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ASH 2016: Multiple myeloma highlights

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Published: 06.12.16
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Prof Marivi Mateos, Prof Philippe Moreau, Prof Saad Usmani, Prof Heinz Ludwig

Prof Marivi Mateos (University Hospital of Salamanca, Salamanca, Spain) chairs an expert discussion on the latest in Multiple Myeloma (MM) for ecancertv at ASH 2016 in San Diego.

With Prof Philippe Moreau (University Hospital of Nantes, Nantes, France), Prof Saad Usmani (Carolinas Healthcare System, Charlotte, USA) and Prof Heinz Ludwig (Wilhelminenspital, Center for Oncology and Hematology, Vienna, Austria).

The discussion started by looking at newly diagnosed multiple myeloma patients, with data from the FIRST trial showing treatment with lenalidomide plus low-dose dexamethasone until disease progression improved outcomes for transplant-ineligible patients.

Whilst PFS and OS were significantly prolonged, the incidence of cataracts seen in this patient population was noted.

The panel then moved on to the relapsed/refractory setting (RRMM), with a focus on the Phase III POLLUX and CASTOR data, which recently have led to the FDA approvals of daratumumab in combination with either lenalidomide and dexamethasone (DRd) or bortezomib and dexamethasone (DVd) for patients with RRMM who have had at least 1 prior therapy.

The updated CASTOR data shows that the treatment benefit of DVd was maintained, with the ‘best benefit’ seen in patients with 1 prior line of therapy.

The updated POLLUX data also showed that responses with DRd were deep and durable, with these ‘practice changing’ results translating into significantly improved clinical outcomes vs Rd in 1-3 PL pts with RRMM.

Leading on from this was the evaluation of Minimal Residual Disease (MRD) in the CASTOR and POLLUX trials, with these ‘outstanding’ results demonstrating that daratumumab -containing therapies are able to drive patients to deep levels of clinical response.

ASH 2016 also saw data presented that analysed a subcutaneous formulation of daratumumab, which was well tolerated and achieved serum trough concentrations similar to or greater than intravenous (IV) daratumumab with a lower rate of infusion related reactions compared to IV daratumumab over a significantly shorter infusion time.

It was noted that the SC formulation of daratumumab should be explored in future clinical trials.

The discussion was rounded up with the mention of promising results with selinexor and the STORM trial, venetoclax as both a single agent and in combination, and the use of checkpoint inhibitors for the treatment of multiple myeloma patients.

This programme has been supported by an unrestricted educational grant from Janssen Pharmaceuticals (A Johnson & Johnson Company).

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