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How Are Monoclonal Antibodies Being Used in Real-World Clinics?

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Published on March 26, 2018

After a few years of using monoclonal antibodies in clinics, how are healthcare teams implementing them into multiple myeloma treatment plans? How are myeloma patients responding? Noted experts, Dr. Suzanne Lentzsch from New York Presbyterian Hospital and Columbia University Medical, and Dr. Sagar Lonial from Emory University School of Medicine, discuss the impact of introducing monoclonal antibodies to patients in clinics and share more recently released antibodies. Tune in to find out more about how monoclonal antibodies are used today to treat myeloma.

Produced by Patient Power. We thank you to thank AbbVie, Inc., Celgene and Takeda Oncology for their support.

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Transcript | How Are Monoclonal Antibodies Being Used in Real-World Clinics?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jenny Ahlstrom:

So maybe we start out with something that came out a couple of years ago, so some of the new monoclonal antibodies. I think experts were really excited to be using them in the clinic, and now that you’ve had a few years to be able to implement those, and we have a new one coming out also, isatuximab, can you comment in general about how they’re now being applied, and they’re moving up closer in the clinic? Why don’t we start with Dr. Lonial? 

Dr. Lonial:            

Yeah, I think antibodies are a really obviously exciting and novel mechanism. I would argue that it has now become the third backbone of therapy, along with proteasome inhibitors in the immunomodulatory drugs. I think that’s really exciting for us, because I think all of us agree that combination therapy makes a lot of sense, and adding in the antibodies with our other therapies will only make things better. What we saw at this meeting was the introduction of antibodies, even in the newly diagnosed setting, in a randomized Phase III trial that continues to support what we’ve already known, which is antibodies plus anything are better than anything.

I think that’s really encouraging, and I think we’re gonna start to move these earlier and earlier in the case of therapy.

 

Jenny Ahlstrom:                 

And part of that reason is because of side effects, so Dr. Lentzsch, do you have any comments about the addition of this new type of therapy and making things a quad, potentially? 

Dr. Lentzsch:      

Yeah. So I had the opportunity to present the updated analysis of the CASTOR trial this year. The CASTOR trial includes bortezomib (Velcade), dexamethasone (Decadron) and daratumumab (Darzalex) and tests that versus Velcade and dex, and it is a long-term follow-up, and even with the long kind of analysis, it is shown that the combination of daratumumab, Velcade, and dex is superior. We also performed the subgroup analysis for patients who were resistant to lenalidomide (Revlimid), patients with high-risk multiple myeloma, and all the subgroups showed that there is a clear advantage when you add daratumumab. 

So I think the new standard for relapsed refractory is daratumumab in combination, and daratumumab will probably be used up front. In terms of side effects, it’s very well-tolerated. We struggled with, I would say, some infusion related reactions when we give Dara the first time that can prolong the infusions, but usually, at least in my experience, I could give daratumumab to all patients. I never had to stop daratumumab due to side effects. Second, third, and the following infusions are very well-tolerated. 

Just as an example of well it is tolerated, yesterday we heard many presentations on amyloidosis and daratumumab. So amyloid patients or myeloma patients with an overlap of amyloidosis usually have difficulties to tolerate treatments, but even in amyloid patients with advanced disease, daratumumab is very well-tolerated. My oldest patient is 91 and has heart amyloidosis, is doing very well. So I think that speaks also in favor of the drug.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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