Multiple Myeloma: Excitement about monoclonal antibodies
Morton Coleman, M.D.
The best treatment for young, fit, transplant-ineligible multiple myeloma patients is three, not four drugs, but the incorporation of new monoclonal antibodies into four-drug regimens has myeloma experts talking about a potential cure, according to experts at the Lymphoma & Myeloma International Conference.
The future of four-drug regimens has brightened with the introduction of monoclonal antibodies in myeloma therapy, he continued. Studies are under way adding the investigational human IgG1k monoclonal antibody daratumumab to bortezomib-thalidomide-dexamethasone or to bor-te-zomib-melphalan-prednisone. Also, the anti-CD38 monoclonal antibody isatuximab has been added to bortezomib-cyclophosphamide-dexamethasone.
“Monoclonal antibodies may make four drugs into R-CHOP for myeloma,” Palumbo said, referring to the combination of the anti-CD20 monoclonal antibody rituximab along with cytotoxic therapies, which revolutionized the treatment of B-cell lymphomas.
In an interview, Congress Chair Morton Coleman, MD, Director of the Center for Lymphoma and Myeloma at New York-Presbyterian Hospital/Weill Cornell Medical College, agreed: “We are looking for an R-CHOP-like therapy in myeloma. If we use monoclonal antibodies in combination with second-or third-generation regimens, with or without transplant, we could possibly cure myeloma patients. The next step to a cure is minimal residual disease negativity. With combinations of new modalities, we can start to talk about a cure.
“Young, fit myeloma patients show no benefit from four drugs. What you gain in efficacy you lose in toxicity,” Coleman continued. “However, with monoclonal antibodies, there may be a role for a fourth drug.”
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This is an excerpt of an article that appeared in Oncology Times. Read the full report here.