Dr. Wong on Recent Developments in AL Amyloidosis

Sandy Wong, MD, a blood disease specialist and an assistant professor at the University of California, San Francisco (UCSF) School of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses the future of daratumumab (Darzalex) plus cyclophosphamide, bortezomib (Velcade), and dexamethasone (CyBorD) in light chain (AL) amyloidosis.

CyBorD has been the de facto frontline therapy for patients with AL amyloidosis for a long time, says Wong. When the organ responses achieved with CyBorD were reported, the data were very impressive; this begs the question of why the regimen is not currently being used.

There are challenges due to the lack of FDA-approved regimens for this disease, explains Wong, who adds that she has started to not give CyBorD as a frontline therapy, as it is sometimes possible to get insurance approval for daratumumab, bortezomib, and dexamethasone. This approach has resulted in impressive responses, according to Wong, although insurance approval and the ability to gain access to the regimen remains a challenge. The hope is that this will no longer be an issue in the future and that subcutaneous daratumumab (Darzalex Faspro) plus CyBorD will be FDA-approved for patients with AL amyloidosis, concludes Wong.