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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,...
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...
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 ...
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...
“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...
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, ...
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,...
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...
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 ...
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...
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...
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...
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...
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)...
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...
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, 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).
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...
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...
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...
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....
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, 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, 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, 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).
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...
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...
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....
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...
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...
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™....
“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...
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...
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...
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...
“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...
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...
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...
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: 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...
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...
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....
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...
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...
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...
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...
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...
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...
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...
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...