Precision Medicine for Myeloma: Are There New Targeted Drugs in Development?

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Jack Aiello:

Myeloma targets are things like BCMA, which we hear is a target for CAR-T therapy, or CD38, which is a target for these monoclonal antibodies like daratumumab (Darzalex) or SLAMF7, which is a target for a monoclonal antibody called elotuzumab (Empliciti).  Are there, Dr. Kaufman, other targets out there that drugs are being developed for? 

Dr. Kaufman:

Yeah, most of—one of our colleagues at Emory, one of our scientists named Larry Boyse has come up with a concept of how we think about myeloma targets, and he calls it the yin and the yang of targeting myeloma. And we target two parts of myeloma. One is the myeloma's plasma cell biology.  Remember, the first thing I said today, that myeloma is cancer of plasma cells, and plasma cell's job in life is to make a lot of protein, and many of our drugs that we use really targets not the myeloma as a cancer but the myeloma as a plasma cell.   

And so all of these other drugs, the BCMA-targeted drugs and the anti-CD38-targeted drug are really focused on that side of the biology, which is the plasma cell biology, which leaves completely the cancer biology.  And when I say the cancer biology I talking about targeting mutations and so forth. And so that's an area where, to be frank, we've had less success in myeloma to date.  And this really gets into that other topic of precision medicine, which is we still don't have ways of looking at a single abnormal molecule in myeloma and targeting it.  

We are starting to ask those questions with looking at groups of abnormalities in like BRAF and RAS and so forth, and we had a drug up there earlier, but we're really somewhat behind in that aspect. There's a lot of drugs that are targeted, a lot of molecules that are targeted, but one of the other challenges in targeting myeloma is that across patients myeloma is different, within patients myeloma is different.   

And so every myeloma cell in the body doesn't share these targets, and so we haven't??and so the future very much is going to be a combination of targeting the plasma cell biology along with targeting the more cancer biology where we can have specific targets and possible multiple targets within that cancer biology.  

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.