Shining a light on hidden gems in the myeloma niche
If we want to go beyond the proteasome inhibitors, IMiDs and anti-CD38 antibodies in multiple myeloma, there are plenty of emerging candidates these days.
This is excellent news, but how will it all fit together, and which gems were under-rated at the recent ASH meeting?
The latter may catch a few people by surprise when the clinical aspects are considered in the totality of what needs to be done and in which patient subsets.
We discuss near and medium term aspects, which may have a lasting impact and also talk about why they matter.
To find out, the final part of our myeloma mini-series offers an engaging and thoughtful fireside chat with a global thought leader in this niche…
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Much of the focus in multiple myeloma over the last decade has focused on two key drug classes – proteasome inhibitors and IMiDs – with some recent approvals for monoclonal antibodies targeting key proteins on the surface of malignant myeloma cells such as CD38.
#ASH16 in San Diego
Combinations of these core therapies have lead to a noticeable improvement in outcomes for people living with the disease – from 3-4 years over a decade ago to now approaching 10 years post diagnosis.
If we want to continuously beat the status quo and improve on the chronicity, however, it is likely that several things will need to happen:
- Better understand mechanisms of resistance that induce relapse
- Develop predictive biomarkers of response
- Identify novel therapeutic targets
Here. we focus on the latest preclinical findings that were recently presented at the American Society of Hematology (ASH) in San Diego and explore where the future might be headed in this disease.
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This year has been an unprecedented Grand Cru year for the field of multiple myeloma, with no less than four drugs approved by the FDA to date… the fourth one just this morning while writing this preview!
- Panobinostat (Farydak) in relapsed/refractory disease in combination with bortexomib plus dexamethsone after at least 2 prior therapies.
- Daratumumab (Darzalex) received accelerated approval based on phase 2 data and is human CD38-directed monoclonal antibody that is indicated for the treatment of patients who have received at least three prior lines of therapy.
- Ixazomib (Ninlaro) is the first oral proteasome inhibitor and is approved in combination with lenalidomide plus dexamethasone, in people who have received at least one prior treatment.
- Elotuzumab (Empliciti) is a monoclonal antibody against CS–1/SLAMF7 approved today in combination with lenalidomide plus dexamethasone after 1–3 lines of prior therapy.
There are also many promising new agents in development and quite a few that may well not make it to market as a result of newer, better tolerated agents coming through.
To learn more about our insights on multiple myeloma, subscribers can log in to read our latest ASH 2015 Preview.