Dr Baljevic on Advancements in the Management of Newly Diagnosed Multiple Myeloma

Muhamed Baljevic, MD, associate professor of medicine, Division of Hematology Oncology; director, Plasma Cell Disorders Research of Vanderbilt-Ingram Cancer Center; director, Vanderbilt Amyloidosis Multidisciplinary Program, Vanderbilt-Ingram Cancer Center; co-chair, VICC Protocol Review and Monitoring System, discusses key trial updates and advancements with quadruplet therapy in newly diagnosed multiple myeloma, as detailed in his presentation at the Vanderbilt Stem Cell Transplant and Cellular Therapy Symposium.

Over the past decade, progress has been made in achieving deep and durable responses to treatment in newly diagnosed multiple myeloma patients, Baljevic begins. Trials such as the phase 2 GRIFFIN study (NCT02874742) have explored the use of quadruplet induction therapy for patients in this population, he states, adding that these regimens typically comprise a proteasome inhibitor, an immunomodulatory drug, an anti-CD38 monoclonal antibody, and a steroid. Results from these trials have demonstrated substantial improvements in time to first progression-free survival (PFS), with median PFS extending from approximately 40 months to as long as 90 months, Baljevic details. Moreover, in some trials, the median PFS has not yet been reached due to sustained responses, he notes.

Placing emphasis on achieving optimal patient outcomes early in the disease course is particularly crucial in the management of multiple myeloma, Baljevic continues. Studies such as the Intergroupe Francophone du Myelome 2009 (NCT01191060) and phase 3 DETERMINATION (NCT01208662) trials have highlighted the importance of optimal upfront treatment; not all patients have the opportunity to undergo stem cell transplantation later in their disease course, Baljevic emphasizes.

Moreover, significant attrition has been observed in select datasets of non-transplant eligible patients, underscoring the urgency of initiating effective treatments to maximize long-term outcomes, Baljevic says. Ultimately, early intervention and achieving deep responses with novel combinations are critical steps towards optimizing the management of newly diagnosed myeloma, he concludes.