Frail Patients With Newly Diagnosed Multiple Myeloma: Triplet Regimen
In the phase II Hovon 143 trial reported in the Journal of Clinical Oncology, Stege et al found that a regimen of ixazomib, daratumumab, and low-dose dexamethasone (Ixa-Dara-dex) was associated with a high response rate in frail patients with newly diagnosed multiple myeloma, but also a high rate...
Daratumumab in Combination With Carfilzomib, Lenalidomide, and Dexamethasone in Newly Diagnosed Multiple Myeloma
Results from the single-institution phase II MANHATTAN study were reported in JAMA Oncology recently by Ola Landgren, MD, PhD, and colleagues. The investigators found that daratumumab in combination with weekly carfilzomib, lenalidomide, and dexamethasone resulted in high rates of minimal residual...
Anti-BCMA–Directed CAR T-Cell Gene Therapy in Relapsed or Refractory Myeloma
"The noblest pleasure is the joy of understanding.” —Leonardo da Vinci To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel...
Recent Studies Explore Efficacy of COVID-19 Vaccination in Patients With Leukemia and Myeloma
Two new studies published in the journal Blood suggest that the BNT162b2 mRNA COVID-19 vaccine may have reduced efficacy in individuals with chronic lymphocytic leukemia (CLL) and multiple myeloma. According to researchers, these studies could help inform the ideal time for vaccination of these...
Role of Whole-Genome Sequencing in Identifying Patients With MGUS at Risk of Progression to Multiple Myeloma
A study published by Oben et al in Nature Communications has shown that whole-genome sequencing can help determine which patients with a multiple myeloma precursor condition known as monoclonal gammopathy of undetermined significance (MGUS) or smoldering myeloma may be at risk for progression to...
FDA Approves Isatuximab-irfc Combination for Relapsed or Refractory Multiple Myeloma
On March 31, the U.S. Food and Drug Administration (FDA) approved isatuximab-irfc (Sarclisa) in combination with carfilzomib and dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three prior lines of therapy. IKEMA The efficacy...
FDA Approves Idecabtagene Vicleucel for Heavily Pretreated Patients With Multiple Myeloma
On March 26, the U.S. Food and Drug Administration (FDA) approved idecabtagene vicleucel (Abecma) for the treatment of adult patients with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 ...
Shaji K. Kumar, MD, on Multiple Myeloma: NCCN Guidelines Update
Shaji K. Kumar, MD, of the Mayo Clinic Cancer Center, discusses the latest data on treating patients with multiple myeloma, including standard-of-care induction before stem cell transplant; the role of quadruplet induction; long-term results with the combination of daratumumab, lenalidomide, and dexamethasone in those who are ineligible for stem cell transplant; CAR T-cell engagers; and the need for more research on how immunotherapy fits in the sequence of treatments.
Older Patients With Multiple Myeloma May Be Able to Avoid Long-Term Steroid Use
The combination of lenalidomide plus the steroid dexamethasone (together called Rd) is considered standard treatment for elderly patients with multiple myeloma. However, prolonged steroid use can be harmful for some older adults. A new study published by Larocca et al in the journal Blood found...
Belantamab Mafodotin-blmf Plus Pomalidomide and Dexamethasone Elicits Responses in Myeloma
Belantamab mafodotin-blmf combined with pomalidomide and dexamethasone led to a very good partial response or better in approximately three-quarters of patients with multiple myeloma that was double-class or triple-class refractory, according to Suzanne Trudel, MSc, MD, FRCPC, of Princess Margaret...
Once-Weekly Selinexor Plus Bortezomib/Dexamethasone vs Twice-Weekly Bortezomib/Dexamethasone in Multiple Myeloma
As reported in The Lancet by Sebastian Grosicki, MD, of the Medical University of Silesia, Katowice, Poland, and colleagues, the phase III BOSTON trial has shown significantly prolonged progression-free survival with once-weekly selinexor plus bortezomib/dexamethasone vs twice-weekly...
Idecabtagene Vicleucel for Heavily Pretreated Patients With Relapsed or Refractory Multiple Myeloma
In the pivotal phase II KarMMa study reported in The New England Journal of Medicine, Nikhil C. Munshi, MD, and colleagues found that the B-cell maturation antigen–directed chimeric antigen receptor (CAR) T-cell therapy idecabtagene vicleucel produced high response rates in patients with...
