Ixazomib Maintenance in Patients With Newly Diagnosed Multiple Myeloma Who Did Not Receive ASCT
As reported in the Journal of Clinical Oncology by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, Greece, and colleagues, the phase III TOURMALINE-MM4 trial has shown that postinduction maintenance with ixazomib prolonged progression-free survival vs placebo in...
Update on Multiple Myeloma: Highlights From NCCN Virtual Congress on Hematologic Malignancies
New diagnostic criteria and modern imaging techniques, a wealth of new therapeutics, and an update on current thinking as to when to treat patients with smoldering myeloma were highlighted during the National Comprehensive Cancer Network (NCCN) 2020 Virtual Congress: Hematologic Malignancies™....
Expert Point of View: Ajay K. Nooka, MD, MPH
“Both KarMMa and CARTITUDE-1 trials presented during the ASCO20 Virtual Scientific Program showed exceptional results, not only in obtaining higher responses in the majority of patients but also in attaining high-quality responses,” said Ajay K. Nooka, MD, MPH, Associate Professor, Department of...
Support Builds for Anti-BCMA CAR T-Cell Therapy in Multiple Myeloma
Based on early results in clinical trials, interest in the use of chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma has been high, especially for products targeting B-cell maturation antigen (BCMA). During the ASCO20 Virtual Scientific Program, further support for CAR T-cell...
Once-Weekly Selinexor Plus Bortezomib/Dexamethasone vs Twice-Weekly Bortezomib/Dexamethasone in Previously Treated Patients With Multiple Myeloma
As reported in The Lancet by Grosicki et al, the phase III BOSTON trial has shown significantly prolonged progression-free survival with once-weekly selinexor plus bortezomib/dexamethasone vs twice-weekly bortezomib/dexamethasone in previously treated patients with multiple myeloma. Study Details...
Carfilzomib vs Bortezomib, Each Combined With Lenalidomide/Dexamethasone, in Newly Diagnosed Patients With Multiple Myeloma
As reported in The Lancet Oncology by Shaji K. Kumar, MD, of the Division of Hematology, Mayo Clinic, Rochester, and colleagues,1 the phase III ENDURANCE trial has shown no improvement in progression-free survival with carfilzomib plus lenalidomide/dexamethasone (KRd) vs bortezomib plus...
Expert Point of View: Ajay K. Nooka, MD, MPH
“Both KarMMa and CARTITUDE-1 trials presented during the ASCO20 Virtual Scientific Program showed exceptional results, not only in obtaining higher responses in the majority of patients but also in attaining high-quality responses,” said Ajay K. Nooka, MD, MPH, Associate Professor, Department of...
Support Builds for Anti-BCMA CAR T-Cell Therapy in Multiple Myeloma
Based on early results in clinical trials, interest in the use of chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma has been high, especially for products targeting B-cell maturation antigen (BCMA). During the ASCO20 Virtual Scientific Program, further support for CAR T-cell...
Expert Point of View: Philip McCarthy, MD
Philip McCarthy, MD, Professor of Oncology and Internal Medicine and Director of the Transplant and Cellular Therapy Center at Roswell Park Comprehensive Cancer Center, Buffalo, New York, found the results of the DREAMM-6 study to be “exciting and promising.” He commented: “The overall response...
Responses Achieved With Belantamab Mafodotin in Relapsed or Refractory Myeloma
The antibody-drug conjugate belantamab mafodotin yielded responses as a single agent and in combination with bortezomib and dexamethasone in the treatment of relapsed or refractory multiple myeloma, according to two reports from the DREAMM team at the ASCO20 Virtual Scientific Program.1,2 In the...
Novel Therapies and New Indications for Use in Treatment of Hematologic Malignancies
Daratumumab and hyaluronidase-fihj: On May 1, 2020, the FDA approved daratumumab and hyaluronidase-fihj (Darzalex) for adult patients with newly diagnosed or relapsed or refractory multiple myeloma. Ibrutinib: On April 21, 2020, the FDA expanded the indication of ibrutinib (Imbruvica) to include...
Novel Treatment Approaches on the Horizon in Multiple Myeloma
Clinicians who treat multiple myeloma can anticipate a host of new treatments: melflufen, cereblon E3 ligase modulators (CELMoDs), antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptor (CAR) T-cell therapies. Kenneth C. Anderson, MD, FASCO, Director of the Jerome Lipper...
Novel Therapies and New Indications for Use in Treatment of Hematologic Malignancies
Venetoclax: On October 16, 2020, the U.S. Food and Drug Administration (FDA) approved venetoclax (Venclexta) in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults aged 75 or older. See page 32 for more on this approval....
