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New Drug Combinations for Treating Multiple Myeloma

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Published on July 15, 2020

Adding a third myeloma drug to the standard of care treatment combination for multiple myeloma is showing promising new results. Dr. Berenson and Patient Power co-founder Andrew Schorr discuss the presentation of the BOSTON study at the recent ASCO (American Society of Clinical Oncology) conference.
 
They discuss the benefits and side effects of adding the drugs selinexor and the recently FDA approved monoclonal antibody isatuximab (Sarclisa) to myeloma treatment plans.
 

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Transcript | New Drug Combinations for Treating Multiple Myeloma

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.

Andrew Schorr:

Dr. Berenson, so we've had two major medical meetings. We've had the ASCO meeting and then sort of an echo of it with the European Hematology Association. And there was discussion of myeloma and used to be just at the ASH meeting, the American Society of Hematology or some other myeloma specific meetings. But now there's more even at these other meetings. What do you think is significant for patients? Any things you want to particularly call out?

Dr. Berenson:

Well, I think it was notable that adding a third drug in this case, the newer drug selinexor (Xpovio), which has some activities in single agent, but again, boosted the activity of the standard bortezomib (Velcade) and dexamethasone (Decadron) quite significantly. I think that was pretty awesome. Obviously, that drug has some issues regarding quality of life in terms of GI, nausea, vomiting, anorexia, that is not wanting to eat and weight loss, but it looks like that drug may be a good player in myeloma from that there are three versus two drug trial.

Andrew Schorr:

Okay. And that's the BOSTON study.

Dr. Berenson:

Yes.

Andrew Schorr:

Using that drug in combination with others earlier. The drug was approved for very late stage myeloma now moving up earlier. And when you talk about the side effects of very powerful medicines, do you, as a specialist feel you have ways to help patients?

Dr. Berenson:

I do. And it's a matter of just getting experience early on. I was like, oh my god, this is really difficult, but people are learning how to deal with it. Being aggressive early with anti-nausea drugs has been very helpful in us treating patients and keeping them on and then reassuring them that usually those affects are first or second cycle. And that's certainly reassuring to them when we can get them through that whirlwind the first couple of months.

Andrew Schorr:

Dr. Berenson, a couple of other things want to ask you about. So there's a couple of new approvals. One has been for yet another monoclonal antibody. Sarclisa, I'm not sure what the regular name of it is.

Dr. Berenson:

Isatuximab (Sarclisa) that's spelled with an I, but isatuximab.

Andrew Schorr:

Right. So first of all, that's yet another tool for you. And then also another administration form of daratumumab (Darzalex). So maybe you'd want to comment on those.

Dr. Berenson:

Yeah, I mean, at this point, the isatuximab or Sarclisa has been shown to add activity to pomalidomide (Pomalyst) and dexamethasone versus pomalidomide and dexamethasone alone, quite significantly in terms of delay in progression or death from any cause so-called progression free survival. And it seems to be active, whether it can be any better or different then Darzalex or daratumumab. I wait to see it. It's really targeting the same antigen or protein on the surface, the CD38. And we'll see. We're trying to do some studies with that molecule as well. The Faspro, which is the name for the daratumumab, the subcutaneous version is now being used and more conveniently. And then it only takes a few minutes to administer. Certainly, there are infusion reactions just as there are with the other two antibodies, the Sarclisa and the Darzalex. And Darzalex by the way, is the same exact antibody as Faspro, just a different form.

So your patient is probably going to have to hang around anyway, all day, the first day. And now we're giving Darzalex and the new one Sarclisa over an hour, an hour and a half. There is certainly some time saving, because the sub Q formulation Faspro of the Daratumumab takes maybe 10, 15 minutes to give. So they will be in clinic a shorter period of time. But, by the time they're in the fifth or six month, they're getting down to once a month anyway. So the saving in time is not obviously a significant as the first month or two when they may be coming in every week.

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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