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Front-line combinations in multiple myeloma: Highlights from EHA 2017

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Published: 25.06.17
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Prof Joy Ho and Prof Je-Jung Lee

Professor Joy Ho (Royal Prince Alfred Hospital, Sydney, Australia) and Professor Je-Jung Lee (Chairman, Korean Multiple Myeloma Working Party) discuss current treatment paradigms in newly diagnosed multiple myeloma (NDMM), recent advances in combination therapy from EHA and the potential impact on clinical practice in countries including Australia and South Korea.

Current treatment practices for transplant eligible and transplant ineligible patients were discussed, noting key regional variations to what patients are prescribed.

Looking at recent advances in combination therapies presented at EHA, discussion moved on to the long-term follow-up of NDMM patients taking weekly ixazomib, lenalidomide and dexamethasone (Rd) who had not undergone stem cell transplantation (SCT). 

Professor Lee noted how this study showed ‘impressive results’ with patients who went on to receive maintenance with single-agent ixazomib at the end of the induction period showing an ORR of 100%, including 44% VGPR and 32% CR.

  It was also noted that safety was ‘acceptable’ and the oral regimen was ‘very compatible for the patient’, especially for the elderly.

It was noted that due to clinical trial involvement across Australia and Korea in the relapsed setting, there has been experience with ixazomib.

Although data remains immature, Professor Ho suggested that this could provide another option in frontline therapy, however the availability of novel treatments remains an issue.

Another study presented at EHA was the UK NCRI Myeloma XI trial comparing, in transplant eligible (TE) patients, the induction quadruplet carfilzomib, cyclophosphamide, lenalidomide and dexamethasone (KCRd) to the sequential strategy of triplet immunomodulatory combinations (with thalidomide or lenalidomide) followed by additional pre-transplant consolidation with PI triplet therapy for those with a suboptimal response.

This programme has been supported by an unrestricted educational grant from Takeda.

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