Multiple Myeloma

The randomized FORTE trial showed that patients who were newly diagnosed with transplant-eligible multiple myeloma (MM) experienced significantly improved progression-free survival (PFS) with carfilzomib plus lenalidomide-dexamethasone (KRd) induction-ASCT-KRd consolidation versus either 12 KRd cycles or carfilzomib plus cyclophosphamide-dexamethasone (KCd) induction-ASCT-KCd consolidation.

Comparing consolidation treatment with bortezomib + lenalidomide + dexamethasone (VRD) followed by lenalidomide maintenance with lenalidomide maintenance alone, the former approach was superior regarding progression-free survival (PFS) and myeloma response in patients with newly diagnosed multiple myeloma (MM) with an acceptable toxicity profile.

This multicenter, retrospective, real-world study (GEM-POMCIDEX) was initiated to evaluate the effectiveness of the guidelines established by the Spanish Myeloma Group (PETHEMA) to treat appropriate patients with relapsed/refractory multiple myeloma (RRMM) with pomalidomide, cyclophosphamide, and dexamethasone (POMCIDEX).

Poor response on subsequent therapies is typically seen in patients with relapsed/refractory multiple myeloma (RRMM) who have had 3 prior lines of therapy with immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and anti-CD38 monoclonal antibodies. In addition, challenges for future treatment options are presented.

Recent studies have illustrated complete response (CR) rates >50% for transplant-eligible patients with multiple myeloma (MM) treated with optimized induction followed by high-dose therapy (HDT) and autologous stem-cell transplantation (ASCT). However, many patients relapse early. Patients who relapse are generally thought to have very low survival rates.

According to data from the phase 2 FORTE trial, 3 different techniques were analyzed and compared to characterize minimal residual disease (MRD), including positron emission tomography/computed tomography (PET/CT), multiparameter flow cytometry (MFC), and next-generation sequencing (NGS).

The combination of carfilzomib with lenalidomide and dexamethasone (KRd) as induction therapy has failed to improve outcomes in newly diagnosed multiple myeloma compared with bortezomib, lenalidomide, and dexamethasone (VRd).

Cellular therapy is quickly becoming an attractive option for heavily pretreated patients with relapsed/refractory multiple myeloma (RRMM). According to data presented at the ASCO20 Virtual Scientific Program, a pair of chimeric antigen receptor (CAR) T-cell products have generated impressive rates of response that appear to be sustainable as well.

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When elotuzumab was given in combination with pomalidomide, bortezomib, and dexamethasone (elo-PVD), patients with multiple myeloma refractory to prior treatment demonstrated encouraging responses, according to data from a phase 2 trial presented at the 2019 ASH Annual Meeting by Andrew Yee, MD, from Massachusetts General Hospital Cancer Center in Boston.