COMy 2022 | Novel agents and clinical trials emerging for the treatment of AL amyloidosis

Regarding the new regimens, now thanks to the ANDROMEDA trial, has shown that the addition of the immunotherapy with daratumumab targeting plasma cells, we have significantly increased the rate of complete response in a first-line therapy in association with VCd or CyBorD. So with CyBorD, we can reach a rate of complete responses at six and 12 months that is significantly inferior to the rate achieved with addition of daratumumab. And the rate of response is above 50% now, an excellent cardiac and renal response both at one year and two years, reaching over 60% of organ response rate. This is critical because it really challenges the role now of stem cell transplantations, because the outcome of the association of bortezomib-based regimens plus daratumumab is really superior to any other regimen so far reported.

Regarding relapsing patients, in the TOURMALINE trials with the use of ixazomib compared to the standard of care, the physician choice, show that ixazomib can improve the time to organ deterioration and also of progression-free survival. And in addition to ixazomib, dexamethasone, it is a valuable therapy for relapsing patient. We have now the possibility in patients who have the translocation 11;14 to use venetoclax, that was reported to achieve almost 50% complete responses in relapsing patients. So these new regimens and drugs are changing our standard of care in AL amyloidosis. And I believe that we have really an excellent outlook nowadays for our patients, already and we can achieve an excellent survival, improving the health of our patient population.