FDA Grants Accelerated Approval to Melphalan Flufenamide for Relapsed or Refractory Multiple Myeloma
On February 26, the U.S. Food and Drug Administration (FDA) granted accelerated approval to melphalan flufenamide (Pepaxto) in combination with dexamethasone for adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy and whose disease is...
New Recommendations Aim to Eliminate Racial Disparities in Multiple Myeloma Therapies and Trials
Recommendations designed to address the underrepresentation of Black patients in clinical trials for multiple myeloma were recently released. Details about the initiative, published by Gormley et al in Blood Cancer Discovery, form a road map for designing multiple myeloma clinical trials to...
DREAMM-2 Analysis: Number of Prior Treatments No Hindrance to Efficacy of Belantamab Mafodotin-blmf
A post hoc analysis of the phase II DREAMM-2 trial showed single-agent belantamab mafodotin-blmf to be efficacious and tolerable in patients with relapsed or refractory multiple myeloma treated with at least three prior therapies, investigators reported at the 2020 American Society of Hematology...
Belantamab Mafodotin-blmf Plus Pomalidomide and Dexamethasone Elicits Responses in Myeloma
Belantamab mafodotin-blmf combined with pomalidomide and dexamethasone led to a very good partial response (VGPR) or better in approximately three-quarters of patients with multiple myeloma that was double-class or triple-class refractory, according to Suzanne Trudel, MSc, MD, FRCPC, of Princess...
Expert Point of View: Ajay K. Nooka, MD, MPH, FACP
Ajay K. Nooka, MD, MPH, FACP, Associate Professor of Hematology and Medical Oncology at Emory University and Medical Director, Winship Research Informatics Shared Resource at Winship Cancer Institute, Atlanta, considered the presentations on bispecific T-cell–engaging antibodies in myeloma to be...
New Targets Explored for Bispecific T-Cell–Engaging Antibodies in Myeloma
B-cell maturation antigen (BCMA) is the most frequent target of immunotherapies in relapsed or refractory multiple myeloma, but bispecific T-cell–engaging antibodies with novel targets are also achieving promising results. Studies presented at the 2020 American Society of Hematology (ASH) Annual...
Expert Point of View: Sagar Lonial, MD, FACP
Sagar Lonial, MD, FACP, the Anne and Bernard Gray Family Chair in Cancer, Chair and Professor of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, commented on the APOLLO trial for The ASCO Post. “APOLLO is a highly awaited study, as the use of daratumumab plus...
Subcutaneous Daratumumab Meets Primary Endpoint in APOLLO Trial in Myeloma
The first phase III study to evaluate the subcutaneous form of daratumumab has met its primary endpoint, investigators of the APOLLO trial reported at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 The triplet of daratumumab, pomalidomide, and low-dose dexamethasone ...
Novel Therapies and New Indications for Use in Treatment of Hematologic Malignancies
Selinexor: On December 18, 2020, the U.S. Food and Drug Administration (FDA) approved selinexor (Xpovio) in combination with bortezomib (Velcade) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. Venetoclax: On October 16,...
ASH 2020 Meeting Highlights
The world of hematologic malignancies continues to move forward at a robust pace despite the challenges of the COVID era. Although some areas of clinical trials and basic research suffered short-term stoppages or delays due to the pandemic, the studies presented at the 2020 American Society of...
Updated Recommendations on the Treatment of Multiple Myeloma–Related Bone Disease From the Bone Working Group of the International Myeloma Working Group
In a policy review reported in The Lancet Oncology, Terpos et al presented updated recommendations from the Bone Working Group of the International Myeloma Working Group on the treatment of multiple myeloma–related bone disease. The recommendations cover: bisphosphonate use/dosing and management of ...
Achievement and Maintenance of MRD Negativity With Daratumumab-Containing Regimens in Patients With Relapsed or Refractory Multiple Myeloma
In an analysis of the phase III POLLUX and CASTOR trials reported in the Journal of Clinical Oncology, Avet-Loiseau et al found that the addition of daratumumab to standard therapy was associated with higher rates of—and more prolonged—measurable residual disease (MRD) negativity in patients with...
Novel Insights Into Multiple Myeloma
“Knowledge has a beginning but no end.” —Geeta Iyengar To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are three abstracts selected from the meeting proceedings focusing on novel therapies for...
