Dr. Rodriguez on Evolving Role of Small Molecules in Multiple Myeloma

Cesar Rodriguez Valdes, MD, assistant professor of Hematology and Oncology, Wake Forest University Comprehensive Cancer Center, highlights the evolving role of small molecules in multiple myeloma.

Small molecule therapies have been available in the treatment of multiple myeloma since the 1950’s, says Rodriquez. Melphalan was the first small molecule used for the disease, and now, selinexor (Xpovio) was just approved by the FDA in July 2019.

The majority of treatments that are being used in the myeloma paradigm, with the exception of immunotherapies, are considered as small molecule therapies, says Rodriguez. There has been a great evolution over the past 2 decades in terms of available options, he adds. Now, a whole new class and new generations of agents have emerged, and with these agents comes greater efficacy, better quality of life, and longer overall survival for those with myeloma.

Going forward, investigators will further explore these classes of therapies and channel their efforts into detecting new molecules that may be used that will hopefully be even more effective at controlling the disease while reducing associated adverse events, he adds.

However, small molecule therapies by themselves are not going to achieve cure for these patients; the answer to that may lie in combining these therapies with immunotherapies, vaccines, or CAR T-cell therapies, Rodriguez concludes.