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Researchers studying the molecular landscape of over 500 patients with relapsed or refractory multiple myeloma discovered a prevalence of activated key oncogenic pathways in these patients—much more than previously thought. Upward of 45% to 65% of NF-κB and RAS/MAPK pathways each had alterations....
Caregivers for patients with multiple myeloma may suffer from higher rates of anxiety and depression than patients themselves, according to a new study published by O’Donnell in Blood Advances. Although medical professionals have long acknowledged the toll a serious or terminal diagnosis can have...
In patients with multiple myeloma exposed or refractory to three standard therapies, treatment with the bispecific antibody teclistamab produced strong and durable responses in the phase I/II MajesTEC-1 study.1 The results of weekly subcutaneous dosing of teclistamab in 165 patients were presented...
A radiologist by training, I knew the minute I saw the results from my chest x-ray that I had multiple myeloma. In 2015, I was semiretired and had just taken up the game of golf. After making a big swing at the ball, I instantly felt pain in my ribs and thought I had either pulled an intercostal...
In a study reported in the Journal of Clinical Oncology, Bertamini et al found that higher levels of circulating tumor cells (CTCs) at diagnosis were associated with poorer progression-free and overall survival in transplant-eligible patients with newly diagnosed multiple myeloma. The prognostic...
In a study reported in the Journal of Clinical Oncology, Garcés et al found that increasing levels of circulating tumor cells (CTCs) at diagnosis were associated with poorer outcomes in newly diagnosed patients with transplant-eligible multiple myeloma, and that inclusion of CTCs in a risk model...
Researchers have, for the first time, identified genes that may predict response to a therapy for a blood cancer that can have serious side effects for some patients. The therapy, selinexor, is part of the treatment armamentarium for multiple myeloma, but the ability to target its use to patients...
In an analysis reported in a research letter in JAMA Oncology, Nguyen et al identified postmarketing cases of ocular toxicity in patients receiving daratumumab in the United States. Daratumumab is a CD38-directed monoclonal antibody that was initially approved in 2015 for the treatment of multiple...
As reported in the Journal of Clinical Oncology by D’Agostino et al in the European Myeloma Network, a second revision (R2-ISS) of the Revised International Staging System (R-ISS) incorporates a risk scoring system that permits delineation of four prognostic risk groups in newly diagnosed multiple...
In the phase I/II MajesTEC-1 trial presented at the 2022 ASCO Annual Meeting (Abstract 8007) and simultaneously published in The New England Journal of Medicine, Philippe Moreau, MD, and colleagues found that the bispecific antibody teclistamab produced responses in nearly two-thirds of patients...
In an analysis presented at the 2022 ASCO Annual Meeting (Abstract 8028) and simultaneously reported in the Journal of Clinical Oncology, Thomas Martin, MD, and colleagues provided data from the 2-year follow-up of the pivotal CARTITUDE-1 trial of the anti–B-cell maturation agent (BCMA) chimeric...
Paul G. Richardson, MD, of Dana-Farber Cancer Institute, discusses phase III findings from the DETERMINATION trial, which showed that, for patients with newly diagnosed multiple myeloma, lenalidomide, bortezomib, and dexamethasone (RVd) with or without autologous stem cell transplant (ASCT) and lenalidomide maintenance to disease progression resulted in the longest median progression-free survival reported for each approach, and a highly significant difference in progression-free survival in favor of early transplant. While overall response rates were similar, rates of MRD favored early transplant also, but toxicity was greater and quality of life was transiently but significantly diminished. No overall survival advantage has been observed to date (Abstract LBA4).
The use of autologous stem cell transplantation (ASCT) early in the course of treatment showed a significant 21.4-month gain in median progression-free survival in younger, newly diagnosed patients with multiple myeloma compared with patients who received chemotherapy without an initial...
The availability of numerous new agents for treating multiple myeloma has created some “conundrums” for clinicians, said Sergio Giralt, MD, Deputy Head of the Division of Hematologic Malignancies at Memorial Sloan Kettering Cancer Center and the Melvin Berlin Family Chair in Myeloma Research and...
In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology® covering eight tumor types. Guidelines are now published for more than 60 tumor types, subtypes, and topics. During the NCCN’s 27th Annual Conference, which was again...
In a study reported in the Journal of Clinical Oncology, Bruinink et al constructed a transcriptomic classifier for primary plasma cell leukemia (PCL) that identified high-risk PCL-like disease in patients with newly diagnosed multiple myeloma. As stated by the investigators, “Primary PCL is an...