Expert Point of View: Sagar Lonial, MD, and Adam D. Cohen, MD
The studies of ALLO-715 “off-the-shelf” CAR T-cell therapy and bb21217 impressed two experts in the field. Sagar Lonial, MD, the Anne and Bernard Gray Family Chair in Cancer, Chair and Professor of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, and Adam D. Cohen, MD, ...
Novel Anti-BCMA CAR T-Cell Therapies Show Activity in Myeloma
In the treatment of relapsed or refractory multiple myeloma, chimeric antigen receptor (CAR) T-cell therapies with unique characteristics, still targeting B-cell maturation antigen (BCMA), are looking promising. At the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition,...
Venetoclax Added to Bortezomib Plus Dexamethasone in Relapsed or Refractory Multiple Myeloma
As reported in The Lancet Oncology by Shaji K. Kumar, MD, of the Division of Hematology, Mayo Clinic, Rochester, and colleagues, the phase III BELLINI trial has shown that the addition of venetoclax to bortezomib/dexamethasone significantly prolonged progression-free survival in patients with...
Expert Point of View: Suzanne Lentzsch, MD, PhD
IFM 2009 showed that autologous stem cell transplant (ASCT) combined with lenalidomide, bortezomib, and dexamethasone (RVd) results in a significantly better progression-free survival than RVd alone in newly diagnosed patients with myeloma.1 “The data favor immediate ASCT, as transplant resulted in ...
Long-Term Follow-up of IFM 2009 Confirms Benefit of Front-Line Transplant in Myeloma
The benefit of autologous transplantation in newly diagnosed multiple myeloma has been confirmed by follow-up of the IFM 2009 trial, reported at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition by Aurore Perrot, MD, PhD, Assistant Professor of Hematology at the Cancer...
Selinexor in Relapsed or Refractory Multiple Myeloma
On December 18, 2020, selinexor was approved for use in combination with bortezomib and dexamethasone for treatment of adult patients with multiple myeloma who have received at least one prior therapy.1,2 Selinexor received accelerated approval in 2019 for use in combination with dexamethasone for...
Belantamab Mafodotin-blmf in Multiple Myeloma: Number of Prior Treatments No Hindrance to Efficacy
A post hoc analysis of the phase II DREAMM-2 trial showed single-agent belantamab mafodotin-blmf to be efficacious and tolerable in patients with relapsed or refractory multiple myeloma treated with at least three prior therapies, investigators reported at the 2020 American Society of Hematology...
Expert Point of View: Ajay K. Nooka, MD, MPH
Ajay K. Nooka, MD, MPH, Associate Professor of Hematology and Medical Oncology at Emory University and Medical Director, Winship Research Informatics Shared Resource at Winship Cancer Institute, Atlanta, considered the presentations on bispecific T-cell–engaging antibodies in myeloma to be among...
New Targets Explored for Bispecific T-Cell–Engaging Antibodies in Myeloma
B-cell maturation antigen (BCMA) is the most frequent target of immunotherapies in relapsed or refractory multiple myeloma, but bispecific T-cell–engaging (BiTE) antibodies with novel targets are also achieving promising results. Studies presented at the 2020 American Society of Hematology (ASH)...
Expert Point of View: Sagar Lonial, MD
Sagar Lonial, MD, the Anne and Bernard Gray Family Chair in Cancer, Chair and Professor of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, commented on the APOLLO trial for The ASCO Post. “APOLLO is a highly awaited study, as the use of daratumumab plus...
Subcutaneous Daratumumab Meets Primary Endpoint in APOLLO Trial in Myeloma
The first phase III study to evaluate the subcutaneous form of daratumumab has met its primary endpoint, investigators of the APOLLO trial reported at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 The triplet of daratumumab, pomalidomide, and low-dose dexamethasone ...
Lena E. Winestone, MD, MSHP, on Health-Care Disparities in Hematologic Cancers: Real-World Data
Lena E. Winestone, MD, MSHP, of the University of California, San Francisco and Benioff Children’s Hospital, reviews different aspects of bias in treatment delivery, including patient selection for clinical trials; racial and ethnic disparities in survival for indolent non-Hodgkin diffuse large B-cell lymphomas; and end-of-life hospitalization of patients with multiple myeloma, as well as outcome disparities (Abstracts 207-212).
Patient-Reported Outcomes With Triplet Therapy for Newly Diagnosed Multiple Myeloma
In an analysis from the phase III MAIA trial reported in the Journal of Clinical Oncology, Perrot et al found that the combination of daratumumab, lenalidomide, and dexamethasone (D-Rd) was associated with better health-related quality-of-life outcomes vs lenalidomide and dexamethasone (Rd) in...
