Ongoing Trials May Pave Way To Bring Later-Line Therapies Upfront in Newly Diagnosed Multiple Myeloma

Ravi Vij, MD, MBA, suggested that 4-drug regimens may be a new standard for frontline therapy in newly diagnosed multiple myeloma, as oncologists await trial readouts from ongoing clinical trials.

As part of CancerNetwork’s Face-Off video series, Ravi Vij, MD, MBA, professor, Department of Medicine, Oncology Division, Bone Marrow Transplantation & Leukemia at Washington University School of Medicine in St. Louis, discussed future directions and studies being done in the myeloma space.

Vij: I think that currently there are several ongoing clinical trials, the results of which are eagerly awaited, that are looking at actually bringing 4-drug regimens even for patients not headed to stem cell transplantation. The 4-drug regimens have become a mainstay of treatment for transplant eligible patients already. But for transplant ineligible patients, we still tend to use the 3-drug regimens.

So in the future adding a CD38 antibody, be it daratumumab (Darzalex) or isatuximab [Sarclisa] is expected to also become the standard of care once those trials looking at [2-, 3-, or 4-drug regimens] are presented at future meetings.

For patients with multiple myeloma, we are fortunate that we have made tremendous progress in the last 20 years with the mainstay of therapy being proteasome inhibitors, immunomodulatory drugs, and CD38 antibodies. We're entering a new era now with a whole new group of targets that have already shown their efficacy in later lines of therapy, including bi-specifics; CAR Ts to BCMA; and other targets including GPRC5D and FCRF5; data with cell mods; venetoclax [Venclexta] and 1114 translocation patients.

We expect that with time, these will move into the paradigm of treatment earlier in the course and will benefit even more patients with multiple myeloma.

Transcription edited for clarity.

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