BSH 2022 | Perspectives on the treatment of patients with R/R multiple myeloma
Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD, University College London Hospitals, London, UK, discusses the management of patients with relapsed/refractory (R/R) multiple myeloma. Despite the introduction of proteasome inhibitors, immunomodulatory agents (IMiDs), and monoclonal antibodies in the myeloma treatment landscape, some patients still relapse. In recent years, alternative treatment strategies targeting BCMA including antibody-drug conjugates (ADCs), bispecific T-cell engagers (BiTEs), and CAR-T therapies have improved the durability of response in these patients. According to Dr Popat, these effective treatment modalities should be tested in earlier lines of treatment when the disease is more sensitive to further improve outcomes. This interview took place at the 62nd Annual Scientific Meeting of the British Society for Haematology (BSH) 2022, in Manchester, UK.
Transcript (edited for clarity)
Patients with relapsed and refractory myeloma are currently a difficult to treat population. Overall, the survival of patients with myeloma has substantially improved over the last few years, and that’s typically with the widespread use of proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies. However, we still find that these patients are relapsing and unfortunately have short durability of response...
Patients with relapsed and refractory myeloma are currently a difficult to treat population. Overall, the survival of patients with myeloma has substantially improved over the last few years, and that’s typically with the widespread use of proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies. However, we still find that these patients are relapsing and unfortunately have short durability of response. So we urgently need to look for new therapeutics to help this class of patients.
Indeed, there is a new class of patients that we are terming triple class refractory. And these are the patients where those main treatment classes have stopped working. Here we are investigating alternative approaches, and indeed there are other targets to use to treat myeloma. One of these targets is BCMA, and a number of different therapeutics have been used to treat patients using BCMA-directed therapies. These can either be antibody drug conjugates, bispecific T-cell engagers, or indeed CAR-T cell therapy. What we have learned by using these three different modalities of treatment is that they can be effective in triple class refractory patients and it has improved their durability of response and we hope will improve their overall survival.
Unfortunately, despite some very nice results from these three classes of agents, we still have not achieved a cure for patients with multiple myeloma. And perhaps the way forward is to try and use these very highly effective treatments earlier on in the treatment pathway when the myeloma disease is more sensitive, where we can try and achieve a cure. So unfortunately, relapsed/refractory myeloma continues to be a difficult disease to treat. But I’m confident with the very rapid strives that we are making in terms of therapeutic delivery, that we will continue to make the outcomes better for these patients.
Read more...
