Dr. Kumar on Future Treatment Landscape of Multiple Myeloma

Shaji Kumar, MD, professor of Medicine, Mayo Clinic, discusses his vision for the future treatment landscape of multiple myeloma.

The key to future treatment approaches in this field will involve identifying new drugs with various mechanisms of actions. What is striking about the monoclonal antibodies, including daratumumab, is that now researchers have an agent that is part of an entirely different class of drugs, versus the proteasome inhibitors and immunomodulatory (IMiD) drugs that are already available.

Additionally, these monoclonal antibodies also have high levels of synergy with the other available agents, including the IMiDs. This means that the combination of these drugs provide better outcomes than have been seen with the existing agents alone, he says.

On the horizon, new classes of drugs will be evaluated. Immunotherapy will likely be an exciting era, Kumar adds. Currently, there is evidence that suggests that pembrolizumab (Keytruda) in combination with lenalidomide (Revlimid) or pomalidomide (Pomalyst) is associated with clinical activity. The next steps will include how these immunotherapy agents will perform in phase III trials, especially as other agents such as chimeric antigen receptor T-cell therapies and bi-specific monoclonal antibodies are also being explored.