Hematologic Oncology Highlights 2019–2020 Almanac
The past year has seen remarkable advances in the treatment of leukemia, lymphoma, and multiple myeloma, which combined account for 9.9% of the estimated 1,806,590 new cases of cancer diagnosed in the United States and an estimated 56,840 cancer-related deaths.1 Novel therapies are providing...
Association of FDG Uptake According to Deauville Criteria With Survival Outcomes in Newly Diagnosed Multiple Myeloma
In an analysis reported in the Journal of Clinical Oncology, Zamagni et al found that fluorodeoxyglucose F-18 (FDG) uptake of less than 4 on the Deauville scale in bone marrow and focal lesions on pre–maintenance therapy FDG positron-emission tomography/computed tomography (PET/CT) scans was...
Intermittent Dosing Schedules of RAF/MEK Inhibitor in RAS/RAF-Mutant Solid Tumors and Multiple Myeloma
In a single-center phase I dose-escalation and basket dose-expansion study reported in The Lancet Oncology, Guo et al identified the phase II dose and schedule for the oral RAF/MEK inhibitor CH5126766 in patients with RAS/RAF-mutant cancers. The agent also showed antitumor activity across various...
ASCO Approves First Joint MSTS/ASTRO/ASCO Guideline on Treatment of Metastatic Carcinoma and Myeloma of the Femur
On June 20, 2020, ASCO approved the first joint Musculoskeletal Tumor Society (MSTS)/American Society for Radiation Oncology (ASTRO)/ASCO guideline on the care of patients with metastatic carcinoma and myeloma of the femur.1 Guideline recommendations were based on a systematic review of clinical...
Ixazomib Maintenance in Newly Diagnosed Patients With Multiple Myeloma Not Undergoing Stem Cell Transplant: TOURMALINE-MM4 Trial
As reported in the Journal of Clinical Oncology by Meletios A. Dimopoulos, MD, and colleagues, the phase III TOURMALINE-MM4 trial has shown that postinduction maintenance with ixazomib prolonged progression-free survival vs placebo in patients with newly diagnosed multiple myeloma not undergoing...
Trends to Watch in Early-Onset Cancer Among Young Adults
Although cancer incidence and mortality rates for all cancers combined are considerably lower in younger adults than older adults, a disturbing pattern is beginning to emerge in the development of early-onset cancers, typically diagnosed in older patients, occurring in younger adults. The rising...
Carfilzomib and Daratumumab With Dexamethasone for Relapsed or Refractory Multiple Myeloma
On August 20, 2020, carfilzomib and daratumumab were approved for use in combination with dexamethasone for treatment of adults with relapsed or refractory multiple myeloma who have received one to three lines of therapy.1-3 Supporting Efficacy Data Approval was based on findings in two clinical...
Red Flag Presentations of Immunoglobulin Light Chain Amyloidosis in Patients With Multiple Myeloma
The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that occasionally quizzes readers on issues in hematology. In this installment, the authors highlight the most common type of systemic amyloidosis in the United States: immunoglobulin light chain [or amyloid light...
FDA Pipeline: Priority Review for Agents in Multiple Myeloma, Anaplastic Large Cell Lymphoma
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to therapies for pretreated patients with multiple myeloma and pediatric patients with ALK-positive anaplastic large cell lymphoma; granted Fast Track designation to novel agents in gastric/gastroesophageal junction...
Updates on BCMA-Directed CAR-Modified T-Cell Gene Therapies
Outcomes in patients with triple-class–failure relapsed and refractory multiple myeloma who experience disease progression on immunomodulatory agents, proteasome inhibitors, and CD38 antibodies are dismal. Most recently, early results of three anti-B-cell maturation antigen (BCMA) chimeric antigen...
Enthusiastic Response to Novel Therapies on the Horizon in Multiple Myeloma
Clinicians who treat multiple myeloma can anticipate a host of new treatments: melflufen, cereblon E3 ligase (CEL) modulators, antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptor (CAR) T-cell therapies. Kenneth C. Anderson, MD, Director of the Jerome Lipper Multiple...
Belantamab Mafodotin-blmf for Relapsed or Refractory Multiple Myeloma
On August 5, 2020, the antibody-drug conjugate belantamab mafodotin-blmf was granted accelerated approval for treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies, including an anti-CD38 monoclonal antibody, a proteasome inhibitor, ...
Carfilzomib vs Bortezomib, Each Combined With Lenalidomide/Dexamethasone, in Newly Diagnosed Patients With Multiple Myeloma
As reported in The Lancet Oncology by Shaji K. Kumar, MD, and colleagues, the phase III ENDURANCE trial has shown no improvement in progression-free survival with carfilzomib plus lenalidomide/dexamethasone (KRd) vs bortezomib plus lenalidomide/dexamethasone (VRd) in patients with newly diagnosed...
