Dr. Richardson on Immunotherapy Advances in Relapsed/Refractory Myeloma

Paul G. Richardson, MD, clinical program leader and director of clinical research, Jerome Lipper Multiple Myeloma Center, and institute physician, Dana-Farber Cancer Institute, discusses advances made with immunotherapy in the treatment of patients with relapsed/refractory multiple myeloma.

There have been several advances made in this setting in the last couple years, the most important of which may be the introduction of monoclonal antibodies, says Richardson. Specifically, the introduction of daratumumab (Darzalex), which targets CD38. Additionally, elotuzumab (Empliciti), which targets SLAMF7, has been an important advance as well, particularly when it is used in combination with immunomodulatory drugs (IMiDs). In the future, isatuximab, a chimeric antibody targeting CD38, is likely to become very valuable in the space, he adds.

With regard to the CD38-targeting space, the results of the phase III ICARIA-MM trial are very exciting and will be presented at the 2019 ASCO Annual Meeting, says Richardson. In the trial, patients received isatuximab in combination with pomalidomide (Pomalyst) and dexamethasone. As in the phase II ELOQUENT-3 trial, where patients received elotuzumab, pomalidomide, and dexamethasone, the primary endpoint of the ICARIA-MM trial was met. In addition to the monoclonal antibodies, next-generation IMiDs, such as pomalidomide, as well as next-generation proteasome inhibitors such as carfilzomib (Kyprolis) have also been hugely impactful.