VIDEO: Deep response key benefit of combination therapy in multiple myeloma

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Multiple myeloma cells can rapidly change and adapt quickly to therapies. This is why we usually combine between two and four drugs to aggressively kill those cells. And the reason for doing that is really that we can target different aspect of myeloma pathogenesis, such as blocking the protosomes and we know are very crucial for cells that produce a large amount of proteins, or activating modulating the immune system, or attacking specific surface antigen. And really as the FDA has really recently attested the role of MRD as well and accept the surrogate for endpoint for some clinical trials, really we want to get the deepest response for our patient upfront, especially in frontline therapies. Another benefit of having like deep responses with intense regimen, especially with like combination therapy is then the possibility with this deep response to space maybe infusion and reduce the number of therapies for, for instance, consolidation or maintenance.

Usually patients start with like upfront front line therapy with like three or four drugs and then they receive some type of consolidation, either stem cell transplant or same regimen with three or four drugs. But then, they're able in the maintenance phase to maybe be just on like one single drug such as lenalidomide or now with like the new clinical trial results coming up from Brazil, and we'll see from the DRAMMATIC trial, maybe one or two drugs for some patient with high risk features. But still like this allows us and allows a patient to have less pill burden or less need to come to infusion center. And then also having deep response with like multiple regimen allows to space the infusion. For instance, positive CD38 antibodies and the biospecific antibodies can, once we have good responses being spaced to biweekly and monthly dosing from light weekly doses.