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What New Myeloma Drugs Are Available?

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Published on July 20, 2020

What New Drugs Have Been Approved For Multiple Myeloma?

With new drugs available for multiple myeloma and more being developed, how much closer are we to a cure?

From our recent Myeloma Answers Now program, Dr. Luciano Costa from the University of Alabama at Birmingham O’Neal Comprehensive Cancer Center and Dr. Joshua Richter of Tisch Cancer Institute at Mount Sinai discuss the latest myeloma drug approvals with host Andrew Schorr.

They also discuss drugs that are close to approval, why you should consider a clinical trial, and why Dr. Richter says, "My goal is to keep you alive until there's a cure." And in fact that we may have a cure today for some patients if we use the right drugs, the right technologies, and the right combinations."

Click on the part to view the other parts in the series: Part 1, Part 2, Part 3.

This program is sponsored by Janssen Biotech, Inc. This organization has no editorial control. It is produced by Patient Power and Patient Power is solely responsible for the content.

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Transcript | What New Myeloma Drugs Are Available?

Andrew Schorr:
So Dr. Costa, it seems like things are changing fast. You guys have a lot to talk about. There was so much that's approved, but now there's a lot in the pipeline, as you say.

Dr. Costa:
Absolutely. I mean, you mentioned several of those, there's an immuno-therapeutic revolution in myeloma with we have now three monoclonal antibodies, some more under development. We have bispecifics with four different targets being approached. We have CAR T-cell, there's three leading CAR T-cell platforms that are expected to get approval as soon as the end of the year. We have other CAR T's developing on different targets. We have drugs like venetoclax (Venclexta). I find it's used in myeloma on 20% of patients who have a specific translocation code, t(11;14). And we have selinexor (Xpovio) that really start this life in myeloma with kind of little bit of a bad rap for being a tough to tolerate medication. But we're seeing with a lot of learning from Dr. Richter and his colleagues who did a lot of those early trials, that this drug can be tolerated, particularly in giving lower dose, particularly given in combination. The BOSTON trial just resulted positive, showing that selinexor plus bortezomib (Velcade) is better than Velcade alone, even looking at a higher dose in patients with early relapse.

And then, you just think about those agents and then you start combining them and there are essentially endless possibilities. Every day, we meet patients who need one option that is still not there yet. So I echo Dr. Richter in, really consult with a myeloma expert, even if you're not going there for every single treatment, but at least have that guidance and please participate in clinical trials.

Andrew Schorr:
Right. Right. So, okay. So to sum up, Dr. Richter, years ago, when I started doing programs with Susie Novus, back in the nineties, we didn't have so much to talk about. And now for people, whether it's yourself, not always, but sometimes an older patient, or it's Mom, or Dad, or Grandpa, it sounds like you have options that can be discussed, lines of therapy that can be discussed in managing side effects as well. Doctor, it's a measure of real hope. This is real. And in myeloma compared to some other solid tumors, for instance, where some areas where we haven't cured brain cancer yet, or some others, you have a lot of hope.

Dr. Richter:
Yeah. I mean, I think the reality is, you and I were talking about before we got on, it's almost like alphabet soup. You know, you combine this drug with this drug, with this drug. So we give regimens VMP, KRd. But the reality is that there's a lot of ways to combine and recombine drugs. The pipeline is enormous. If you go onto clinicaltrials.gov, which houses all the trials over the world, it's always around, the last time I checked, a little over 3000 active trials in myeloma across a variety of different technologies. And what I tell patients when I first started in this, I would always start off the diagnosis saying, "We don't have a cure for this." And what I say now is, "My goal is to keep you alive until there's a cure." And in fact that we may have a cure today for some patients if we use the right drugs, the right technologies, and the right combinations. To me, that's been the biggest change over the last couple of years is at least how I conceptualize even curing myeloma.

Andrew Schorr:
Dr. Costa, how do you say it to patients now?

Dr. Costa:
I totally agree with Dr. Richter. I'm no longer afraid of putting cure in my note. And the thing I tell patients is, there are about five, 10% of patients who got treated 15 years ago, who are still in remission, some without therapy, they’re for all practical purposes cured. We're probably curing more than that now, but it's going to take us 15 years to find out. So I tell patients, "Forget about that statement that you're going to find on the first paragraph of every textbook that says about myeloma. Let's focus about, no matter what you call or how you define, what matters is that we're going to do our very best to give you the longest response and the best quality of life.” And for some those might end up being a cure, and we might be curing patients right now. And I really believe that.

Andrew Schorr:
Well, what a great message of hope, but real effectiveness, and thank you to the FDA. And we should say thank you to trial patients, thank you to the FDA as well. They're really looking at this. They're trying to protect our safety, but they're also trying to approve new drugs as well. Thanks to you guys, clinicians, and researchers who are working on it. Ladies and gentlemen, we are doing these myeloma programs roughly every two weeks. I want to thank these experts who've been with us today, and many others, who've been with us. Look at the replays on patientpower.info, and you will see a lot. I'm going to let you go. Dr. Costa from University of Alabama, Birmingham, thank you. We wish you well with COVID there in Alabama, as we do around the world. And thank you for your dedication to patients.

Dr. Costa:
Thank you. Thank you. It was my great pleasure, thank you so much.

Andrew Schorr:
Thank you. And Dr. Joshua Richter, from New York, thank you so much for what you do at Mount Sinai, and for helping us understand, make sense of some of this research, and what a difference it can make to patients. Keep at it, okay.

Dr. Richter:
Thank you so much for having me on today.

Andrew Schorr:
Thank you for joining us today in San Diego County, California, I'm Andrew Schorr. Remember, knowledge can be the best medicine of all.

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