ASH Groundbreaking Trials and Therapies Transform Multiple Myeloma Treatment
The recent American Society of Hematology (ASH) meeting showcased significant advancements in multiple myeloma treatment, with a particular focus on integrating CD38 monoclonal antibodies into frontline therapy and exploring the benefits of quadruplet regimens. These developments promise to reshape patient care, offering new hope for those battling this challenging disease and were highlighted at the MOASC Spotlight on Myeloma 2024.
[VIDEO with 36 SLIDES] 2024 Multiple Myeloma Updates – Lisa X. Lee, MD
The Griffin and PERSIUS Trials: A New Era in Myeloma Treatment
Dr. Lisa X. Lee highlighted the impact of the Griffin and PERSIUS trials, which investigated the efficacy of quadruplet therapy regimens in multiple myeloma. The Griffin trial, a phase two study, demonstrated superior outcomes with DRVD (daratumumab, lenalidomide, bortezomib, and dexamethasone) over the standard RVD (lenalidomide, bortezomib, and dexamethasone) therapy. The PERSIUS trial, a late-breaking phase three study, confirmed these findings, showing significant improvements in progression-free survival and overall response rates. Despite these advancements, both trials noted increased cytopenias and infections as side effects of the enhanced regimens.
Addressing the Needs of Transplant-Ineligible Patients
The MIA trial shed light on the benefits of incorporating daratumumab into the treatment regimen for older, transplant-ineligible patients. With a marked improvement in overall response rates and progression-free survival, the daratumumab-based regimen (DERA-RD) is now a preferred option according to NCCN guidelines. This underscores the importance of personalized treatment approaches in maximizing patient outcomes.
Retrospective Studies Reinforce Quadruplet Therapy’s Efficacy
Multiple retrospective studies have corroborated the superiority of quadruplet therapy with daratumumab over the RVD regimen, further supporting its adoption in clinical practice. These studies underscore the therapy’s ability to reduce the risk of disease progression or death significantly.
Novel Therapies and the Future of Myeloma Treatment
The presentation also touched upon emerging treatments, including bispecific T-cell engagers and CAR-T therapies, which are being considered for earlier use in the treatment journey. Studies like KarMMa-3 and CARTITUDE-4 explore these advanced therapies in newer, less heavily treated patient populations, showing promising results that could redefine standard myeloma care.
The Path Forward: Integrating Novel Therapies and Addressing Challenges
As the myeloma treatment landscape continues to evolve, questions remain about the best strategies for integrating new therapies, especially regarding upfront transplant necessity and sequencing of treatments. The ongoing need for comprehensive data and understanding of clinical and biomarker correlates of response will guide future treatment decisions.
Dr. Lee’s insights from ASH 2024 not only highlight significant progress in multiple myeloma treatment but also emphasize the critical need for ongoing research and collaboration in the field. As novel therapies and regimens continue to emerge, the myeloma community remains hopeful for even more effective and personalized treatment options in the years to come.
Reference Links:
Daratumumab, VELCADE (Bortezomib), Lenalidomide and Dexamethasone Compared to VELCADE, Lenalidomide and Dexamethasone in Subjects With Previously Untreated Multiple Myeloma (Perseus): https://www.clinicaltrials.gov/study/NCT03710603
Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial: https://ashpublications.org/blood/article/136/8/936/454474/Daratumumab-lenalidomide-bortezomib-and
Efficacy and Safety Study of bb2121 Versus Standard Regimens in Subjects With Relapsed and Refractory Multiple Myeloma (RRMM) (KarMMa-3): https://clinicaltrials.gov/study/NCT03651128
A Study Comparing JNJ-68284528, a CAR-T Therapy Directed Against B-cell Maturation Antigen (BCMA), Versus Pomalidomide, Bortezomib and Dexamethasone (PVd) or Daratumumab, Pomalidomide and Dexamethasone (DPd) in Participants With Relapsed and Lenalidomide-Refractory Multiple Myeloma (CARTITUDE-4): https://www.clinicaltrials.gov/study/NCT04181827
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