VIDEO: Novel agents in the multiple myeloma pipeline

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You know I think again, it gets down to this issue of practical options that could be readily available to patients from all walks of life and all communities. So oral therapies particularly appeal to me. I think infusional outpatient treatments that can be given in a really, truly outpatient setting, with the convenience of that. We’ve got multiple of them coming. I mean, obviously, we have the so-called CELMoDs, which are looking very promising. We have, in my opinion, belantamab mafodotin [Blenrep, GSK] an antibody-drug conjugate obviously still approved in Europe, but essentially on a hold here in the United States, I think will come through. In the same spirit, I think melflufen, which is this peptide-drug conjugate. So, it’s not melphalan. It’s absolutely not. It is a way of delivering the melphalan warhead without the damage around it. So, it’s a peptide-drug conjugate. I guess the analogy would be, if you think of belantamab mafodotin, it’s belantamab with the mafodotin warhead. And in a sense, melflufen is a peptide-drug conjugate which delivers that warhead into the tumor. Leverages the enzyme system within it. And as a result of that delivers the warhead to where it’s supposed to be. I’ll take a metaphor from a great friend of mine, Pete Voorhees. He described it as a Trojan horse. And I think that’s exactly right. So, I think there are lots of ideas like that. So belantamab, melflufen, the CELMoDs, other small molecules.

I really to want make a shout for other small molecules, because obviously we’ve got all these exciting new cellular platforms and fabulous bispecifics and in no way to take away for a moment from their potential and their success. But the other small molecule approaches can matter just as much and allow us that ability to bridge to next steps and to offer additional therapies, additional times to patients, because immune exhaustion is real. You know, you can have CAR-Ts, you can have bispecifics, but your T cells can become exhausted. Natural killer cell strategies, therefore, really matter. There’s lots of excitement there. There’s other exciting targets that are biologically rational, such as targeting CD47. Although, like a lot of things, that’s been much more challenging than we thought it would be. And then, as I mentioned, there’s some very exciting small molecules coming along with novel targets. And these are just oral therapies and we hope to build them into combination strategies that will make a big difference in the future.