Multiple Myeloma

On September 26, 2019, the FDA approved daratumumab (Darzalex; Janssen) in combination with bortezomib, thalidomide, and dexamethasone for the treatment of newly diagnosed patients with multiple myeloma who are eligible for autologous stem-cell transplant (ASCT). The FDA granted this application priority review.
Once-weekly carfilzomib (Kyprolis) therapy at a higher dose significantly improved progression-free survival (PFS) and reduced the risk of disease progression or death compared with twice-weekly carfilzomib in patients with relapsed or refractory multiple myeloma. The overall safety profile for both regimens in the randomized phase 3 ARROW clinical trial were similar, said co-lead investigator María-Victoria Mateos, MD, PhD, Director, Myeloma Unit, University Hospital Salamanca-IBSAL, Spain, at the 2018 European Hematology Association Congress.
The results of the phase 3 OPTIMISMM clinical trial showed a 39% risk reduction in disease progression or death with pomalidomide, bortezomib, and low-dose dexamethasone compared with bortezomib and low-dose dexamethasone alone.

The second-generation chimeric antigen receptor (CAR) T-cell therapy, bb2121, engineered to target B-cell maturation antigen, a protein on the surface of certain myeloma cells, displayed continuing efficacy and safety in an update of a phase 1 clinical trial in patients with relapsed or refractory multiple myeloma.

Multiple myeloma is a cancer of plasma cells in the bone marrow that often leads to bone destruction and bone marrow failure. According to the American Cancer Society, more than 30,280 new cases of multiple myeloma will be diagnosed in 2017, and 12,590 deaths will be attributed to the disease. In the past 20 years, mortality rates associated with multiple myeloma have declined. Novel therapies, as well as improvements in autologous hematopoietic stem-cell transplantation (HSCT) procedures and supportive care, have contributed to extended survival for patients with this malignancy.
According to the results of an open-label, phase 1b study presented at ASCO 2017, induction therapy with the KRd regimen was well-tolerated, and the overall safety profile was consistent with previous reports for KRd, with no additional toxicity observed with the addition of daratumumab.
Although the 5-year survival rate for multiple myeloma is less than 50%, this type of cancer has witnessed a resurgence of drug therapies.

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