VIDEO: Lack of personalized medicine approach, other unmet needs in multiple myeloma

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So one of the first really unmet need still remains the fact that myeloma is incurable. Novel therapies are needed especially for patient that relapse, and we see a very huge heterogeneity between our patients. We have patient that do very well, and they maybe just need one or two lines of therapies, and they are in remission for 10 years, but also, we see patient that progress quickly and practically after every single therapy. So, on the same team, really finding personalized approach based on the genetics and molecular characteristics of the disease is important because that can really improve outcomes of patients. So right now, in myeloma, we don't really have any personalized medicine approach. I mentioned before venetoclax, so drug indication that works better in translocation 11;14 but is still not used like, for instance, in frontline in these patients. And then, some data are starting to come up between a correlation of response between isatuximab and the presence of 1q gain, but we are still, like, really in the early phase of personalized medicine in myeloma.

Moreover, the other real important point is we know that multiple myeloma arise from precursor condition from MGUS or smoldering myeloma, but we really don't have good ways to predict who will progress or, even more, prevent the development of active myeloma. And the way for doing that, and there are different, like, ongoing clinical trial, and it's really to try to use early on therapies used in active myeloma, but these can still lead to severe side effects.

The other big area of improvement connecting to side effects is really the mitigation of short-term and long-term side effects. We know that unfortunately, some of medication that we use can cause peripheral neuropathy, can cause cytopenias, risk of infection, GI toxicity, so all these field of kind of, like, personalized medicine and mitigation of toxicity is also something that I think is an unmet need in myeloma.

And finally, really, access to care. So access to clinical trials, access to transplant even or CAR T therapies still remain some major issues especially from patient that lives in rural areas or for minorities, and as I mentioned previously, we are a referral center for community oncologies and also out-of-state patients. A lot of our patient comes for transplant or CAR-T therapies from, I live in Ohio, so from Kentucky, from Indiana, from West Virginia, and this always poses a lot of problems in terms of logistics and also, like, insurance copayment and stuff like that. So having opportunities also to trials access and all this, it really remains an unmet need for our patients.