Maung Myo Htut, MD, assistant clinical professor of hematology and hematopoietic cell transplantation, City of Hope, discusses the use of immunotherapy in the treatment of patients with multiple myeloma.
Htut says that he has a vested interest in immunotherapy—using PD-1/PD-L1 inhibitors to modify a patient's immune system. Thus far, there has been a trial using the PD-1 inhibitor pembrolizumab (Keytruda) in myeloma. Unfortunately, there were some issues with safety, so the FDA stopped the trial.
The phase III KEYNOTE-183 and KEYNOTE-185 trials were exploring pembrolizumab combined with an immunomodulatory agent and dexamethasone. The FDA wanted to alert oncology researchers about the risk of death associated with pembrolizumab in these patients.
However, Htut believes that there is an active pathway in multiple myeloma. If in some way physicians can modify the agent or use a different PD-1 inhibitor, physicians can revisit the issue. Htut states that it may be too early to say, “this is it,” in terms of using PD-1/PD-L1 inhibitors.