Dr. Voorhees on the Utilization of Proteasome Inhibitors for Newly Diagnosed Multiple Myeloma

Peter Voorhees, MD, director of outreach for hematologic malignancies, Plasma Cells Disorder Program, Department of Hematologic Oncology and Blood Disorders, Atrium Health’s Levine Cancer Institute, discusses developments in the efficacy and application of proteasome inhibitors for patients with newly diagnosed multiple myeloma.

Unprecedented progression-free survival (PFS) data from recent studies of proteasome inhibitors in the frontline setting indicate incredible progress in the field of multiple myeloma treatment, Voorhees states.

One such study is the phase 3 MAIA trial (NCT02252172) evaluating the addition of daratumumab (Darzlex) to a standard doublet of lenalidomide (Revlimid) plus dexamethasone (DRd). This study produced the longest PFS observed in a study of transplant-ineligible patients. Similarly, the phase 3 DETERMINATION trial (NCT01208662) of bortezomib (Velcade) in combination with lenalidomide and dexamethasone (RVd) produced the longest PFS observed in the transplant-eligible space. Clinicians are hopeful that the addition of daratumumab to the RVd backbone in will further extend PFS in transplant-eligible patients.

These trials indicate that novel therapeutics developed for the relapsed/refractory setting can be successfully utilized in the newly diagnosed space to improve patient outcomes, particularly in those with high-risk disease, Voorhees continues. These patients typically do not enjoy the same level of benefit from the current standard of care as their standard-risk counterparts. Future research on the viability of bispecific antibodies and CAR T-cell therapies in this patient population could also have substantial effect on the current treatment paradigm, Voorhees concludes.