients with RRMM, with brief remissions and limited treatment effectiveness. The absence of a comparator group and lack of novel therapies approved after 2020 emphasize the need for innovation. Emerging options, including chimeric antigen receptor T-cell therapies and bispecific antibodies, offer hope for improved outcomes. LocoMMotion serves as a critical benchmark for assessing these new treatments and addressing the unmet needs in this challenging patient population. 

Reference: Mateos MV, Weisel K, De Stefano V, et al. LocoMMotion: a study of real-life current standards of care in triple-class exposed patients with relapsed/refractory multiple myeloma – 2-year follow-up (final analysis). Leukemia. 2024;38(12):2554-2560. doi:10.1038/s41375-024-02404-6