VIDEO: Treatment pipeline for multiple myeloma

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Myeloma continues to really excel in the sense that, you know, although we have not yet turned this into a curable disease, it is now a highly treatable and increasingly treatable blood cancer. That being said, there are still many unmet needs. And unfortunately there are still patients, you know, those with high risk or ultra high risk disease, you know, who haven't really or aren't able to enjoy nearly the same degree of benefit from our current therapies as most patients do. So we have a lot of work to do. In terms of the pipeline, there are agents that are a bit further down the pipeline that I think we already have a good idea that they work. That there's definitely an impressive efficacy signal. And so far a pretty good safety signal. The first class that comes to mind is the cell mods, kind of the next generation cereblon. Targeting drugs, Revlimid Pomalyst type of of drugs, but with very important structural differences that seem to make them even more potent and active even in the refractory patients. So I think, you know, the CC-220, which has an actual name now, Iberdomide, you know, and then not too far behind is CC-480, are both under clinical trial investigation here and elsewhere. And I see them as likely making their way into the space and, you know, either providing backup for or potentially, you know, supplanting, you know, our current standard of care amidst in earlier lines of therapy. So I would definitely keep an eye on the cell mods. You know, I've already talked ad nauseum about the BCMA CAR T-cells and the bispecifics. And those are definitely fairly far along the pipeline. There are other forms of immunotherapy to include. Other, you know, immune effector cellular therapies, CAR T-cell therapies that are kind of just getting started on the pipeline or less far along than, say, cell-to-cell, for example, with different targets, you know, different types of T-cell mediated therapies. You know, both in the CAR T-cell and the bispecific classes. There are even newer therapies that are trying to harness the power, you know, different arm of the immune system. You know, kind of, the therapies focusing on natural killer cell activation and engagement. You know, even newer therapies that are looking at the macrophage component of the immune system that are nowhere near being FDA approved for myeloma but are starting to be studied and have shown pretty good promise in other hematologic malignancies. There are small molecules inhibitors. Sorry, small molecule inhibitors forms of kind of targeted therapy that are currently being combined with a current standard of care. Myeloma agents, my drug study that's currently open here and other centers I think is one good example of that principle. And, oh, what else? Tons else, different types of, you know, monoclonal antibody based therapies, both the quote unquote, next generation, naked antibodies with potentially higher affinity compared to what's currently available. As well as antibodies that are armed with payloads, you know, different forms of either chemotherapy or immunotherapy. You know, delivered directly to the myeloma cell via the the MAB construct. I could probably go on and on, but those are at least some of the things that are in the pipeline. Perhaps, you know, versions 2.0 or even 3.0 at this point of compounds that are very similar to what's the current standard of care. Newer forms of immunotherapy, both CAR T-cell based and non-CAR T-cell based in terms of T-cell mediated immunity, different forms of immunotherapy that actually are not specifically or exclusively T-cell mediated targeted forms of therapy, and, you know, last but not least, forms of therapy that are attempting to target the quote unquote microenvironment, the milieu that surrounds the myeloma cell. You know, that may help it survive, may help it resist certain therapies, may at least be part of why myeloma is still unfortunately incurable. These are all things that are being actively studied. So I guess in summary, I can say that multiple myeloma is actively being attacked from all sides and all fronts and how we're eventually going to figure things out in terms of sequencing therapies that do show, you know, great activity and clinically meaningful benefit is a whole other conversation. But I think, you know, with where we're at right now, having come a long way, but still needing to go much further in terms of benefiting our patients. I'm personally really excited about all the very promising and different types of ways that myeloma is being attacked, you know, in, in the lab and in the clinic.