Marc J. Braunstein, MD, PhD

Marc J. Braunstein, MD, PhD, assistant professor in the Department of Medicine at NYU Long Island School of Medicine; course co-director of the Hematology-Oncology System and co-director of the Autologous Stem Cell Transplant Program, NYU Winthrop Hospital of NYU Langone Health’s Perlmutter Cancer Center, discusses the utility of maintenance therapy in patients with multiple myeloma.

​In both prospective studies and meta-analyses, maintenance therapy has demonstrated an overall survival benefit in patients with multiple myeloma, particularly after autologous stem cell transplantation (ASCT), says Braunstein.

Maintenance therapy can target the multiple myeloma clone over time with ​reduced-dose therapies, explains Braunstein. Implementing active surveillance throughout treatment can identify resistant clones.

Multiple myeloma remains an incurable disease because patients have multiple non-identical plasma cell clones ​at diagnosis. Moreover, some of these clones may persist in the bone marrow microenvironment following ASCT, Braunstein concludes.

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Marc J. Braunstein, MD, PhD, discusses the utility of maintenance therapy in patients with multiple myeloma.

Dr. Braunstein on the Utility of Maintenance Therapy in Multiple Myeloma

Marc J. Braunstein, MD, PhD, assistant professor in the Department of Medicine at NYU Long Island School of Medicine; course co-director of the Hematology-Oncology System and co-director of the Autologous Stem Cell Transplant Program, NYU Winthrop Hospital of NYU Langone Health’s Perlmutter Cancer Center, discusses updated results from the GRIFFIN trial in multiple myeloma.

The phase 2 GRIFFIN study evaluated the addition of daratumumab (Darzalex) to lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVd) versus the standard triplet regimen of RVd in transplant-eligible patients with myeloma. The results showed an improvement in progression-free survival with the quadruplet. Additionally, the primary endpoint, which was stringent complete response (sCR), was superior at every evaluable timepoint in the quadruplet arm compared with the triplet arm.

The quadruplet could become the new standard of care for transplant-eligible patients, says Braunstein. However, longer-term follow-up data are needed in order to see which patient benefits the most from this treatment, concludes Braunstein.

Marc J. Braunstein, MD, PhD, discusses updated results from the GRIFFIN trial in multiple myeloma.

Dr. Braunstein on Updated Results of the GRIFFIN Trial in Multiple Myeloma

Marc J. Braunstein, MD, PhD, assistant professor in the Department of Medicine at NYU Long Island School of Medicine; course co-director of the Hematology-Oncology System and co-director of the Autologous Stem Cell Transplant Program, NYU Winthrop Hospital of NYU Langone Health’s Perlmutter Cancer Center, discusses updated results from the GRIFFIN trial in multiple myeloma.

The phase 2 GRIFFIN study evaluated the addition of daratumumab (Darzalex) to lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVd) versus the standard triplet regimen of RVd in transplant-eligible patients with myeloma. The results showed an improvement in progression-free survival with the quadruplet. Additionally, the primary endpoint, which was stringent complete response (sCR), was superior at every evaluable timepoint in the quadruplet arm compared with the triplet arm.

The quadruplet could become the new standard of care for transplant-eligible patients, says Braunstein. However, longer-term follow-up data are needed in order to see which patient benefits the most from this treatment, concludes Braunstein.

Marc J. Braunstein, MD, PhD, assistant professor in the Department of Medicine at NYU Long Island School of Medicine; course co-director of the Hematology-Oncology System and co-director of the Autologous Stem Cell Transplant Program, NYU Winthrop Hospital of NYU Langone Health’s Perlmutter Cancer Center, discusses quadruplet therapies in multiple myeloma.

The field has had quadruplet therapies for many years in the form of multi-chemotherapy agents and involve cytotoxic agents. Although these combination chemotherapies were not specifically designed for multiple myeloma, but they were effective against aggressive plasms cell clones, explains Braunstein.

Now that more targeted therapies and monoclonal antibodies are available, physicians are able to consider quadruplet therapies for many more patients because these drugs are much more tolerable since they are targeted.

As such, research efforts are now focused on taking the monoclonal antibodies, which have been approved for use in the second- or third-line setting, and using them in combination with standard triplet regimens up front for myeloma, concludes Braunstein.

Marc J. Braunstein, MD, PhD, discusses quadruplet therapies in multiple myeloma.

Author | Marc J. Braunstein, MD, PhD

Articles

Dr. Braunstein on the Utility of Maintenance Therapy in Multiple Myeloma

Dr. Braunstein on Updated Results of the GRIFFIN Trial in Multiple Myeloma

Dr. Braunstein on Updated Results of the GRIFFIN Trial in Multiple Myeloma

Dr. Braunstein on Quadruplet Therapies in Multiple Myeloma