Dr. Kazandjian on Evaluating Retreatment With BCMA-Directed Therapy in Multiple Myeloma

Dickran G. Kazandjian, MD, professor of medicine, Myeloma Program, Sylvester Comprehensive Cancer Center, discusses the rationale to evaluate retreatment with BCMA-directed therapy in multiple myeloma.

Retreatment with BCMA-targeted therapies is a reasonable therapeutic strategy for patients with multiple myeloma and is being adopted in clinical practice, says Kazandjian. Utilizing different modalities of BCMA-directed therapies may offer patients valuable treatment options, Kazandjian says.

However, evaluating BCMA-directed therapy retreatment has been challenging in the setting of clinical trials because many studies exclude relevant patients, says Kazandjian. For example, a study evaluating a BCMA-directed antibody-drug conjugate may exclude patients who received prior BCMA-directed CAR T-cell therapy, Kazandjian explains.

If initial efficacy and safety signals emerge suggesting retreatment is feasible, clinical trial inclusion criteria may become less conservative, Kazandjian says. A similar clinical scenario was observed with the CD38-targeted monoclonal antibodies daratumumab (Darzalex) and isatuximab-irfc (Sarclisa), concludes Kazandjian.