Dr. Chari on Treatment of Penta-Refractory Patients With Myeloma

Ajai Chari, MD, associate professor, Icahn School of Medicine, Mount Sinai Hospital, discusses the treatment of patients with penta-refractory multiple myeloma.

Myeloma in general is an exciting field, with over 10 drugs receiving FDA approval in the past decade, including 4 in 2015, Chari notes. However, with 6 classes of drugs and multiple drugs in each class, it becomes challenging when patients exhaust those options. The so-called penta-refractory patients are the ones who have disease progression after treatment with proteasome inhibitors, immunomodulatory agents, and the CD38-targeted monoclonal antibody daratumumab (Darzalex). A big question of ongoing research is what the standard of care should be for these patients.

There are 3 promising options, Chari says. One of them, selinexor, recently received a fast-track designation by the FDA for this patient population. JSK916, an antibody-drug conjugate, and bb2121, a chimeric antigen receptor T-cell therapy, have earned breakthrough designations.