Medical Roundtable: New Multiple Myeloma Treatments
Dr. Lonial: Yes, daratumumab is a different target than elotuzumab, so it's targeting CD38. We know that CD38 is ubiquitously expressed on plasma cells. We showed at ASCO and EHA this year that in a refractory myeloma patient population—median of five prior lines of therapy—we got single agent activity with daratumumab. About 30% of patients had a response.7
Again, you're right, it's very exciting to have completely new mechanisms of action and drugs. These are patients who really have very few—if any—options left over. They were all double refractory, most of them were triple refractory. The ones that weren't quadruple refractory, were not quadruple refractory because they couldn't get the fourth drug because of toxicity, side effects, or other issues. I think to see responses—even complete responses—in this patient population is really very encouraging. In our experience, bringing it to earlier lines of therapy, partnering it with a PI or with an IMiD, the response rates are really very exciting. I think it's going to be together with elotuzumab. I think these are going to be game changers for us in myeloma.
Dr. Kalaycio: I agree. It's been game changing for oncology in general. Immunotherapies have finally come of age and are certainly coming of age in the treatment of multiple myeloma.
While the prognosis for patients with multiple myeloma has certainly improved, the complexities of treatment are often difficult to manage. Even myeloma experts are challenged with patient selection, practice guidelines, supportive care, and treatment approach. However, with appropriate attention to detail, providers can maximize the benefits obtainable with newer treatments while limiting their adverse effects. For all the advances made in the last decade, the next decade is promising to be even better.
