Dr. Lonial Discusses Emerging Agents in Relapsed/Refractory Myeloma

Sagar Lonial, MD, professor and chair, Department of Hematology & Medical Oncology, Emory University School of Medicine, chief medical officer, Winship Cancer Institute of Emory University, discusses emerging agents in relapsed/refractory multiple myeloma.

There are 3 or 4 new agents coming down the pike in the management of relapsed/refractory myeloma. First is venetoclax (Venclexta), which is particularly promising in the t(11;14) subset of patients. Lonial says that there is clearly activity in this population, but it may have additional additive activity with proteasome inhibitors, such as bortezomib (Velcade).

Selinexor is another new agent showing promise alone in penta- and quad-refractory populations, Lonial says. It also partners well with proteasome inhibitors such as bortezomib and carfilzomib (Kyprolis). When combined, the adverse event rate of selinexor drops significantly, Lonial adds.

Chimeric antigen receptor (CAR) T-cell therapy is also beginning to show promise in relapsed/refractory myeloma. Data with the CAR T-cell therapy bb2121 presented at the 2018 ASCO Annual Meeting showed a median progression-free survival of 11.8 months and a median duration of response of 10.8 months for patients with relapsed/refractory heavily pretreated disease.