Dr. Ailawadhi on the Potential Role of Melflufen in Multiple Myeloma

Sikander Ailawadhi, MD, professor of medicine, Division of Hematology/Oncology, Departments of Medicine and Cancer Biology, Mayo Clinic, discusses the potential role of melflufen in multiple myeloma.

In August 2020, the FDA granted a priority review designation to a new drug application for melflufen in combination with dexamethasone for the treatment of patients with triple-class refractory multiple myeloma.

 Melflufen is an alkylating agent and cytotoxic chemotherapy, and the investigational therapy could play a role in the myeloma paradigm where regimens such as cyclophosphamide, VTD PACE (bortezomib [Velcade], dexamethasone, thalidomide [Thalomid], cisplatin, doxorubicin, cyclophosphamide, and etoposide), and DT PACE (dexamethasone, thalidomide, and PACE) are still utilized. Future research may evaluate melflufen in combinations, as well as in settings that incorporate alkylating agents, Ailawadhi says.

Notably, melflufen is a variant of melphalan (Evomela), which is not as commonly utilized agent in the United States, Ailawadhi explains. Now, the field must parse out the true role of melflufen and how it compares with melphalan, Ailawadhi concludes.