VIDEO: New drugs are game changer for multiple myeloma

Multiple myeloma over the last 30 years has evolved from few drugs — mainly cytotoxic drugs — to now having 17 new drugs approved in last 20 years, almost one drug a year. The most important recent developments have focused around immunotherapy. There are immune approaches that we all have been studying for a long period of time with limited success. But development of antibodies — there are three of them — daratumumab [Darzalex, Janssen], cetuximab [Erbitux, Eli Lilly] and inotuzumab [Besponsa, Pfizer] — which have become now standard of care. The anti-CD38 targeting antibodies are being utilized now as the induction regimens. And then more recently, two developments in the immunotherapy field, which has literally revolutionized the treatment of myeloma, and outcome in patients, has been the [chimeric antigen receptor (CAR)] T cell. There are two of them approved — Abecma [Bristol Myers Squibb, 2seventy bio] and Carvykti [Janssen, Legend Biotech]. And then bispecific, one is approved, two more likely to be approved. And together, this potential five immunotherapeutic approaches, starting at a late stage — each of them are approved to be given in the United States as a fifth-line treatment. They’re soon to be brought earlier on as first- and second-line treatment. And they're literally revolutionizing the treatment. And why is that? It’s because of their incredible efficiency and efficacy. So, if you take either of the CAR T cells, the response rates are anywhere from 85% to 99%. Almost everybody responds, even when given at a median of six lines of treatment. So even in a very late stage disease, it gives incredible response. And if you look at data from Carvykti, the progression-free survival given to patients in median sixth-line has been close to over 3 years. So incredible length. So deep response and long duration is making them incredibly important. And the second stage is the bispecific antibodies. The one which is approved is teclistamab [Tecvayli, Janssen Biotech]. The two more likely to be approved are elranatamab [Elrexfio, Pfizer] and talquetamab [Talvey, Janssen]. The two of the antibodies are targeting BCMA. The third one is going to be targeting GPRC5D — both important targeting myeloma. And these bispecifics by themselves, they’re off-the-shelf. They don’t need any cell production. They give around 65% responses. Again, in very advanced patient population with a very good duration of response over 12 months to 18 months. And, so, this is the most recent development in multiple myeloma that is changing our field tremendously in less cell disease moving forward in earlier part of the disease.