Graham Jackson, MD, PhD, Northern Institute for Cancer Research, Newcastle University, discusses some of the ongoing challenges in the treatment of patients with multiple myeloma.

There are many challenges that oncologists are still facing in this field, including the fact that there is not a 100% cure rate, Jackson explains. There are a lot of patients with durable responses who have low-risk disease; however, for patients with high-risk disease who go through treatment lines very quickly, they are mostly transient responses, leading researchers to believe that this subpopulation is a higher unmet need.

Additionally, patients become refractory to several therapies. Results of the STORM study, which explored selinexor (KPT-330) in this population of patients, are intriguing, he adds. Novel agents moving through the pipeline are likely to lead excitement in the field.

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Dr. Jackson on Ongoing Challenges in Treating Patients With Multiple Myeloma

Graham Jackson, MD, PhD, Northern Institute for Cancer Research, Newcastle University, discusses the toxicity profile of lenalidomide (Revlimid) maintenance therapy in the treatment of patients with multiple myeloma.

Some of the main adverse events that arise after treatment with lenalidomide maintenance are hematological in nature. The most common grade 3/4 toxicity was neutropenia, says Jackson. As a whole, he explains, most patients seemed to tolerate the treatment very well. He also notes that, with lenalidomide maintenance, it is possible to adjust the dose so the patient stays on the therapy without having to come off the drug due to toxicity.

One piece of data has shown that patients benefit more if they stay on lenalidomide maintenance longer. Jackson and his colleagues saw that patients who came off the study early because of toxicity generally relapsed more quickly than patients who stayed on the drug. Though the reasons for that quicker relapse are unknown at this time, Jackson says that the data speak to the possibility that prolonged maintenance is important.

Graham Jackson, MD, PhD, Northern Institute for Cancer Research, Newcastle University, discusses the toxicity profile of lenalidomide maintenance therapy in the treatment of patients with multiple myeloma.

Dr. Jackson on the Toxicity Profile of Lenalidomide Maintenance in Myeloma

Graham Jackson, MD, PhD, Northern Institute for Cancer Research, Newcastle University, discusses the benefits of maintenance therapy for patients with multiple myeloma.

Eight-hundred fifty-seven patients in the study went on to receive lenalidomide (Revlimid) maintenance. It’s safe and deliverable while prolonging remission for most subgroups of patients, such as transplant eligible patients and the patients that are older, frailer, and not eligible for a transplant, explains Jackson.

Although there have been instances of malignancies, it has been shown that the secondary malignancies are not as serious as previously thought.

Dr. Jackson on Benefits of Maintenance Therapy for Myeloma

Graham Jackson, MD, PhD, Northern Institute for Cancer Research, Newcastle University, discusses results of a study that determined lenalidomide (Revlimid) is a highly-effective maintenance therapy in myeloma patients of all ages.

In a study of about 850 patients, lenalidomide was found to increase progression-free survival (PFS). Across the entire cohort of patients, PFS increased by approximately 22 months. In the transplant eligible patients, PFS was increased by approximately 28 months. Even for the older population, the PFS increased by more than 12 months, Jackson says.

The results show that lenalidomide maintenance is now standard of care for frontline treatment in patients with myeloma, Jackson says.

Graham Jackson, MD, PhD

Articles

Dr. Jackson on Ongoing Challenges in Treating Patients With Multiple Myeloma

Dr. Jackson on the Toxicity Profile of Lenalidomide Maintenance in Myeloma

Dr. Jackson on Benefits of Maintenance Therapy for Myeloma

Dr. Jackson on Lenalidomide as a Highly-Effective Maintenance Therapy in Myeloma