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Alan Skarbnik, MD, staff physician, department of Bone Marrow Transplant, Department of Lymphoma, John Theurer Cancer Center, discusses triplet combinations in hematologic malignancies.
Alan Skarbnik, MD, staff physician, department of Bone Marrow Transplant, Department of Lymphoma, John Theurer Cancer Center, discusses triplet combinations in hematologic malignancies.
An important consideration when combining agents is overlapping toxicities, explains Skarbnik. For example, combining ipilimumab (Yervoy) with a PD-1 inhibitor could potentially increase the toxicity since both agents are immune mediated, which could cause more immune-related adverse events.
Toxicity associated with combinations is a cost that patients pay for more efficacy across all cancer types, says Skarbnik. Adding a third drug may be complicated but it is possible. There has been success with triplet sequential therapy in hematologic malignancies, and it did not demonstrate any unexpected added toxicity.