Treatment Options and Unmet Needs Evaluated in Multiple Myeloma

C. Ola Landgren, MD, PhD, reviewed the plethora of emerging treatment options in multiple myeloma, and how unmet needs in the space can be overcome.

In an interview with CancerNetwork® following a recent Around the Practice® program, panel moderator C. Ola Landgren, MD, PhD, recapped the program and provided an overview of upcoming treatment options in the multiple myeloma space, including bispecifics, trispecifics, naked antibodies, and various cell therapies.

Landgren also noted the major commonality linking these new treatment options, which is that many of them are immunotherapies. He stated that they’ve already begun to make an impact in the space. Additionally, he touched on their potential to change the standard of care in multiple myeloma, and how the standards have already changed due to recent developments.

Landgren is a professor of hematology, chief of the Myeloma Section, leader of the Experimental Therapeutics Program, and co-leader of the Tumor Biology Program at the University of Miami Sylvester Comprehensive Cancer Program. Treatment standards for multiple myeloma remain limited by several unmet needs, and Landgren identified how these challenges are being addressed by clinicians and investigators. Among these is an inability to distinguish high-risk disease well enough to fully optimize therapy. He also touched on the need for curative therapies, despite the gains in survival made over the past few decades.


There are so many different [emerging treatment] options. A commonality is that [many of] the upcoming drugs are immunotherapy agents, [including] many of the antibodies. [There are] bispecifics, trispecifics in development, naked antibodies, and cell therapies. There are many other options as well. Additionally, the drugs that have recently arrived have already begun to change the standard of care quite a bit.

The unmet needs for myeloma have shifted over time. We used to have unlimited unmet needs because we lacked drugs. Nowadays, we have a lot of drugs [available], but unfortunately, there are patients who don’t do well in the upfront setting. We’ve referred to these patients as [having] high-risk disease; we lack better markers to identify true high-risk disease. [Current] cytogenetic markers are not good enough. [As such], many of the patients we label as having high-risk disease don’t [actually] have high-risk disease. Also, unfortunately, some patients who are not labeled as having high-risk disease still have poor outcomes. So, they [should have been labeled as] high-risk. We need better markers. We also need better drugs for patients with high-risk disease.

Overall, we [also] need curative treatments. Patients continue to relapse, but we have come a long way. Patients can [often] live for 10 or 20 more years [than they used to], but they still need therapy.

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