Dr. Moreau on Combination Treatments in Multiple Myeloma

Philippe Moreau, MD, head of the Hematology Department, University Hospital of Nantes, France, discusses the combination treatments being used to treat patients with multiple myeloma.

The triplet combinations that patients with multiple myeloma are receiving are mainly based on the findings of several large phase II and III randomized studies. According to Moreau, bortezomib (Velcade) and dexamethasone serve as the backbone of the basic treatment regimen for these patients. Thus, triplet combinations almost always include these 2 agents, and the common third drugs used for these patients include lenalidomide (Revlimid), cyclophosphamide, thalidomide (Thalomid), and doxorubicin.

Moreau speculates that carfilzomib (Kyprolis) may replace bortezomib in such treatment combinations, though he notes that the toxicities associated with that agent tend to present more issues for patients.

He also suggests that the future may see not just triplet combinations, but quadruplet combination therapies as well, which would likely include monoclonal antibodies such as daratumumab (Darzalex) on top of the already established triplet combinations.