Dr. Chaudhry on Novel Treatment Regimens in Relapsed/Refractory Multiple Myeloma

Maria Chaudhry, MBBS, a hematologist at The Ohio State University Comprehensive Cancer Center—James, discusses novel treatment regimens in relapsed/refractory multiple myeloma.

One agent that is being used in the relapsed/refractory setting is daratumumab (Darzalex), says Chaudhry. Typically, daratumumab is used at the time of first relapse in combination with pomalidomide (Pomalyst) and dexamethasone.

In terms of other agents, carfilzomib (Kyprolis) is a very potent proteasome inhibitor that can be given in combination with pomalidomide and dexamethasone at the time of first and second relapse, adds Chaudhry. Generally, the most common treatment backbones in the relapsed/refractory setting are pomalidomide and dexamethasone.

In addition to daratumumab, another monoclonal antibody called isatuximab has shown activity in the relapsed/refractory setting. The agent was evaluated in combination with pomalidomide and dexamethasone in the phase III ICARIA-MM trial. Results showed that the triplet reduced the risk of progression or death by 40% versus pomalidomide and dexamethasone alone.

In July 2019, the FDA accepted a biologics license application for the triplet, which may lead to another option for patients with relapsed/refractory disease, concludes Chaudhry.