COMy 2021 | How close is a cure for multiple myeloma?
Substantial advances in the treatment of multiple myeloma over the last decade, attributable to novel agents and novel combinations, are leading investigators to challenge the long-standing belief that myeloma is incurable. Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France, discusses cure as a goal of therapy rather than disease control, and reinforces the concept of operational cure. This interview took place during the 7th World Congress on Controversies in Multiple Myeloma (COMy), 2021.
Transcript (edited for clarity)
Over the last decade, we have seen some major advances in the field of multiple myeloma and we owe this to novel agents, novel combinations. And given the efficacy and the results of all of these novel combinations, now more and more, we are talking about a cure in multiple myeloma. Well, it’s slightly subtle because, obviously, we need to acknowledge that it’s very difficult to eradicate the malignant plasma cells...
Over the last decade, we have seen some major advances in the field of multiple myeloma and we owe this to novel agents, novel combinations. And given the efficacy and the results of all of these novel combinations, now more and more, we are talking about a cure in multiple myeloma. Well, it’s slightly subtle because, obviously, we need to acknowledge that it’s very difficult to eradicate the malignant plasma cells. However, I think the concept is about the operational cure, which is about living long enough and maybe dying of something else. And this is now within reach and I think can be achieved for many patients.
I will give only one example to highlight this story. If you are treating an elderly multiple myeloma patient, age 77, and one of the regimens recommended by the recent EHA-ESMO guidelines is daratumumab, lenalidomide and dexamethasone. Actually, when you look to the results of PFS that can be achieved with this combination, thanks to the randomized Phase III MAIA trial, then this patient is likely to respond for five or even six years. So, 77 at diagnosis, and we’re already 82. So, you would see this kind of patient are likely operationally cured because, obviously, this patient may experience other problems, other health problems, and die of something else.
So, it’s becoming extremely attractive to try to use the best combinations from the beginning in multiple myeloma patients because actually the survival of these patients is dramatically and significantly increasing, and in some patients, we are seeing this so-called operational cure.
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