Dr. Chaudhry on Unmet Needs in Relapsed/Refractory Multiple Myeloma

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

The unmet need in multiple myeloma is largely with patients who have relapsed/refractory disease. This is because at second relapse and later, patients have difficult-to-control disease with toxicities that add up, explains Chaudhry. Patients who relapse within the next 2 years will have received bortezomib (Velcade) or carfilzomib (Kyprolis) as frontline therapy, which allows an anti-CD38 agent in the relapsed/refractory setting to still be relevant, says Chaudhry.

Additionally, data from the CANDOR trial looking at daratumumab (Darzalex), carfilzomib, and dexamethasone are promising and suggest a regimen free of immunomodulatory drugs. Chaudhry plans on using this regimen in her practice and anticipates daratumumab will be increasingly used in the frontline setting. When these patients relapse, they will require agents with different mechanisms of action, according to Chaudhry.

Clinical trials looking at different drugs in multiple myeloma continues, including studies evaluating monoclonal antibodies and bispecific T-cell engagers that target plasma cells. Chaudhry believes a few of these drugs may be FDA approved in 2020, providing this patient population with more options should they relapse.