Maung Myo Htut, MD, assistant clinical professor of hematology and hematopoietic cell transplantation, City of Hope, discusses the use of immunotherapy in the treatment of patients with multiple myeloma.

Htut says that he has a vested interest in immunotherapy—using PD-1/PD-L1 inhibitors to modify a patient's immune system. Thus far, there has been a trial using the PD-1 inhibitor pembrolizumab (Keytruda) in myeloma. Unfortunately, there were some issues with safety, so the FDA stopped the trial.

The phase III KEYNOTE-183 and KEYNOTE-185 trials were exploring pembrolizumab combined with an immunomodulatory agent and dexamethasone. The FDA wanted to alert oncology researchers about the risk of death associated with pembrolizumab in these patients.

However, Htut believes that there is an active pathway in multiple myeloma. If in some way physicians can modify the agent or use a different PD-1 inhibitor, physicians can revisit the issue. Htut states that it may be too early to say, “this is it,” in terms of using PD-1/PD-L1 inhibitors.

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Dr. Htut on Immunotherapy in Multiple Myeloma

Maung Myo Htut, MD, assistant clinical professor of hematology and hematopoietic cell transplantation, City of Hope, discusses the use of chimeric antigen receptor (CAR) T-cell therapy in patients with multiple myeloma.

City of Hope now has 2 different protocols for the use of CAR T-cell therapy in patients with multiple myeloma. First is the BCMA-targeted therapy protocol from Juno therapeutics. The second protocol is high-affinity T-cell receptor targeting NY-ESO-1/HLA-A. Both are active and currently enrolling patients. Physicians at City of Hope also plan to have a homegrown CAR T-cell therapy targeting CS1. The study will be led by Htut, the principal investigator, pending FDA approval.

There are other potential targets including CD44v6, CD8, and CD138. Physicians are also looking to combine a T cell that can target CS1 as well as BCMA.

Maung Myo Htut, MD

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Dr. Htut on Immunotherapy in Multiple Myeloma

Dr. Htut on CAR T-Cell Therapy in Patients With Multiple Myeloma