MULTIPLE MYELOMA

Sundar Jagannath, MD, director of the multiple myeloma program, professor of medicine (hematology and medical oncology), Tisch Cancer Institute at Mount Sinai School of Medicine, discusses advances in the management of relapsed multiple myeloma.

Current approaches to the management of multiple myeloma (MM), in particular the introduction of proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs), have improved the survival of patients.

Novel combinations and immunotherapies have significantly expanded treatment options for myeloma. Numerous studies, including the ASPIRE and ELOQUENT-2 trials, have shown positive results for triple drug combinations.

The treatment options for patients with relapsed/refractory multiple myeloma are expanding rapidly, notably through clinical trial evidence supporting a number of three-drug combination regimens.

Carfilzomib (Kyprolis) doubled progression-free survival (PFS) versus bortezomib (Velcade) in patients with relapsed multiple myeloma in the phase III ENDEAVOR trial.

The FDA has approved panobinostat (Farydak) in combination with bortezomib (Velcade) and dexamethasone for patients with previously treated multiple myeloma.

Lenalidomide (Revlimid) plus dexamethasone has been approved by the FDA for the treatment of newly diagnosed patients with multiple myeloma who are not candidates for stem cell transplant, based on findings from the phase III FIRST trial.

Amgen and its subsidiary Onyx Pharmaceuticals have submitted an sNDA to the FDA for the full regulatory approval of carfilzomib (Kyprolis) as a treatment for patients with relapsed multiple myeloma.

The proteasome inhibitor ixazomib (MLN9708) met its primary endpoint of improving PFS at a prespecified interim analysis of a phase III trial of patients with relapsed/refractory multiple myeloma.

Gareth Morgan, MD, PhD, the director of the Myeloma Institute at the University of Arkansas, discusses gene expression profiling for patients with smoldering myeloma.

Irene Ghobrial, MD, director, Michele & Stephen Kirsch Laboratory, senior physician, Dana-Farber Cancer Center Institute, discusses the novel anti-CXCR4 ulocuplumab for the treatment of multiple myeloma.

Anti-CD38 monoclonal antibodies continue to demonstrate promise and generate excitement that a new treatment paradigm could be on the horizon for patients with multiple myeloma.

Shaji Kumar, MD, professor of medicine, Mayo Clinic, discusses the results of the phase III ASPIRE trial.

The FDA’s Oncologic Drugs Advisory Committee (ODAC) voted 5-2 against the accelerated approval of panobinostat (Farydak) in combination with bortezomib (Velcade) and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy.

The FDA has scheduled an ODAC advisory hearing to discuss the NDA for panobinostat in combination with bortezomib and dexamethasone for patients with multiple myeloma who have received at least one prior therapy.

Andrzej Jakubowiak, MD, PhD, professor of medicine, director, Myeloma Program, University of Chicago Medicine, discusses the toxicity profile of panobinostat in combination with bortezomib and dexamethasone in relapsed or relapsed/refractory multiple myeloma as seen in the PANORAMA trial.

Treatment with single-agent carfilzomib (Kyprolis) was unable to significantly extend overall survival (OS) compared with best supportive care in heavily pretreated patients with multiple myeloma.

The FDA has expanded the bortezomib (Velcade) label to allow for retreatment in patients with multiple myeloma who previously responded to the proteasome inhibitor.

The combination of carfilzomib, carfilzomib, and low-dose dexamethasone extended PFS by 8.7 months compared with lenalidomide and dexamethasone alone for patients with relapsed multiple myeloma.

Angela Dispenzieri, MD, a professor of medicine in the division of hematology at the Mayo Clinic, discusses the results of the PANORAMA 1 trial: a randomized, double-blind, phase III study of panobinostat or placebo plus bortezomib and dexamethasone in relapsed or relapsed and refractory multiple myeloma.

The FDA has approved the radioactive diagnostic imaging agent Lymphoseek injection to guide sentinel lymph node biopsy in patients with cancer of the head and neck.

Combining the pan-deacetylase inhibitor panobinostat with bortezomib and dexamethasone delayed disease progression by 3.9 months over bortezomib and dexamethasone alone in patients with relapsed or relapsed and refractory multiple myeloma.

SAR650984 demonstrated encouraging efficacy as a monotherapy and in combination with dexamethasone and lenalidomide without reaching a maximum tolerated dose in patients with heavily pretreated multiple myeloma.

The addition of the investigational hypoxia-targeted drug TH-302 to dexamethasone has demonstrated beneficial activity and a manageable adverse event profile in the treatment of patients with relapsed/refractory multiple myeloma.

In the treatment of multiple myeloma (MM), following decades of little progress, the last 10 years have been characterized by more clinical advancements than for any other cancer.