Dr. Cho on Promising Combinations in Multiple Myeloma

Hearn Jay Cho, MD, PhD, associate professor of medicine, Hematology/Oncology, Icahn School of Medicine, Mount Sinai Hospital, discusses promising combinations in multiple myeloma.

There are several trials combining daratumumab (Darzalex) with immune checkpoint inhibitors, says Cho. Preliminary analyses have shown promising activity with this approach. However, these are early-phase trials that are not powered for efficacy, he cautions. If these combinations turn out to be effective, it will be important to understand what their efficacy is relative to other daratumumab combinations, as many daratumumab-based combinations show excellent response rates in long-term follow-up. Examples of this include the combination of daratumumab with pomalidomide (Pomalyst) and dexamethasone or lenalidomide (Revlimid) and dexamethasone.

However, some patients cannot tolerate these agents—particularly older patients or those who have received a lot of prior therapy. If a noncytotoxic-based regimen—such as an all immunotherapy-based regimen—becomes available to these patients, it will be an important addition to the armamentarium, says Cho.