Ivan M. Borrello, MD, discusses the current multiple myeloma treatment paradigm.
Ivan M. Borrello, MD, associate professor of oncology, Johns Hopkins Medicine, discusses the current multiple myeloma treatment paradigm.
Multiple myeloma has turned into a chronic disease, according to Borrello. There is an increasing recognition of the concept of clonal evolution, the idea that the disease at the time of diagnosis is much different than the disease at the time of the third or fourth relapse, adds Borrello. Furthermore, the number of available drugs in the treatment of patients with multiple myeloma has significantly increased. These substantial treatment advances have translated into improvements in progression-free survival and overall survival for patients.
Specifically, combinations composed of several different classes of drugs have emerged in this space; they can provide an additive, if not synergistic effect in patients, which can sometimes lead to an improvement in OS, says Borrello. Additionally, some drugs have been shown to molecularly target certain chromosomal abnormalities, Borrello adds. For example, venetoclax (Venclexta) is one such treatment that has demonstrated impressive activity in patients whose disease harbors 11;14 translocation; this is one of the more interesting targeted approaches in the field of myeloma, concludes Borrello.