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Expanded drug combinations produce best myeloma induction

Friday, April 14, 2017

This is an excerpt of a story that appeared in Hematology News. Read the full article here.

Dr. Paul G. Richardson (left) and Dr. Ruben NiesvizkyDr. Paul G. Richardson (left) and Dr. Ruben Niesvizky. Photo by Mitchel L. Zoler/Frontline Medical News

What is the optimal induction therapy for patients with multiple myeloma? According to Harvard Medical School professor Paul G. Richardson, M.D., all the therapeutic tools currently available for combination therapy, which means using four agents followed by autologous stem cell transplantation. 

But speaking at a recent meeting on Hematologic Malignancies held by Imedex, Ruben Niesvizky, M.D., suggested a more cautious approach to using the monoclonal antibody daratumumab for induction. He cited the published experience in adding the antibody to pared-down backbone therapy in the setting of relapsed or relapsed and refractory disease, such as a proteasome inhibitor plus dexamethasone (N Engl J Med. 2016 Aug 25;375[8]:754-66) or an immunomodulator plus dexamethasone (N Engl J Med. 2016 Oct 6;375[14]:1319-31).

Adding a monoclonal antibody such as daratumumab to combination therapy is the “wave of the future,” said Dr. Niesvizky, professor of medicine and director of the Multiple Myeloma Center at NewYork-Presbyterian/Weill Cornell Medical Center. It provides treatment that reduces disease-related complications and achieves effective and extended disease control with improved overall survival, while being well tolerated and facilitating stem cell collection, he said.