Dr. Shain Discusses Novel Agents in Multiple Myeloma

Kenneth H. Shain, MD, PhD, assistant member, Moffitt Cancer Center, discusses novel agents in multiple myeloma.

The triplet regimen of lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVd) is widely accepted as the standard of care for the frontline treatment of patients with multiple myeloma, says Shain. Although, carfilzomib (Kyprolis) is also showing promise in triplets as well.

In June 2018, the FDA approved a supplemental new drug application adding overall survival data from the phase III ASPIRE trial to the label for carfilzomib for use in patients with relapsed or refractory multiple myeloma. In this trial, carfilzomib, lenalidomide, and dexamethasone reduced the risk of death by 21% compared with lenalidomide and dexamethasone alone for patients with relapsed multiple myeloma following prior treatment with 1 to 3 regimens. Shain says it is too early to tell if this will replace the standard of care, but the data is compelling.

In May, the FDA approved daratumumab (Darzalex) in combination with bortezomib, melphalan, and prednisone (VMP) for the treatment of patients with newly diagnosed multiple myeloma, but Shain says that the utility of this combination in the United States is still unknown.