SOHO 2023 | The current SOC in AL amyloidosis: dara-CyBorD & considerations for patients with relapsed disease

AL amyloidosis, now, of course we have daratumumab, cyclophosphamide, bortezomib, and dexamethasone as the standard. It’s wonderful to have a regimen as effective as that one. There’s much we need to do in that space because, although you have CR rates of 50% or better, it’s not everybody. We also don’t know how long these responses are going to last, so we need additional follow up. We need to know if there are other drugs to add or if you need all the drugs in that regimen. Will the two-year kind of maintenance period or full therapy be sufficient? So there are a lot of questions even with that regimen. But I think it’s very exciting to have something showing such good results. It clouds what we do with stem cell transplant as first line- but that is pretty much the standard these days, is that as an induction plus or minus transplant, but there is less and less stem cell transplant in that space. And then, relapsed disease is a little bit the wild West, borrowing from what we know from small Phase II trials and also what we know from multiple myeloma. But being cognizant of the toxicity being a little higher in AL patients than it would be in multiple myeloma patients.