Dr. Atrash on Investigational Combinations With Venetoclax in Relapsed/Refractory Multiple Myeloma

Shebli Atrash, MD, a physician in hematology and medical oncology at Levine Cancer Institute, Atrium Health, discusses investigational combinations with venetoclax (Venclexta) in relapsed/refractory multiple myeloma.

At the 2019 ASH Annual Meeting, Jonathan L. Kaufman, MD, from Emory University School of Medicine, presented data on the combination of venetoclax and dexamethasone. Dexamethasone encourages plasma cells to be more dependent on BCL-2, and venetoclax inhibits BCL-2, so the drugs are thought to act synergistically, explains Atrash. Although the early-phase trial enrolled a small number of patients, the overall response rates (ORRs) were in the range of 87%, says Atrash.

Additionally, the combination of daratumumab (Darzalex), venetoclax, and dexamethasone was also evaluated in an early-phase trial. Notably, 4 patients enrolled on the trial had 11;14 translocations. Another arm of the trial evaluated venetoclax in combination with daratumumab, bortezomib (Velcade), and dexamethasone in patients who had received 1 to 3 prior lines of treatment. In order to be eligible for enrollment, patients could not be refractory to a proteasome inhibitor, says Atrash. The regimen was found to be well tolerated, and the ORRs were in the range of 95% in both arms, concludes Atrash.