Hematologic Oncology Update, Issue 1, 2016 (Video Program)Incorporation of the newly FDA-approved monoclonal antibody elotuzumab into the therapeutic algorithm for MM
1:58 minutes.
TRANSCRIPTION:
DR LOVE: So I want to drill down a little bit more again on how you’re using the monoclonal antibodies, but the one kind of scenario I’ve heard people talk about, and I’ve heard both enthusiasm and not enthusiasm about this, is the patient who’s relapsing while receiving len maintenance. So, for example, maybe they got RVd up front. They might have gotten a transplant. They’re on len maintenance, and now they’re having a biochemical relapse. They feel totally fine. And what I’ve heard people talk about is bumping up the dose of lenalidomide to therapeutic for maintenance and adding in elo. What do you think about that strategy? DR FONSECA: It can be done, but I would be probably more in the camp that there are better options than that for that particular patient. What I’d tell you I’m very excited about is the idea of using elo up front in the nontransplant candidate who’s a candidate for Rd. So the typical scenario is a more elderly person who has hyperdiploid variant myeloma, multiple trisomies, no high-risk factors. So that patient nowadays is an ideal candidate for Rd. And if the results for that clinical trial hold as they did for the relapsed and refractory, then that patient may be an ideal candidate for elotuzumab. DR LOVE: That's interesting. How do you see elo/len playing out in the elderly patients? Obviously, a lot of these people getting Rd induction are older and in their eighties, et cetera. What do you see in terms of infusion reaction and other issues with elo? DR FONSECA: Elo has been reported and published, one of the safest when it comes down to infusional toxicity. I think in general the monoclonals are well tolerated. We don’t have experience outside of the clinical trials with cetuximab. We have developed quite a bit of experience with daratumumab. And there is some toxicity to be managed, and the nursing staff has learned how to deal with that. I think there’s a bit of a learning curve at the beginning. There’s the logistics of doing all of that. But I would anticipate that elo is probably going to be more on the easier side of things. |