Multiple Myeloma

Atlanta, GA—Although chimeric antigen receptor (CAR) T-cell therapies directed against the CD19 protein garnered much attention at ASH 2017, CAR T-cells targeting B-cell maturation antigen (BCMA), a protein expressed nearly universally on multiple myeloma cells, were found to be remarkably effective in patients with heavily pretreated multiple myeloma.

Chicago, IL—In patients with newly diagnosed multiple myeloma, the addition of daratumumab to carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone (ie, the KRd regimen) is showing promise as a frontline treatment regimen. According to the results of an open-label, phase 1b study presented at ASCO 2017, induction therapy with the KRd regimen was well-tolerated, and the overall safety profile was consistent with previous reports for KRd, with no additional toxicity observed with the addition of daratumumab. Moreover, the study investigators reported that the regimen was very effective, with 100% overall response rate observed.

Chicago, IL—The era of immunotherapy in multiple myeloma is near. Two presentations at ASCO 2017 demonstrated that cellular therapy can steer immune reconstitution against multiple myeloma.

Orlando, FL—A conditioning regimen before autologous hematopoietic stem-cell transplant (HSCT) consisting of carfilzomib (Kyprolis) plus high-dose melphalan can help sustain post­transplant remission in patients with relapsed multiple myeloma who respond to transplant.

San Diego, CA—Nelfinavir (Viracept), a drug used for HIV, led to a surprisingly high response rate when added to bor­tezomib (Velcade) in patients with proteasome inhibitor–refractory multiple myeloma, according to a phase 2 study reported by Christoph Driessen, MD, myeloma specialist, Kantonsspital St. Gallen, Switzerland, at the 2016 American Society of Hematology meeting.

San Diego, CA—The addition of venetoclax (Venclexta) to bortezomib (Velcade) and dexamethasone yields high response rates in patients with relapsed or refractory multiple myeloma, especially in patients with disease that is not refractory to bortezomib and who received 1 to 3 previous lines of therapy, according to findings presented by Philippe Moreau, MD, Department of Hematology, Nantes University Hospital, France, at the 2016 American Society of Hematology meeting.

Interim results from a phase 1b study indicate that the investigational monoclonal antibody isatuximab, in combination with lenalidomide and dexamethasone, achieves responses in >50% of patients with relapsed or refractory multiple myeloma, including those with disease refractory to immunomodulatory drugs (IMiDs).

Adding the recently approved daratumumab (Darzalex), a human, CD38-directed monoclonal antibody, to a standard regimen of bortezomib (Velcade) and dexamethasone improved progression-free survival (PFS) by >60% compared with the standard regimen in patients with relapsed or refractory multiple myeloma, according to Antonio Palumbo, MD, Chief of the Multiple Myeloma Unit, University of Torino, Italy.