MULTIPLE MYELOMA

Current approaches to the management of multiple myeloma (MM), in particular the introduction of proteasome inhibitors (PIs) and immunomodulatory agents (IMiDs), have improved the survival of patients.

Novel combinations and immunotherapies have significantly expanded treatment options for myeloma. Numerous studies, including the ASPIRE and ELOQUENT-2 trials, have shown positive results for triple drug combinations.

The treatment options for patients with relapsed/refractory multiple myeloma are expanding rapidly, notably through clinical trial evidence supporting a number of three-drug combination regimens.

Carfilzomib (Kyprolis) doubled progression-free survival (PFS) versus bortezomib (Velcade) in patients with relapsed multiple myeloma in the phase III ENDEAVOR trial.

The FDA has approved panobinostat (Farydak) in combination with bortezomib (Velcade) and dexamethasone for patients with previously treated multiple myeloma.

Lenalidomide (Revlimid) plus dexamethasone has been approved by the FDA for the treatment of newly diagnosed patients with multiple myeloma who are not candidates for stem cell transplant, based on findings from the phase III FIRST trial.

Amgen and its subsidiary Onyx Pharmaceuticals have submitted an sNDA to the FDA for the full regulatory approval of carfilzomib (Kyprolis) as a treatment for patients with relapsed multiple myeloma.

The proteasome inhibitor ixazomib (MLN9708) met its primary endpoint of improving PFS at a prespecified interim analysis of a phase III trial of patients with relapsed/refractory multiple myeloma.

Gareth Morgan, MD, PhD, the director of the Myeloma Institute at the University of Arkansas, discusses gene expression profiling for patients with smoldering myeloma.

Irene Ghobrial, MD, director, Michele & Stephen Kirsch Laboratory, senior physician, Dana-Farber Cancer Center Institute, discusses the novel anti-CXCR4 ulocuplumab for the treatment of multiple myeloma.

Anti-CD38 monoclonal antibodies continue to demonstrate promise and generate excitement that a new treatment paradigm could be on the horizon for patients with multiple myeloma.

Shaji Kumar, MD, professor of medicine, Mayo Clinic, discusses the results of the phase III ASPIRE trial.

The FDA’s Oncologic Drugs Advisory Committee (ODAC) voted 5-2 against the accelerated approval of panobinostat (Farydak) in combination with bortezomib (Velcade) and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy.

The FDA has scheduled an ODAC advisory hearing to discuss the NDA for panobinostat in combination with bortezomib and dexamethasone for patients with multiple myeloma who have received at least one prior therapy.

Andrzej Jakubowiak, MD, PhD, professor of medicine, director, Myeloma Program, University of Chicago Medicine, discusses the toxicity profile of panobinostat in combination with bortezomib and dexamethasone in relapsed or relapsed/refractory multiple myeloma as seen in the PANORAMA trial.

Treatment with single-agent carfilzomib (Kyprolis) was unable to significantly extend overall survival (OS) compared with best supportive care in heavily pretreated patients with multiple myeloma.

The FDA has expanded the bortezomib (Velcade) label to allow for retreatment in patients with multiple myeloma who previously responded to the proteasome inhibitor.

The combination of carfilzomib, carfilzomib, and low-dose dexamethasone extended PFS by 8.7 months compared with lenalidomide and dexamethasone alone for patients with relapsed multiple myeloma.

Angela Dispenzieri, MD, a professor of medicine in the division of hematology at the Mayo Clinic, discusses the results of the PANORAMA 1 trial: a randomized, double-blind, phase III study of panobinostat or placebo plus bortezomib and dexamethasone in relapsed or relapsed and refractory multiple myeloma.

The FDA has approved the radioactive diagnostic imaging agent Lymphoseek injection to guide sentinel lymph node biopsy in patients with cancer of the head and neck.

Combining the pan-deacetylase inhibitor panobinostat with bortezomib and dexamethasone delayed disease progression by 3.9 months over bortezomib and dexamethasone alone in patients with relapsed or relapsed and refractory multiple myeloma.

SAR650984 demonstrated encouraging efficacy as a monotherapy and in combination with dexamethasone and lenalidomide without reaching a maximum tolerated dose in patients with heavily pretreated multiple myeloma.

The addition of the investigational hypoxia-targeted drug TH-302 to dexamethasone has demonstrated beneficial activity and a manageable adverse event profile in the treatment of patients with relapsed/refractory multiple myeloma.

In the treatment of multiple myeloma (MM), following decades of little progress, the last 10 years have been characterized by more clinical advancements than for any other cancer.

C. Ola Landgren, MD, PhD, a senior investigator in the Multiple Myeloma Section of the National Cancer Institute, discusses the treatment of older patients (over age 70) with multiple myeloma.

More than two dozen abstracts at the December 2013 meeting of the American Society of Hematology (ASH) focused on the detection, measurement, or monitoring of MRD in patients with multiple myeloma.

In most malignancies, early detection and intervention are prerequisites for a possible cure. Consequently, why is the standard of care for myeloma a watch-and-wait approach, with no treatment until progression?

Screening for prostate-specific antigen (PSA) significantly cuts the death rate from prostate cancer, but at the same time, America’s medical community should work harder to avoid the screen’s potential pitfalls.

Jacob Laubach, MD, MPP, from Dana-Farber Cancer Institute and an Instructor in Medicine at the Harvard Medical School, discusses daratumumab as a potential treatment option for patients with multiple myeloma.

Brian G.M. Durie, MD, chairman, International Myeloma Foundation (IMF), hematologist/oncologist, Cedars-Sinai Medical Center, Los Angeles, California, discusses results from a phase III trial that compared lenalidomide (Revlimid) plus dexamethasone versus the standard treatment of melphalan plus prednisone and thalidomide (MPT) in patients with multiple myeloma who are over 65 years old. Durie offers his thoughts regarding the impact of this trial.