Dr. Anderson on Recent Advances With Novel Therapies in Multiple Myeloma

Larry Anderson, MD, PhD, associate professor in the Department of Internal Medicine of the Division of Hematology/Oncology, at Harold C. Simmons Comprehensive Cancer Center of UT Southwestern Medical Center, discusses recent advances made with novel therapies in multiple myeloma.

The frontline treatment setting for multiple myeloma is where most of the changes are happening, says Anderson. The field has seen some new approvals, such as the monoclonal antibody daratumumab (Darzalex). The drug is now being incorporated into frontline therapy, at least in patients who are ineligible for transplant, says Anderson. Other research has evaluated the incorporation of daratumumab into multidrug regimens in the pre-transplant setting, as well; these efforts look very promising, according to Anderson. Similar combinations with daratumumab and carfilzomib (Kyprolis) in the relapsed/refractory setting have been shown to result in deep remissions.

Data with bispecific T-cell engagers (BiTEs) have also been reported. At the 2019 ASH Annual Meeting, a presentation on CC-093269 showed an 89% response rate with this approach in patients with heavily refractory multiple myeloma who were treated with >6 mg; these patients experienced very deep responses. This approach offers a way to provide patients with T-cell immunity without having to generate CAR T-cells, Anderson adds.

CAR T-cells are also very exciting but the challenge with this approach is that it takes approximately 1 month to genetically engineer and grow the cells, says Anderson. Sometimes patients cannot that long for the T-cells because their disease is progressing.