FDA Pipeline: Priority Reviews in Multiple Myeloma, Metastatic Breast Cancer, and NSCLC
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents for the treatment of refractory multiple myeloma, metastatic breast cancer, and metastatic non–small cell lung cancer (NSCLC); gave Fast Track designation to treatments for NTRK mutation–positive solid tumors...
How to Treat Patients With Multiple Myeloma Cost-Effectively Without Compromising Outcome
The dramatic advances in the diagnosis and treatment of multiple myeloma over the past 20 years have resulted in significant improvements in overall survival, with 5-year relative survival rates now around 50% and more than 60% for patients younger than age 70.1 The proteasome inhibitors...
FDA Approves Daratumumab Plus Carfilzomib and Dexamethasone for Relapsed or Refractory Multiple Myeloma
On August 20, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with carfilzomib (Kyprolis) and dexamethasone (DKd) for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three previous lines of therapy....
FDA Grants Accelerated Approval to Belantamab Mafodotin-blmf for Pretreated Patients With Relapsed or Refractory Multiple Myeloma
On August 5, the U.S. Food and Drug Administration (FDA) granted accelerated approval to belantamab mafodotin-blmf (Blenrep), an anti-B-cell maturation antigen antibody-drug conjugate, for adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies,...
Analysis of Deep Whole-Genome Sequencing in Patients With Multiple Myeloma Identifies Superior Outcome Subgroup
In a study of genome-wide somatic alterations in multiple myeloma reported in the Journal of Clinical Oncology, Samur et al identified a subgroup of patients with superior outcomes who are not adequately identified by traditional risk markers. The study involved analysis of deep whole-genome...
CANDOR Trial: Carfilzomib, Dexamethasone, and Daratumumab vs Carfilzomib and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma
As reported in The Lancet by Meletios Dimopoulos, MD, and colleagues, the phase III CANDOR trial has shown prolonged progression-free survival with carfilzomib, dexamethasone, and daratumumab (KdD) vs carfilzomib and dexamethasone (Kd) in patients with relapsed or refractory multiple myeloma....
FDA Pipeline: Novel Treatments for Hematologic Malignancies
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to pembrolizumab for the second-line treatment of patients with relapsed or refractory Hodgkin lymphoma, and also accepted a supplemental new drug application for selinexor for pretreated patients with multiple myeloma....
Combination of Isatuximab, Carfilzomib, and Dexamethasone Reduces Risk of Disease Progression in Myeloma
The addition of the CD38 antibody isatuximab-irfc to carfilzomib and dexamethasone nearly halved the risk of disease progression or death in patients with relapsed or refractory multiple myeloma, the interim analysis of the phase III IKEMA trial has shown.1 “Isatuximab plus carfilzomib and...
Prolonged Overall Survival With Autologous-Allogeneic vs Tandem Autologous Transplant in Newly Diagnosed Myeloma
In a pooled analysis reported in Bone Marrow Transplantation,1 Luciano J. Costa, MD, PhD, of the University of Alabama at Birmingham, and colleagues found that autologous hematopoietic cell transplantation followed by reduced-intensity conditioning allogeneic transplantation (auto-allo) was...
Expert Point of View: Suzanne Lentzsch, MD, PhD, and Joshua Richter, MD
Two myeloma specialists weighed in on the disappointing findings of SWOG S1211: Suzanne Lentzsch, MD, PhD, Professor of Medicine at Columbia University and Director of the Multiple Myeloma and Amyloidosis Service, and Joshua Richter, MD, Assistant Professor of Medicine, Icahn School of Medicine at...
Elotuzumab Fails to Add Benefit in Newly Diagnosed High-Risk Myeloma
The addition of elotuzumab to a standard three-drug induction regimen did not improve outcomes in patients with high-risk multiple myeloma enrolled in the randomized phase II SWOG S1211 trial, according to findings reported during the ASCO20 Virtual Scientific Program by Saad Zafar Usmani, MD,...
Expert Point of View: Philip McCarthy, MD
Philip McCarthy, MD, Professor of Oncology and Internal Medicine and Director of the Transplant and Cellular Therapy Center at Roswell Park Comprehensive Cancer Center, Buffalo, New York, found the results of the DREAMM-6 study to be “exciting and promising.” He commented: “The overall response...
Responses Achieved With Belantamab Mafodotin in Relapsed or Refractory Myeloma
The antibody-drug conjugate belantamab mafodotin yielded responses as a single agent and in combination with bortezomib and dexamethasone in the treatment of relapsed or refractory multiple myeloma, according to two reports from the DREAMM team at the ASCO20 Virtual Scientific Program.1,2 In the...
