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VIDEO: Flood of new myeloma drug approvals carries new combination options, clinical choices
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Shaji Kumar, MD, professor of medicine, division of hematology, Mayo Clinic, Rochester, Minn., discusses how the FDA approval of several new myeloma therapies in the past year stands to shift every day practice.
“The important thing is that all these drugs are of different classes, and they are going to significantly impact how we treat myeloma going forward,” he said.
Kumar provides an in-depth look at monoclonal antibodies daratumumab (Darzalex, Janssen) and elotuzumab (Empliciti, Bristol-Myers Squibb), touching on their specific protein targets as well as patient outcomes with combination treatment.
He also highlights the “remarkable progress” seen with proteasome inhibitor carfilzomib (Kyprolis, Amgen), proven superior to bortezomib (Velcade, Millennium) as an adjunct to dexamethasone in the phase 3 ENDEAVOR 3 study, and the benefits observed with the first oral proteasome inhibitor ixazomib (Ninlaro, Takeda Pharmaceuticals).
“These all have significant advantages in terms of new therapies for myeloma. At the same time, this also leads to the question ‘Where are we going to use all these drugs?’”
Kumar emphasizes the new array offers the option of “mixing and matching” to generate good regimens and points to preferred choices in both newly-diagnosed and relapsed myeloma
“The disadvantage with myeloma right now is that it’s incurable,” he said. “At the end of the day, we’ll end up using many of these drugs in sequence in these patients.”