In a study reported in the British Journal of Haematology, Staron et al found that the prevalence of plasma cell and lymphoproliferative disorders among blood relatives of probands with light chain (AL) amyloidosis was low overall and varied according to proband AL amyloidosis subtype. Despite...
When I was diagnosed with multiple myeloma in 1996, I was given 3 years to live. At the time, there was little understanding of this disease, which was termed incurable. There were no new treatments, few drugs in the pipeline, hardly any clinical trials, and no multiple myeloma community or...
Ongoing evaluation of novel, targeted, and immunotherapies has led to exciting advances across the array of hematologic malignancies over the past year. The availability of new treatment options, along with emerging data on novel combinations and sequencing approaches, is rapidly changing...
Poor outcomes are observed in patients with myeloma who are refractory to multiple classes of therapies, with the average patient experiencing disease progression in up to 6 months and living no longer than 6 to 15 months. Patients often rapidly cycle through regimens that use less effective or...
For the first-line treatment of newly diagnosed multiple myeloma, the percentage of patients achieving measurable residual disease (MRD, previously called minimal residual disease) negativity was significantly greater when the anti-CD38 monoclonal antibody isatuximab was added to a standard...
As reported in The Lancet Oncology by Thierry Facon, MD, of the Centre Hospitalier Universitaire de Lille, and colleagues, a prespecified interim analysis of overall survival in the pivotal phase III MAIA trial has shown a significant benefit with the addition of daratumumab to...
As reported in The Lancet Oncology by Philippe Moreau, MD, of the University Hospital Hôtel-Dieu, Nantes, and colleagues, an interim analysis of part 2 of the phase III CASSIOPEIA trial has showed significantly prolonged progression-free survival with maintenance daratumumab vs observation...
As reported in The Lancet Oncology by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase III APOLLO trial has shown significantly improved progression-free survival with the addition of subcutaneous (SC) daratumumab to oral...
In the phase Ib/II CARTITUDE-1 trial reported in The Lancet, Jesus G. Berdeja, MD, and colleagues found that ciltacabtagene autoleucel (cilta-cel), a chimeric antigen receptor (CAR) T-cell therapy with two B-cell maturation antigen (BCMA)-targeting single-domain antibodies, produced a high rate of...
In an analysis from the UK phase III MYELOMA XI trial reported in the Journal of Clinical Oncology, de Tute et al found that persistent measurable residual disease (MRD)-negative status after autologous stem cell transplantation (ASCT) and conversion from MRD-positive to -negative status were...
Most immunocompromised people with multiple myeloma benefited from a third dose of COVID-19 vaccines—a promising sign after it was shown that two doses tended to not be sufficient for them. However, some people with multiple myeloma still remained vulnerable and may need a fourth dose or antibody...
On February 28, 2022, ciltacabtagene autoleucel was approved for treatment of adults with relapsed or refractory multiple myeloma after at least four lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.1 Ciltacabtagene autoleucel is a...
In a long-term follow-up of a Chinese phase II study reported in the Journal of Clinical Oncology, Wang et al found that the combination of anti–B-cell maturation antigen (BCMA) and anti-CD19 chimeric antigen receptor (CAR) T cells produced durable responses and favorable survival outcomes in...
On February 28, the U.S. Food and Drug Administration (FDA) approved ciltacabtagene autoleucel (Carvykti) for the treatment of adults with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 ...
As reported in The Lancet Oncology by Paul G. Richardson, MD, and colleagues, a prespecified interim overall survival analysis of the phase III ICARIA-MM trial showed that the addition of isatuximab to pomalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma produced...
The ASCO Post asked Joseph Mikhael, MD, Chief Medical Officer of the International Myeloma Foundation and Professor in the Applied Cancer Research and Drug Discovery Division at the Translational Genomics Research Institute (an affiliate of City of Hope Cancer Center), to comment on the GMMG-HD7...
For the first-line treatment of newly diagnosed multiple myeloma, the percentage of patients achieving measurable residual disease (MRD, previously called minimal residual disease) negativity was significantly greater when the anti-CD38 monoclonal antibody isatuximab was added to a standard...
The ASCO Post invited myeloma expert Philip L. McCarthy, MD, Director of the Transplant and Cellular Therapy Program at Roswell Park Comprehensive Cancer Center, Buffalo, New York, to comment on the trials evaluating early detection of myeloma at the 2021 American Society of Hematology (ASH) Annual ...
