Peter Voorhees, MD, hematology, medical oncology, Carolinas HealthCare System, discusses pivotal ongoing clinical trials in the field of multiple myeloma.

It is likely that the addition of daratumumab (Darzalex) to the lenalidomide (Revlimid)/dexamethasone backbone will lead to a significant progression-free and overall survival benefit for patients with multiple myeloma, Voorhees explains. This regimen is also associated with high response rates. In a study with this regimen in the relapse setting, at least three-fourths of patients achieved a very good partial response and a little over 40% achieved a complete response or better, he adds. These numbers will likely be higher in newly diagnosed disease.

The addition of elotuzumab (Empliciti) and ixazomib (Ninlaro) to the field are overall well tolerated agents that provide additional options for patients.

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Dr. Voorhees on Pivotal Ongoing Trials in Multiple Myeloma

Peter Voorhees, MD, associate professor, School of Medicine, University of North Carolina (UNC)-Chapel Hill, Clinical Research, Leukemia, Lymphoma, and Myeloma Program, UNC Lineberger Comprehensive Cancer Center, discusses the triplet regimen of pomalidomide, dexamethasone, and ixazomib in patients with double refractory multiple myeloma.

A phase I study examined the triplet regimen versus pomalidomide/dexamethasone in patients who had received two prior lines of therapy, had lenalidomide-refractory disease, and were refractory to either carfilzomib or bortezomib.

The safety profile of the triplet therapy has been encouraging, Voorhees says. Grade 3/4 adverse events include neutropenia and thrombocytopenia, but are manageable. Nonhematologic toxicities are grade 1/2, he says. The overall response rate for the first 20 evaluable patients is 55%. The triplet will be investigated further with a fourth dose cohort in a randomized phase II study, Voorhees adds.

Peter Voorhees, MD, associate professor, School of Medicine, University of North Carolina (UNC)-Chapel Hill, Clinical Research, Leukemia, Lymphoma, and Myeloma Program, UNC Lineberger Comprehensive Cancer Center, discusses the triplet regimen of pomalidomide, dexamethasone, and ixazomib in patients with double refractory multiple myeloma.


Dr. Voorhees on Triplet Regimen in Multiple Myeloma

Peter Voorhees, MD, associate professor, School of Medicine, UNC-Chapel Hill, Clinical Research, Leukemia, Lymphoma, and Myeloma Program, UNC Lineberger Comprehensive Cancer Center, discusses the future treatment paradigm for myeloma.

With an emergence of monoclonal antibodies, such as daratumumab and elotuzumab, it is likely that these agents will be administered in combination with existing therapies, Voorhees explains. Emerging checkpoint blockade agents are predicted to eradicate minimal residual disease in patients with myeloma.

Voorhees notes that it will be interesting to see if stem cell transplantation will remain a part of the treatment paradigm over the next decade. However, the procedure will likely remain beneficial to eligible patients.

Peter Voorhees, MD, UNC Lineberger Comprehensive Cancer Center, discusses the future treatment paradigm for myeloma. 


Peter Voorhees, MD, Atrium Health

Articles

Dr. Voorhees on Pivotal Ongoing Trials in Multiple Myeloma

Dr. Voorhees on Triplet Regimen in Multiple Myeloma

Dr. Voorhees on the Future Treatment Paradigm for Myeloma