VIDEO: Stem cell transplant for myeloma ‘here to stay,’ stands to improve with help of new agents

Amrita Krishnan, MD, FACP, director of the Judy and Bernard Briskin Center for Multiple Myeloma Research at the City of Hope Comprehensive Cancer Center in Duarte, Calif., discusses where stem cell transplantation fits into the myeloma treatment paradigm amidst the rapidly-evolving therapeutic armamentarium.

“Especially in the era of new drugs for myeloma … the question always comes up ‘is there a role for transplantation?’”

Krishnan highlights promising data on PFS and complete response rate with early vs. delayed transplant presented at the American Society of Hematology Annual Meeting and Exposition, noting the field eagerly anticipates longer follow-up — particularly with lenalidomide (Revlimid, Celgene) maintenance used in the trial.

She also points to an ongoing investigation into the use of lenalidomide until progression, which could provide answers on the “optimal duration of maintenance.”

Krishnan offers investigator insight on consolidation chemotherapy with maintenance from both the Blood and Marrow Transplant Clinical Trials Network STaMINA Trial, using lenalidomide, as well as from a study through the Multiple Myeloma Research Consortium, using ixazomib (Ninlaro, Takeda Pharmaceuticals).

She also touches on two “very attractive” frontiers now being explored following transplant including the use of checkpoint inhibitors and monoclonal antibodies such as daratumumab (Darzalex, Janssen).

“Certainly transplant is here to stay,” Krishnan said. “It’s really a question of how do we continue to make it even better.”