Oncology Today with Dr Neil Love: Key Presentations on Multiple Myeloma from Recent Major Oncology/Hematology Conferences
Oct 18, 2023
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Dr Joseph Mikhael discusses updates in multiple myeloma management, including the concept of stopping treatment for patients with deep responses, the use of MRD negativity to determine treatment level, neurological toxicities associated with certain treatments, utilization of specific treatments in medical oncology offices, advantages of bertimide vs. lintalitamide, and the examination of a treatment for multiple myeloma.
CAR-T therapy using iDECeL shows promising results in both newly diagnosed and relapsed/refractory multiple myeloma patients, providing a targeted treatment option with manageable toxicity.
CAR-T therapy targeting GPRC5D demonstrates high response rates in heavily pretreated multiple myeloma patients, offering a valuable alternative for patients, especially as BCMA-targeted therapies become more prevalent.
Bi-specific antibodies, such as Callistimab and El Renata Mab, show effectiveness in treating heavily pre-treated myeloma patients, with lower cytokine release syndrome rates compared to CAR-T therapy.
Deep dives
Early CAR-T therapy shows promising results in high-risk multiple myeloma patients
A study evaluated the use of early chimeric antigen receptor T-cell therapy (CAR-T) in high-risk multiple myeloma patients. The CARMA-3 trial administered the CAR-T therapy, iDECeL, to patients with two to four prior lines of therapy. Results showed a response rate of 86%, with even favorable outcomes in patients who previously received BCMA-directed therapy. The study highlights the potential for CAR-T therapy to overcome high-risk disease and provides a targeted treatment option with GPRC5D as the antigen. While BCMA-directed therapies remain effective, exploring new targets like GPRC5D expands treatment possibilities.
CAR-T therapy using Ide-cel demonstrates improved responses in heavily relapsed multiple myeloma
A study assessed the effectiveness of CAR-T therapy using iDECeL in heavily relapsed multiple myeloma patients. Results showed a response rate of 85%, with a deeper response achieved in 73% of patients treated with iDECeL compared to traditional regimens. The study demonstrated the potential of CAR-T therapy in providing durable responses for patients with relapsed disease. Additionally, the therapy showed manageable toxicity, with fewer adverse events compared to later lines of treatment.
CAR-T therapy targeting GPRC5D shows promise as a treatment option for multiple myeloma
A phase 1 study investigated CAR-T therapy targeting GPRC5D as a potential treatment option for multiple myeloma. The study showed an impressive response rate of 86% in heavily pretreated patients. Even in patients who had previously received BCMA-directed therapy, a significant response rate of 76% was observed. These findings suggest that CAR-T therapy targeting GPRC5D provides a valuable alternative for patients, especially as BCMA-targeted therapies become more prevalent in the field.
CAR-T therapy with iDECeL demonstrates efficacy even in high-risk multiple myeloma patients
The CARMA-3 trial evaluated the use of iDECeL, a CAR-T therapy, in high-risk multiple myeloma patients with two to four prior lines of therapy. The study demonstrated a high response rate of over 80% in these patients, including those with high-risk genetic abnormalities. This highlights the potential of CAR-T therapy to effectively target and treat high-risk disease. Additionally, the study showed that the toxicity profile of iDECeL was manageable, making it a promising treatment option for this patient population.
Key Point 1: Different bi-specific antibodies show promising response rates in heavily pre-treated myeloma patients
The podcast discusses the efficacy of different bi-specific antibodies in the treatment of heavily pre-treated myeloma patients. Two specific bi-specific antibodies, to Callistimab and El Renata Mab, are highlighted. The first bi-specific antibody studied, to Callistimab, showed a response rate of 63% in patients who have previously received multiple lines of therapy. While not as effective as CAR-T therapy, it still represents a significant improvement over prior agents. The second bi-specific antibody, El Renata Mab, showed similar response rates of 60-70% in patients who had not received prior BCMA-directed therapy. Both bi-specific antibodies demonstrated lower cytokine release syndrome rates compared to CAR-T therapy. However, there are still challenges in managing long-term dosing and potential immunosuppression.
Key Point 2: Considerations for bi-specific antibody treatment in myeloma
The podcast highlights the need for optimal use of bi-specific antibodies in myeloma treatment. It emphasizes the importance of including diverse patient populations, as African American patients tend to have different responses and tolerances to treatment. The podcast also discusses the significance of clinical trial accrual and the role of African American doctors in increasing minority participation. The potential benefits and challenges associated with transplant in myeloma patients are also explored. The speaker suggests that continued research and evolution of bi-specific antibodies is necessary to improve efficacy, reduce toxicities, and provide more options for patients.
Dr Joseph Mikhael from the City of Hope Cancer Center in Phoenix, Arizona, discusses recent updates and future directions in the management of newly diagnosed and relapsed/refractory multiple myeloma.
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