[Pauillac]

Article: New drugs & treatment regimens for myeloma

by Pauillac on Mon Oct 16, 2017 3:49 am

Hello,

I recently came across this new journal article, which I found to be a good summary of new multiple myeloma treatments and the major clinical trials related to them:

Larocca, A, et al, "Emerging drugs and combinations to treat multiple mye­loma," Oncotarget, Sep 1, 217 (full text of article)

Abstract:

In the past few years, multiple targeted therapies and immunotherapies including second gen­era­tion immunomodulatory drugs (pomalidomide) and proteasome inhibitors (carfilzomib, ixazo­mib), mono­clonal antibodies and checkpoint inhibitors were approved for the treatment of mye­loma or entered advanced phases of clinical testing. These agents showed significant activity in ad­vanced myeloma and increased the available treat­ment strategies.

pomalidomide is well-tolerated and effective in patients with relapsed/refractory multiple mye­loma who have exhausted any possible treatment with lenalidomide and bortezomib. Car­filz­o­mib, a second-generation proteasome inhibitor, is active as a single agent and in combi­nation with other anti-myeloma agents. Ixazomib is the first oral proteasome inhibitor to be evaluated in mye­loma and is associated with a good safety profile and anti-myeloma activity in relapsed / refractory patients, even in those refractory to bortezomib. Monoclonal antibodies and immune checkpoint inhibitors are likely to play a major role in the treatment of myeloma over the next decade.

In phase 3 studies, triplet regimens based on these agents combined with a backbone therapy (including lenalidomide, pomalidomide or bortezomib) were more efficacious than doublet regimens in patients with relapsed/refractory multiple myeloma, with limited additional toxic effects.

This paper aims to provide an overview of the recent use of these agents for the treatment of myeloma, in particular focusing on the role of multi-agent combinations.