Identifying Multiple Myeloma Prognostic Subgroups With Distinct Genetic and Clinical Features
Multiple myeloma is the second most common blood cancer, after non-Hodgkin lymphoma, diagnosed in the United States. In 2020, it is estimated that about 32,270 people will be diagnosed with the cancer, and despite advances in more effective treatments, nearly 13,000 will die of the disease.1...
FDA Approves Selinexor for Refractory or Relapsed Multiple Myeloma
On December 18, 2020, the U.S. Food and Drug Administration (FDA) approved selinexor (Xpovio) in combination with bortezomib (Velcade) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. The FDA granted selinexor accelerated...
Does Melflufen Plus Dexamethasone Show Activity in Heavily Pretreated Patients With Relapsed and Refractory Multiple Myeloma?
In the phase II HORIZON study reported in the Journal of Clinical Oncology, Paul G. Richardson, MD, and colleagues found that the combination of the peptide-drug conjugate melflufen and dexamethasone showed activity in patients with heavily pretreated relapsed and refractory multiple myeloma....
Oral Panobinostat and Dexamethasone Plus Subcutaneous Bortezomib for Patients With Relapsed or Refractory Multiple Myeloma
The randomized phase II PANORAMA 3 trial found that when used in combination with subcutaneous bortezomib and oral dexamethasone, oral panobinostat produced higher response rates with 20-mg dosing regimens and lower toxicity with a 10-mg regimen. The safety profile also appeared to be better than...
Meletios A. Dimopoulos, MD, on Multiple Myeloma: Daratumumab, Pomalidomide, and Dexamethasone
Meletios A. Dimopoulos, MD, of the University of Athens, discusses data from the phase III APOLLO study, which evaluated the use of subcutaneous daratumumab plus pomalidomide and dexamethasone, vs pomalidomide and dexamethasone alone, in patients with relapsed or refractory multiple myeloma (Abstract 412).
Paul G. Richardson, MD, on Multiple Myeloma: Roundup of Three Key Studies
Paul G. Richardson, MD, of Dana-Farber Cancer Institute, gives his expert perspective on three important studies in multiple myeloma: long-term results from the IFM 2009 trial on early vs late autologous stem cell transplant in patients with newly diagnosed disease; the effect of high-dose melphalan on mutational burden in relapsed disease; and daratumumab plus lenalidomide, bortezomib, and dexamethasone in transplant-eligible patients with newly diagnosed disease (Abstracts 143, 61, and 549).
Sagar Lonial, MD, on CAR T-Cell Therapies for Myeloma: Novel Approaches and Longer-Term Follow-up Data
Sagar Lonial, MD, of the Emory University School of Medicine, summarizes key papers presented in a session he co-moderated on how second-generation CAR T cells can be used to treat patients with multiple myeloma (Session 653).
ASH 2020: Multiple Myeloma Patient Similarity Network Identifies Prognostic Subgroups With Distinct Genetic and Clinical Features
An analysis by Bhalla et al of multiomics data from newly diagnosed patients with multiple myeloma has identified 3 main patient groups and 12 prognostic subgroups (as well as potential vulnerabilities in each subgroup) based on five data types generated from genomic and transcriptomic patient...
ASH 2020: Subcutaneous Teclistamab for Relapsed or Refractory Multiple Myeloma Studied in Phase I Trial
A subcutaneous injection of the BCMAxCD3 bispecific antibody teclistamab was found to be safe and elicited responses in a majority of patients with relapsed or refractory multiple myeloma, according to findings from a multi-institutional phase I study presented by Alfred L. Garfall, MD, and...
ASH 2020: APOLLO Findings Support Use of Subcutaneous Daratumumab Plus Pomalidomide/Dexamethasone in Relapsed or Refractory Multiple Myeloma
For patients with relapsed or refractory multiple myeloma whose disease progressed after at least one prior regimen, the subcutaneous form of daratumumab, given with pomalidomide and dexamethasone, significantly improved progression-free survival vs pomalidomide and low-dose dexamethasone alone....
Discordance Among Risk Models for Smoldering Multiple Myeloma
In a study reported as a research letter in JAMA Oncology, Hill et al found a low degree of concordance in risk categorization among commonly used smoldering multiple myeloma risk models. Study Details The study involved application of the Mayo Clinic Risk Stratification Model 2008, the Programa...