Daratumumab and Hyaluronidase-fihj for Multiple Myeloma
On May 1, 2020, the combination of daratumumab and hyaluronidase-fihj was approved for adult patients with newly diagnosed or relapsed/refractory multiple myeloma. This new product allows for subcutaneous (SC) dosing of daratumumab.1,2 Daratumumab and hyaluronidase-fihj is for SC use only. The...
Phase III BOSTON Study Finds Selinexor Improves Outcomes in Myeloma
When added to bortezomib and dexamethasone in patients with multiple myeloma, selinexor significantly improved progression-free survival and response rates, with a lower incidence of peripheral neuropathy, compared with bortezomib/dexamethasone alone, according to results from the global phase III...
Expert Point of View: Philip McCarthy, MD
Philip McCarthy, MD, Professor of Oncology and Internal Medicine and Director of the Transplant and Cellular Therapy Center at Roswell Park Comprehensive Cancer Center, Buffalo, New York, found the results of the DREAMM-6 study to be “exciting and promising.” He commented: “The overall response...
Belantamab Mafodotin Shows Activity in Relapsed or Refractory Myeloma
Treatment of relapsed or refractory multiple myeloma yielded responses with the antibody-drug conjugate belantamab mafodotin, both as a single agent and in combination with bortezomib and dexamethasone. Two reports from the DREAMM team expanded on these findings at the ASCO20 Virtual Scientific...
Expert Point of View: Jesús G. Berdeja, MD
The importance of first-line therapy in multiple myeloma is that the first therapy typically achieves the most impact, and subsequent lines of therapy tend to be less effective, explained ENDURANCE study discussant Jesús G. Berdeja, MD, Director of Myeloma Research at the Sarah Cannon Research...
Outcomes in Newly Diagnosed Multiple Myeloma Unimproved by Carfilzomib Triplet vs Standard Bortezomib-Based Regimen
No superior efficacy was shown with the combination of carfilzomib, lenalidomide, and dexamethasone (KRd) in newly treated patients with standard- and intermediate-risk multiple myeloma who are not slated for immediate autologous stem cell transplantation (ASCT), compared with the standard of care: ...
Conference Highlights From the ASCO20 Virtual Scientific Program
The global outbreak of the COVID-19 pandemic forced many cancer societies, including ASCO, to cancel their in-person meetings this year and instead present the latest advancements and new approaches in oncology care via a virtual platform. For the first time in its 56-year history, the ASCO Annual...
Sarah A. Holstein, MD, PhD, on Multiple Myeloma: Expert Perspective on Five Key ASCO20 Abstracts
Sarah A. Holstein, MD, PhD, of the University of Nebraska Medical Center, discusses top myeloma abstracts from the ASCO20 Virtual Scientific Program: the ENDURANCE trial on carfilzomib, lenalidomide, dexamethasone, and bortezomib; the STaMINA study on transplantation strategies; a first-in-human study on the novel CELMoD agent CC-92480 plus dexamethasone; the CARTITUDE-1 trial on CAR T-cell therapy; and a phase I study of teclistamab (Abstracts LBA3, 8506, 8500, 8505, and 100).
Adding Cyclophosphamide to Bortezomib/Dexamethasone in Patients With Multiple Myeloma and Acute Kidney Injury From Cast Nephropathy
In a French trial reported in the Journal of Clinical Oncology, Bridoux et al found adding cyclophosphamide to bortezomib/dexamethasone offered no benefit for renal recovery of patients with multiple myeloma and initial cast nephropathy not requiring dialysis. Study Details In the multicenter...
Parameswaran Hari, MD, on Multiple Myeloma: Expert Commentary on Four Key Abstracts
Parameswaran Hari, MD, of the Medical College of Wisconsin, discusses data from four trials and their clinical implications for the treatment of patients with multiple myeloma: the KarMMa and EVOLVE studies on CAR T cell therapies; SWOG-1211 on bortezomib, lenalidomide, and dexamthasone with/without elotuzumab for newly diagnosed, high-risk disease; and the GMMGCONCEPT trial on isatuximab, carfilzomib, lenalidomide, and dexamethasone in front-line treatment (Abstracts 8503, 8504, 8507, 8508).
Paul G. Richardson, MD, on Multiple Myeloma: First-in-Human Study of the Novel Agent CC-92480
Paul G. Richardson, MD, of Dana-Farber Cancer Institute, discusses early results on a cereblon E3 ligase modulator agent combined with dexamethasone in patients with relapsed or refractory multiple myeloma, with an overall response rate of 48%. The study is ongoing to further optimize dose and schedule (Abstract 8500).
