MULTIPLE MYELOMA

Managing High-Risk Multiple Myeloma

New agents and combinations have been introduced to the treatment landscape of multiple myeloma, including chimeric antigen receptor T-cell therapy, according to C. Ola Landgren, MD, PhD. Regimens of 2- and 3-drugs have also proven successful for patients with relapsed/refractory multiple myeloma.

Selinexor was recently granted a Fast Track designation by the FDA for the treatment of patients with multiple myeloma who have received at least 3 prior lines of therapy, according to Karyopharm Therapeutics, the manufacturer of the oral SINE compound.

Joshua R. Richter, MD, a hematologist/oncologist at John Theurer Cancer Center, discusses results from the Living with Cancer patient-reported outcomes (PROs) tool, which is a survey to record self-reported symptoms from patients. Richter used this tool to survey 239 patients with multiple myeloma on their symptoms and psychological distress.

Based on data from the phase III 482 study, denosumab (Xgeva) has been approved for an expanded indication by the European Commission for the prevention of skeletal-related events in adult patients with multiple myeloma, according to Amgen, the developer of the RANK ligand inhibitor.

Agne Paner, MD, recently shared the treatment considerations and decisions she makes when treating patients with multiple myeloma. Paner, an assistant professor of medicine at Rush University Medical Center, Chicago, Illinois, explained her treatment decisions based on 2 case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives presentation.

C. Ola Landgren, MD, PhD, recently shared the treatment considerations and decisions he makes when treating patients with newly diagnosed multiple myeloma. Landgren, chief of the Myeloma Service at Memorial Sloan Kettering Cancer Center in New York, explained how he would treat these patients based on the review of a case scenario during a <em>Targeted Oncology </em>live case-based peer perspectives dinner discussion.

Denise. L. Pereira, MD, recently shared the treatment considerations and decisions she makes when treating patients with multiple myeloma. Pereira, assistant professor of clinical medicine, University of Miami, Sylvester Comprehensive Cancer Center, Miami, Florida, explained her treatment decisions based on 2 case scenarios during a <em>Targeted Oncology</em> live case-based peer perspectives presentation.

Ajai Chari, MD, associate professor of medicine at the Mount Sinai School of Medicine, advises on the best way to choose treatment regimens for patients with multiple myeloma. Since 9 different drugs have been approved after many phase III trials, a community physician may be overwhelmed by this surplus of options, Chari says.

Shaji Kumar, MD, professor of medicine in the Division of Hematology at the Mayo Clinic, discusses the effects genetic abnormalities have on patients with high-risk multiple myeloma. Recent advancements have helped to identify these abnormalities in patients.

Patients with relapsed/refractory multiple myeloma with renal impairment who were treated with pomalidomide and&nbsp;low-dose dexamethasone had an overall response rate of up to 39%,&nbsp;according to findings of a phase II study published in the <em>Journal of Clinical Oncology.</em> &nbsp;

Denosumab was recently recommended for approval by the European Medicines Agency&rsquo;s Committee for Medicinal Products for Human Use for the&nbsp;prevention of skeletal-related events in patients with multiple myeloma, according to Amgen, the developer of the RANK ligand inhibitor.

Saad Z. Usmani, MD, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Carolinas HealthCare System, highlights some of the ongoing studies presented at the 2017 ASH Annual Meeting.

C. Ola Landgren, MD, PhD, recently shared the treatment considerations and decisions he makes when treating patients with newly diagnosed multiple myeloma

A meta-analysis and systemic review&nbsp;specifically assessing carfilzomib-associated cardiovascular adverse events&nbsp;suggests an elevated risk in patients with multiple myeloma who are taking the proteasome inhibitor.

Enrollment in a phase I/II clinical trial began recently for a study of PT-112 monotherapy in patients with relapsed or refractory multiple myeloma, according a news release from Phosplatin Therapeutics LLC, the company developing the small molecule conjugate.

Using next-generation squencing methods, researchers are attempting to combine clinical and genomic biomarkers to identify patients with smoldering multiple myeloma who are at high risk for disease progression.

According to recently published results of the&nbsp;international, double-blind randomized phase III 482 Study&nbsp;in&nbsp;<em>The Lancet Oncology,&nbsp;</em>^&nbsp;denosumab was noninferior to zoledronic acid (Zometa) in preventing skeletal-related event in patients with newly diagnosed multiple myeloma.

In a phase Ib/II dose escalation study, rapid and tolerable responses were seen with the combination of selinexor, daratumumab, and low-dose dexamethasone in patients with relapsed/refractory multiple myeloma who were previously exposed to immunomodulatory and proteasome inhibitors.<br /> &nbsp;

Overall survival was extended for patients with relapsed or refractory multiple myeloma by nearly 8 months with the&nbsp;combination of carfilzomib, lenalidomide, and dexamethasone compared with&nbsp;lenalidomide and dexamethasone alone in results from the phase III ASPIRE trial.

Patients with relapsed/refractory myeloma&nbsp;who had prior exposure to lenalidomide (Revlimid) experienced a significant improvement in&nbsp;progression-free survival with pomalidomide (Pomalyst) added to the combination of bortezomib (Velcade) and low-dose dexamethasone,&nbsp;according to findings from the phase III OPTIMISMM trial.