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Advances in Treating Relapsed Multiple Myeloma

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Published on March 15, 2021

Experts Discuss Recent Advances in Myeloma Treatment

Treatment for relapsed multiple myeloma has been advancing rapidly, including several new FDA approvals and combination therapies. Hear two myeloma experts discuss these developments and more in a video excerpt from our recent "Dinner with the Docs" program on living with multiple myeloma.

Accompanied by host and patient advocate Jack Aiello, Dr. James Berenson, MD, Founder and Principal of the Berenson Cancer Center and Dr. Alberto Bessudo, MD, FACP, Medical Oncologist at the Compassionate Oncology Medical Group cover everything from approved treatments to drug combinations and what they envision for the future of myeloma treatment. Keep watching to learn more.

Support for this series has been provided by Karyopharm Therapeutics. Patient Power maintains complete editorial control and is solely responsible for program content.

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Transcript | Advances in Treating Relapsed Multiple Myeloma

Jack Aiello: Hi, everyone. Welcome to Dinner with the Docs for Southern California, featuring our local multiple myeloma experts. My name is Jack Aiello. I'm hosting the event tonight. Here with us today are Drs. James Berenson in West Hollywood from the Berenson Cancer Center and Dr. Alberto Bessudo in Encinitas from the California Associates for Research and Excellence. So, let's meet our experts, Drs. Bessudo and Berenson. Dr. Berenson, would you please introduce yourself?

Dr. Berenson: Yeah. Hi, I'm Dr. Jim Berenson and I have several hats I wear. One is I’m the Medical and Scientific Director at the Institute for Myeloma and Bone Cancer Research in West Hollywood, California. We do preclinical treatment of myeloma. We try to develop new therapies, new ways to monitor myeloma, all before it gets into the clinic. And then we have a practice group. We see about 150 patients a week with myeloma, and we do all of their treatment right here in West Hollywood.

Jack Aiello: Thank you, and Dr. Bessudo?

Dr. Bessudo: I'm a medical oncologist practicing in a very large community practice. I was at UCSD for maybe 12 years doing immunoglobulin and myeloma lymphoma, basic research. And then in the year 2000, came out of private practice. I do a lot of lymphoma and myeloma as part of my specialty in this large community medical group.

Jack Aiello: Thank you very much. I'd like to run our last poll, poll four, so if we can get that up on the screen, it applies to you regarding your myeloma status. Are you in first-line treatment? Are you in your first remission? Have you relapsed once? Have you relapsed more than once? Okay, so let's close the poll and see where we are. So, most are on first-line treatment or in first remission. So that's great. And about 40%, 35% have relapsed once or more than once. And the reason I ask it is because especially those patients that have that first relapse and then are worried about their next relapse, they will ask me what happens when I run out of treatments. And rather than me answer that, I thought maybe Dr. Berenson, can you talk a little bit about the highlights that just came from ASH 2020 in terms of myeloma treatments?

What Are the Current Treatment Options for Relapsed Myeloma Patients?

Dr. Berenson: Well, I think we saw more emerging data, certainly suggesting that selinexor (Xpovio) is having good activity and multiple combinations. We presented the first data ever on single agent Jakafi (ruxolitinib) showing that the JAK inhibitors are going to have a role in myeloma. They're extremely well tolerated. They've been used in other blood-based abnormalities or disorders. And I'm very encouraged by that data. We saw more emerging data, as you probably are aware with daratumumab (Darzalex) and a multitude of combinations as well. A lot of talk about CAR T-cells, this immune-based cellular therapy and its promise in a number of companies working on that and moving toward first approvals.

Jack Aiello: What about these things called bi-specific T-cell engagers?

Dr. Berenson: Yeah, so these are really cool molecules. Amgen has one that they've been working on, and basically, they have an antibody that instead of just having one thing it's going after, that is the myeloma cell, it also brings the immune cell over to put them in close proximity. And that's why it's called bi-specific. It's got a T-cell to bring it over to the myeloma cell and to punch it out. And I think that those are very hopeful.

Jack Aiello: One of the things I saw among the different bi-specific antibodies that you've discussed is that some are going after different targets.

Dr. Berenson: Yeah, some of them are actually, Jack, trying to use tri-specific quantitative, try to go after multitudes. There are attempts now, not just to target one protein with one of these, but multiple on one of these constructs.

Jack Aiello: So when I go back to that patient who says, "Will I run out of treatments?" I'm always just of the opposite, it seems like treatments are coming faster than you can handle them. And then you get into situations of not only which treatment might work best for someone, personalizing treatments, but how do you sequence these treatments? Which order do you give these drugs in?

Dr. Berenson: Yeah, we're trying to work on that right now with a new initiative we call Precision Myeloma, where we're trying to use and interrogate the genetic makeup of the patient, the tumor and the past treatments to actually do exactly what you said. We don't have that answer yet. That's the future, but we hope we're there in the next few years.

Jack Aiello: So, I would remind folks listening and watching this conversation again, Dr. Berenson, Dr. Bessudo show us why it's so important to get myeloma experts on our medical team. Even if you only see them in a consulting role and they consult with your local oncologist who treats you, it is really important. And there are lots of myeloma expert doctors throughout the country in any major city these days. Dr. Bessudo, do you have hope that patients can live for a long time with myeloma?

What Words of Hope Do You Have for Multiple Myeloma Patients?

Dr. Bessudo: People with myeloma really live a long time and the new molecules and the new treatments, like the Jakafi that Dr. Berenson is working on, is going to continue to bring hope. We're in the year 2021, and we have no toxic drugs. We have biologic agents that will work directly in the biology of what causes the disease. And they are going to live a long, long time. Every day we have new drugs coming to the market that will make things longer and better.

Jack Aiello: And Dr. Berenson, closing thoughts?

Dr. Berenson: Well, the future is bright. Survival is getting better every year. We have new possibilities, and we know with each trial how better to use these drugs. And I don't think we're curing patients yet, but I think we're getting closer and certainly giving patients long and very fruitful lives, which is very good news for not only the patients, but importantly, their significant others and their friends and family. I think the future looks good.

Jack Aiello: Thank you both.


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