Research Highlight: Changing the Landscape of Treatment for Multiple Myeloma (Part 1)

Patients with active MM require therapy; such as chemotherapy, proteasome inhibitors (Bortezomib, Carfilzomib and Ixazomib), immunomodulatory IMiDs (Thalidomide, Lenalidomide and Pomalidomide), Histone deacetylase (HDAC) inhibitors (Panobinostat) and monoclonal antibodies (Daratumumab, Elotuzumab and Isatuximab). Chemotherapy plus stem cell transplant has also been the standard treatment. LLS advanced many of these to approval and current clinical use.

One of the more recent approvals for MM came July 2019, when Xpovio (Selinexor) was approved for relapsed or refractory multiple myeloma (R/R MM). This drug has received extensive support from LLS: over $4M in 9 grants for acute myeloid leukemia, chronic lymphocytic leukemia, diffuse large B-cell lymphoma and for multiple myeloma. Earlier this year in March, the FDA approved Sarclisa (isatuximab-irfc), in combination with pomalidomide and dexamethasone, for the treatment of adult patients with relapsed or refractory multiple myeloma. Currently, one project in the SCOR grant of Robert Z. Orlowski, M.D., Ph.D. (MD Anderson) is a multi-center clinical trial of isatuximab in high-risk smoldering myeloma (SMM) exploring the use of this monoclonal anti-CD38 antibody in the precursor disease of MM. More about Dr. Orlowski’s published research at https://faculty.mdanderson.org/profiles/robert_orlowski.html.

The most recent approval of daratumumab and hyaluronidase-fihj for adult patients with newly diagnosed or relapsed/refractory multiple myeloma occurred in May 2020. Daratumumab and hyaluronidase-fihj is approved for the following indications that intravenous daratumumab had previously received: in combination with bortezomib, melphalan and prednisone in newly diagnosed patients who are ineligible for autologous stem cell transplant, in combination with lenalidomide and dexamethasone in newly diagnosed patients who are ineligible for autologous stem cell transplant and in patients with relapsed or refractory multiple myeloma who have received at least one prior therapy, in combination with bortezomib and dexamethasone in patients who have received at least one prior therapy, as monotherapy, and in patients who have received at least three prior lines of therapy including a proteasome inhibitor and an immunomodulatory agent or who are double-refractory to a PI and an immunomodulatory agent.

For more information on treatment options, myeloma and LLS resources, please contact an Information Specialist.