N Engl J Med. One can expect these armed immunotherapies to eventually replace the drugs we prescribe today upfront and displace these drugs in the relapse setting. Please confirm that you would like to log out of Medscape. Print Diagnosis Sometimes multiple myeloma is diagnosed when your doctor detects it accidentally during a blood test for some other condition. 3 The annual age-adjusted incidence in the United States has remained stable for decades at approximately 4 per 100,000. : Daratumumab (DARA) Plus Lenalidomide, Bortezomib, and Dexamethasone (RVd) in Patients with Transplant-Eligible Newly Diagnosed Multiple Myeloma (NDMM): Updated Efficacy and Safety Analysis of the Safety Run-in Population of Griffin. Introduction. New treatment options for patients with multiple myeloma (MM) have expanded rapidly in the past decade, leading to deeper responses. The .gov means its official. Vhody smoothies zvisia od toho, o do nich dte. 1, Virginia Naso 1, Massimiliano Mazza 3, Fabio Nicolini 3, Andrea Ghelli Luserna di Ror 4, Giorgia Simonetti 4, Sonia Ronconi 5, Michela Ceccolini 5, Gerardo Musuraca 5, Giovanni Martinelli 5 and Claudio Cerchione We herein summarize the recent therapeutic advances in MM. For instance, the phase III EXCALIBER trial will explore the association of iber-Dd versus DVd (EudraCT 020-000431-4). Ongoing studies are investigating their administration in patients with renal impairment. 2020;105(10):2358-2367. doi:10.3324/haematol.2020.247015, 2. the contents by NLM or the National Institutes of Health. : Descriptive Analysis of Isatuximab Use Following Prior Daratumumab in Patients with Relapsed/Refractory Multiple Myeloma. Multiple myeloma (MM), a plasma cell (PC) malignancy, is the second most common hematological malignancy. The patient was then placed on lenalidomide maintenance therapy. Carfilzomib. : Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma (MAIA): Overall survival results from a randomised, open-label, phase 3 trial. CAR-T cells are even tested upfront in trials such as CARTITUDE-5 (VRd followed by cilta-cel then Rd for NDMM NTE, {"type":"clinical-trial","attrs":{"text":"NCT04923893","term_id":"NCT04923893"}}NCT04923893) and CARTITUDE-6 (dara-VRd followed by cilta-cel or dara-VRd followed by ASCT, {"type":"clinical-trial","attrs":{"text":"NCT05257083","term_id":"NCT05257083"}}NCT05257083) or as in the KARMMA-4 ({"type":"clinical-trial","attrs":{"text":"NCT04196491","term_id":"NCT04196491"}}NCT04196491) for high-risk NDMM. 1.25 CE Advances in Multiple Myeloma Navigating the Evolving Treatment Landscape Rapid Fire Emerging Data in Multiple Myeloma A woman has told how she feared she'd never become a mum but gave birth to a boy at age 45 after taking Viagra to get pregnant.. Carin Rockind, 48, welcomed a "miracle" baby after trying to have a . Becnel MR, Horowitz SB, Thomas SK, et al. The identification of new targets is encouraged and expected, as knowledge of MM pathophysiology is increasing, to expand the options of MM treatments to ultimately lead to a cure. 2016;374(17):1621-1634. doi:10.1056/NEJMoa1516282, 17. 5. . Another option for the treatment of NTE NDMM is the association with D-VMP (M, melphalan; P, prednisone), which showed a median PFS of 36.4 months in the phase III ALCYONE trial6. Batch CBD Full-Spectrum Gummies. Lonial highlighted that it is the first of the B-cell maturation antigen (BCMA)directed treatments, a promising novel therapeutic target in multiple myeloma due to its expression on mature B lymphomas and limited expression on hematopoietic stem cells.26. The most common AEs were mainly CRS (70%) and neutropenia (60%). Clipboard, Search History, and several other advanced features are temporarily unavailable. A phase 2 study of modified lenalidomide, bortezomib, and dexamethasone in transplant-ineligible multiple myeloma. Updated November 20, 2015. The expression of anti-apoptotic BCL-2 proteins is increased in