Dr. Holstein Discusses Triplets and Quadruplets in Myeloma

Sarah Holstein, MD, PhD, associate professor, University of Nebraska Medical Center, discusses the use of triplets and quadruplets in the treatment of patients with multiple myeloma.

For triplet therapy, Holstein says that there is a lot of excitement around carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone (KRd). There has also been some interest with lenalidomide, ixazomib (Ninlaro), and dexamethasone in older patients, as this is an all-oral triplet. Currently, the standard of care for newly diagnosed patients is the triplet of lenalidomide plus bortezomib (Velcade) and dexamethasone (RVd).

Most quadruplets being currently tested center around adding antibodies such as daratumumab (Darzalex) to the backbone of a proteasome inhibitor plus an immunomodulatory agent, says Holstein. Some of these quadruplets include daratumumab plus RVd and daratumumab plus KRd. Initial studies are showing high response rates, Holstein says.