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COMy 2025 | The role of melflufen in multiple myeloma: which subgroups may benefit from this agent?
Claudio Cerchione, MD, PhD, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy, discusses the current role of melflufen in the treatment landscape of multiple myeloma (MM). Dr Claudio explains that melflufen has a favorable safety profile and convenient administration without the need for significant supportive care, making it an attractive therapeutic approach for elderly and frail patients, as well as those who lack a caregiver or experience logistical barriers. Data from clinical trials and the real-world setting also indicate that patients with extramedullary disease (EMD) and adverse cytogenetics benefit from this agent. This interview took place at the 11th World Congress on Controversies in Multiple Myeloma (COMy) congress in Paris, France.
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Transcript
Melphalan flufenamide is a new opportunity that we also have available in our country, Italy. And this is a new concept of chemotherapy because it is really personalized and the idea to select only the myeloma plasma cells in order to reduce adverse events. Let’s not forget that this is chemotherapy but without any mucositis, any alopecia, and any big adverse events...
Melphalan flufenamide is a new opportunity that we also have available in our country, Italy. And this is a new concept of chemotherapy because it is really personalized and the idea to select only the myeloma plasma cells in order to reduce adverse events. Let’s not forget that this is chemotherapy but without any mucositis, any alopecia, and any big adverse events. In my opinion, this is a very good option for the elderly and frail population, for people that lack caregivers and in some way have some problem with logistics. Also, thanks to its way of administration, only one time every week, every 28 days, fixed dose without any need for frequent access to the hospital, for frequent blood checks, for big supportive care and so on. That’s why we are going to position melflufen also as a potential bridge to other immunotherapies and in general I think that the compliance with this drug is really important.
Waiting for the future I think that this is going to cover a really important unmet medical need and moreover it would be really nice to explore the chemosensitivity of our patients because in my idea there is an emerging heterogeneity in multiple myeloma. We call everyone in the same way, but maybe this is not one myeloma, but several myelomas. And some of our patients show a refractoriness to immunotherapies, first generation, also new generation immunotherapies, but respond very well to new kinds of chemotherapy. And that’s why we should understand which are the biomarkers who drive this response.
And moreover, in my opinion, another really important thing is that melflufen can be used, we have seen fantastic data, not only from the trials, but also from the real world, in extramedullary disease, where we in this moment have an unmet medical need to cover, and also in patients with not favorable cytogenetics, For example, the one with deletion 17p, in which we have seen subanalysis with dedicated data. So in my idea, the revolution means also to understand which is the right drug for every patient. Melflufen can be used in the setting that I have cited, and maybe in the next future could be also a potential backbone for new combinations.
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Disclosures
Advisory board and/or Consultant and/or speaker for Abbvie, AMGEN, Astellas, Beigene, BMS, Curis, Glycomimetics, GSK, Immunogen, Janssen, Jazz, Karyopharm, Menarini – Stemline, Oncopeptides, Pfizer, Sanofi, Servier, Skyline DX, Stemline, Takeda.