MM, therefore promoting cell survival. Dr Hari has collaborated with Dr Leleu on a large paper in March 2021: Dr Morgan has collaborated with Dr Leleu on a large paper in October 2020: multiple myeloma, immunotherapy, CD38, CAR-T, {"type":"clinical-trial","attrs":{"text":"NCT03710603","term_id":"NCT03710603"}}, {"type":"clinical-trial","attrs":{"text":"NCT04483739","term_id":"NCT04483739"}}, {"type":"clinical-trial","attrs":{"text":"NCT04751877","term_id":"NCT04751877"}}, {"type":"clinical-trial","attrs":{"text":"NCT04181827","term_id":"NCT04181827"}}, {"type":"clinical-trial","attrs":{"text":"NCT03651128","term_id":"NCT03651128"}}, {"type":"clinical-trial","attrs":{"text":"NCT04923893","term_id":"NCT04923893"}}, {"type":"clinical-trial","attrs":{"text":"NCT05257083","term_id":"NCT05257083"}}, {"type":"clinical-trial","attrs":{"text":"NCT04196491","term_id":"NCT04196491"}}, {"type":"clinical-trial","attrs":{"text":"NCT04162210","term_id":"NCT04162210"}}, {"type":"clinical-trial","attrs":{"text":"NCT04484623","term_id":"NCT04484623"}}, {"type":"clinical-trial","attrs":{"text":"NCT04091126","term_id":"NCT04091126"}}, {"type":"clinical-trial","attrs":{"text":"NCT03539744","term_id":"NCT03539744"}}, {"type":"clinical-trial","attrs":{"text":"NCT04973605","term_id":"NCT04973605"}}. Elranatamab After Prior BCMA-Directed Therapy Induces Early Responses in RRMM. Kostopoulos IV, Ntanasis-Stathopoulos I, Gavriatopoulou M, Tsitsilonis OE, Terpos E. Minimal residual disease in multiple myeloma: current landscape and future applications with immunotherapeutic approaches. There clearly are lots of expectations for these novel immunotherapies, and, though first developed in relapsed myeloma, they will surely challenge the current strategies in early lines of treatment. Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Soon, it may be an FDA-approved therapy. In the end, the development of non-immunological drugs must continue as patients will eventually relapse and immunotherapies have not yet allowed a cure for MM to be achieved, even though immune-based treatments seem to be in the pole position to obtain a long remission that could be seen as a functional cure. The major hematological events are thrombocytopenia (66%), which seems to be dose-dependent, and neutropenia (37%). FOIA Abstract. 2020; 38(15_suppl): 8539. Accessed February 12, 2022. https://bit.ly/3h865Zj, 8. Ide-cel was the first CAR-T cell approved in the US and Europe, following the results of the phase II KARMMA 1 trial for patients with advanced RRMM; the overall response rate (ORR) was 73%, 33% of patients had a CR, 18-month PFS was 8.6 months, and median overall survival (OS) was 24.8 months (median follow-up of 15.4 months)16. Anderson attributed it to combining classes of drugs like proteasome inhibitors, immunomodulatory drugs (IMiDs), and monoclonal antibodies for newly diagnosed patients and those with relapsed/refractory multiple myeloma. Accessed February 12, 2022. https://bit.ly/3vcApu4, 28. For that reason, the development of drugs using novel mechanisms or new targets is still encouraged. She achieved a complete remission with VRd and transplant and was also minimal residual disease (MRD) negative. Lancet Oncol.2021;22(11):1582-1596. doi:10.1016/ S1470-2045(21)00466-6, 19. Promising results reported from a study of GC012F in patients with relapsed or refractory multiple myeloma, warrant further research. The anti-CD38 drug class has been extended with the emergence of isatuximab, which exhibits slightly different mechanisms of action from daratumumab. : Isatuximab plus pomalidomide/dexamethasone versus pomalidomide/dexamethasone in relapsed/refractory multiple myeloma: ICARIA Phase III study design. Multiple myeloma: 2012 update on diagnosis, risk-stratification, and management Am J Hematol.2012;87(1):78-88. 