Precursors to multiple myeloma were identified by population screening in two studies reported at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition. The prevalence of monoclonal gammopathies was determined in the PROMISE trial using cutting-edge technology in a high-risk ...
Ajay K. Nooka, MD, MPH, FACP, Associate Professor in the Department of Hematology and Medical Oncology at Winship Cancer Institute, Emory University, Atlanta, commented on the promising emergence of bispecific T-cell engaging (bispecific) antibodies, as represented by studies presented at the 2021...
Poor outcomes are observed in patients with myeloma who are refractory to multiple classes of therapies, with the average patient experiencing disease progression in up to 6 months and living no longer than 6 to 15 months. Patients often rapidly cycle through regimens that use less effective or...
An updated analysis of the phase III CANDOR study—recently reported by Usmani et al and summarized in this issue of The ASCO Post—confirmed a significant progression-free survival benefit for the combination of daratumumab, carfilzomib, and dexamethasone (KdD) over carfilzomib and dexamethasone...
In an updated analysis of the pivotal phase III CANDOR trial reported in The Lancet Oncology, Saad Z. Usmani, MD, of Levine Cancer Institute/Atrium Health, and colleagues found that the addition of daratumumab to carfilzomib and dexamethasone (KdD) continued to show a large progression-free...
On November 30, 2021, daratumumab/hyaluronidase-fihj and carfilzomib were approved for use in combination with dexamethasone for adults with relapsed or refractory multiple myeloma who had one to three prior lines of therapy.1,2 Supporting Efficacy Data Approval was based on findings in a cohort...
For the first-line treatment of newly diagnosed multiple myeloma, the percentage of patients achieving measurable residual disease (MRD, previously called minimal residual disease) negativity was significantly greater when the anti-CD38 monoclonal antibody isatuximab was added to a standard...
The ASCO Post invited myeloma expert Philip L. McCarthy, MD, Director of the Transplant and Cellular Therapy Program at Roswell Park Comprehensive Cancer Center, Buffalo, New York, to comment on the trials evaluating early detection of myeloma at the 2021 American Society of Hematology (ASH) Annual ...
Precursors to multiple myeloma were identified by population screening in two studies reported at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition. The prevalence of monoclonal gammopathies was determined in the PROMISE trial using cutting-edge technology in a high-risk ...
Proteasome inhibitors, the therapeutic backbone of current treatments for multiple myeloma, are effective in treating newly diagnosed disease, but resistance or intolerance to these molecules often develops, leading to relapse. While studying a neglected tropical disease, Buruli ulcer, researchers...
Romanos Sklavenitis-Pistofidis, MD, of Dana-Farber Cancer Institute, discusses study findings on a next generation of clinical assays to assess both tumor biology and immune state, as well as common clinical biomarkers in the marrow or blood. These biomarkers may accurately predict which patients with smoldering multiple myeloma might benefit from early treatment, monitor response to immunotherapy, and improve patient outcomes (Abstract 330).
Anil Aktas-Samur, PhD, of Dana-Farber Cancer Institute, discusses study findings on the genomic characterization of non-progressor smoldering multiple myeloma, results that may provide a molecular definition of the disease as well as its risk-driving features. Combining this low-risk model with current high-risk models may possibly improve clinical trials for patients with this early precursor to myeloma (Abstract 545).
Nikhil C. Munshi, MD, PhD, of Dana-Farber Cancer Institute, discusses the findings from a large nationwide Veterans Affairs study, which showed that, for patients with multiple myeloma, the effectiveness of the COVID-19 vaccine is reduced, likely due to patients’ immunosuppression. Dr. Munshi describes what next steps should be taken (Abstract 400).
In the phase II MASTER trial reported in the Journal of Clinical Oncology, Luciano J. Costa, MD, PhD, and colleagues found that daratumumab, carfilzomib, lenalidomide, and dexamethasone (Dara-KRd) induction; autologous hematopoietic cell transplantation (AHCT); and measurable residual disease (MRD) ...
Molecular and genetic research has advanced the categorization of different risk groups in patients with smoldering myeloma. Notable presentations at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition included reports on biomarkers to predict response to immunotherapy in...
In the past decade, use of immunotherapy has arisen as a novel adjunct to multiple myeloma therapy. Daratumumab is the first anti-CD38 monoclonal antibody to be approved by the U.S. Food and Drug Administration (FDA), in November 2015, for use in treating relapsed or refractory multiple myeloma.1...