Multiple Myeloma

Atlanta, GA—A recent analysis of US administrative claims data showed that stem-cell transplantation (SCT) is associated with increased healthcare resource utilization and costs compared with matched controls. According to data presented at 2017 ASH, patients who underwent SCT had, on average, >$114,000 increase in healthcare costs compared with age-, sex-, and comorbidity-matched patients with multiple myeloma who did not undergo SCT.

Multiple myeloma is a cancer of plasma cells in the bone marrow that often leads to bone destruction and bone marrow failure. According to the American Cancer Society, more than 30,280 new cases of multiple myeloma will be diagnosed in 2017, and 12,590 deaths will be attributed to the disease. In the past 20 years, mortality rates associated with multiple myeloma have declined. Novel therapies, as well as improvements in autologous hematopoietic stem-cell transplantation (HSCT) procedures and supportive care, have contributed to extended survival for patients with this malignancy.

Atlanta, GA—Single-agent daratum­umab (Darzalex) shows significant activity in smoldering multiple myeloma (SMM). The 12-month progression-free survival (PFS) rate with a long dosing schedule of daratumumab was 95%, and the median PFS was not yet reached in any of the 3 dosing schedules studied, announced Craig C. Hofmeister, MD, MPH, Associate Professor, Division of Hematology, the Ohio State University, Columbus, at ASH 2017.

Atlanta, GA—A maintenance regimen of lenalidomide (Revlimid) and elotuzumab (Empliciti) after autologous stem-cell transplant (ASCT) improved the quality of responses achieved with induction therapy in patients with multiple myeloma.

Atlanta, GA—A recent analysis of a commercial claims database suggests that oral therapy for multiple myeloma may help decrease the economic burden for patients and healthcare systems. According to data presented at ASH 2017, patients with multiple myeloma who received injectable therapy used significantly more disability benefits and incurred higher productivity costs than patients who received oral medications.

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.