30 Years of Improved Survival in Non-Transplant-Eligible Newly Diagnosed Multiple Myeloma. Front Oncol. JCO. The supremacy of these types of treatment can be explained by a favorable toxicity profile as well as high efficacy. Lonial S, Dimopoulos M, Palumbo A, et al; ELOQUENT-2 Investigators. But thats clearly not the case, with response rates between 60% and 80% with any of the BCMA-directed CAR T cell or bispecifics, Lonial said, noting that he is excited about the potential of having an off-the-shelf immune-stimulator product, which could be a great adjunct to CAR T cells. 2018;182(2):222-230. doi:10.1111/bjh.15261, 11. Moreau P, Masszi T, Grzasko N, et al; TOURMALINE-MM1 Study Group. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Al Hamed R, Bazarbachi AH, Malard F, Harousseau JL, Mohty M. Current status of autologous stem cell transplantation for multiple myeloma. A one-size-fits-all approach may not be the best way to deal with patients with multiple myeloma, he said. Moores Cancer Center U.S. FDA Approves CARVYKTI (ciltacabtagene autoleucel), JanssensFirst Cell Therapy, a BCMA-Directed CAR-T Immunotherapy for the Treatment of Patients with Relapsed or Refractory Multiple Myeloma. But, of course, our goal is to try and cure the disease, Kumar said. Dimopoulos MA, Moreau P, Palumbo A, et al; ENDEAVOR Investigators. 2017;11:2399-2408. doi:10.2147/DDDT.S115456, 25. It arises from red marrow due to the monoclonal proliferation of plasma cells and manifests in a wide range of radiographic abnormalities. Moreau P, Dimopoulos MA, Mikhael J, et al. Gavriatopoulou M, Chari A, Chen C, et al. Accessed February 12, 2022. https://bit.ly/3tgRTmz, 21. Careers, Unable to load your collection due to an error. Anderson defines this past decade as the immune era, and Lonial agrees, noting that the revolution in myeloma treatment during the past 10 years has been in immune-based therapies. Consultant or advisor for: Adaptive Biotechnologies; Bristol Myers Squibb Company; GlaxoSmithKline; Janssen; Pfizer, Inc.; Regeneron Pharmaceuticals, Inc.; Sanofi; Sutro Biopharma, Inc. Speaker or member of speakers bureau for: Bristol Myers Squibb Company; GlaxoSmithKline; Takeda, Contracted researcher for: Janssen; Sutro Biopharma, Inc.; Takeda, Owns stock (publicly traded) in: Bristol Myers Squibb Company, Consultant or advisor for: AbbVie Inc.; Amgen, Inc.; Bristol Myers Squibb Company; Celgene Corporation; Genentech; GlaxoSmithKline; Janssen; Novartis; Takeda, Research funding from: Bristol Myers Squibb Company; Janssen; Novartis; Takeda, Owns stock (publicly traded) in: TG Therapeutics, Other: Board of Directors for TG Therapeutics, Consultant or advisor for: AbbVie Inc.; Aggios; Amgen, Inc.; AstraZeneca Pharmaceuticals LP; Bristol Myers Squibb Company; Takeda, Speaker or member of speakers bureau for: AbbVie Inc.; Bristol Myers Squibb Company; Takeda, Consultant or advisor for: AbbVie Inc.; Amgen, Inc.; Bristol Myers Squibb Company; Janssen; Karyopharm; Pfizer, Inc.; Sanofi; Takeda, Research funding from: Bristol Myers Squibb Company. Myeloma Drug Sensitivity Testing to Optimize Retreatment with Anti-CD38 Monoclonal Antibodies in Daratumumab-Refractory Patients. Isatuximab in association with proteasome inhibitors represents a promising option for R-refractory patients with RRMM. On the other hand, the development of non-immune-based treatments will be key for subsets of patients whose tumor cells carry specific abnormalities that could be specifically targeted, such as anti-BCL-2 agents (venetoclax). Several DREAMM studies such as DREAMM-3 (belantamab vs. Pd, phase 3 for registration, {"type":"clinical-trial","attrs":{"text":"NCT04162210","term_id":"NCT04162210"}}NCT04162210), DREAM-8 (belantamab + Pd vs. Pd, {"type":"clinical-trial","attrs":{"text":"NCT04484623","term_id":"NCT04484623"}}NCT04484623), and DREAMM-9 (belantamab + VRd, {"type":"clinical-trial","attrs":{"text":"NCT04091126","term_id":"NCT04091126"}}NCT04091126) are ongoing or planned. 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