Current Clinical Algorithms and Recent Therapeutic Advances in the Management of Multiple Myeloma and Related Blood Disorders (Video Program)Phase II trial of elotuzumab/lenalidomide/dexamethasone for high-risk smoldering multiple myeloma (MM)
1:52 minutes.
TRANSCRIPTION:
DR LOVE: I see at the ASH meeting, Irene Ghobrial from Dana-Farber is presenting a Phase II study that I think is a fascinating idea of elotuzumab with len/dex in smoldering myeloma. Any thoughts about that strategy? DR RAJE: They’ll be using an immune approach to try and address smoldering myeloma. And I think that’s a great idea. If you want to be using immune approaches, I think the earlier you do it in the context of myeloma, the better because that’s where your immune system is intact. Having said that, even in a smoldering myeloma patient population, we do see some immune paresis. And given that the combination is generally well tolerated, the other pieces you have to think about when you’re considering treatment for smoldering myeloma is that the treatment, in itself, should be fairly well tolerated because these are healthy, well patients. So I think the strategy is very helpful. As a starting point, this elo/len/dex is a great study. It’s a Phase II study, end of the day, and Phase II studies come with the caveats of, of course it’s going to show efficacy, but the true test is going to be when you start randomizing and seeing whether or not this combination is really going to make an impact on the long-term outcome. We just don’t have that data. DR LOVE: So for these patients who, in the past, would have been called smoldering — now they’re called myeloma — are they going to get triple therapy? DR FONSECA: Well, I think they will because once you cross the Rubicon, you’re committed, I think, to the treatment. There’s this concern that suboptimal therapy will lead to resistance, will create opportunity for emergence of more aggressive clones. So I think if we get to the point that we decide it is time to start therapy, I think it has to go with the full commitment of what we would have in any otherwise newly diagnosed patient. |