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EMN 2021 | Monoclonal antibodies for lenalidomide-refractory multiple myeloma

Enrique M. Ocio, MD, PhD, Marqués de Valdecilla University Hospital, Santander, Spain, discusses optimization of the treatment sequence for patients with lenalidomide-refractory multiple myeloma. In particular, Dr Ocio highlights the potential of monoclonal antibody therapies such as isatuximab in combination with other drugs including carfilzomib or pomalidomide, and pomalidomide plus bortezomib and dexamethasone. This interview took place during the 2021 European Myeloma Network (EMN) congress.

Transcript (edited for clarity)

We know that currently at relapse, the main problem we are facing, the main challenge is those patients that are len-refractory. So, I will speak here, during the EMN, about the treatment of these len-refractory patient and how to sequence treatment. I think that we have several options for these patients but we know that many of the old drugs we had, or the old combinations, were not particularly focused in these len-refractory patients...

We know that currently at relapse, the main problem we are facing, the main challenge is those patients that are len-refractory. So, I will speak here, during the EMN, about the treatment of these len-refractory patient and how to sequence treatment. I think that we have several options for these patients but we know that many of the old drugs we had, or the old combinations, were not particularly focused in these len-refractory patients.

Now we are starting to have data on, on randomized trials in these specific patient population. I think it’s important to say that we have combinations, such as anti-CD38 monoclonal antibodies, daratumumab, or rituximab in combination with carfilzomib, also in combination with pomalidomide. And also, we will have some data, as you know, from all the studies across the world with pomalidomide, bortezomib and dexamethasone.

This makes the field very attractive for the near future, that we will have many different combinations and then how to decide how to use one or the other. This is probably the next question, and here we have to focus on what previous treatments with anti-CD38 monoclonal antibodies, the type of resistance we have, what is the profile of patients and their family and their way of living, their work? So, there are many other full points to take into consideration for these type of patients, but the good now, the good news is that we will have many different options for them.

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