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Myeloma Regimens Require Coping Mechanisms for Toxicity

Ellie Leick
Published: Monday, Oct 14, 2019

blood cellsD Multiple myeloma treatment has made significant strides, but many of the regimens cause considerable toxicity, making it a priority to optimally manage the associated adverse events (AEs) or create less-toxic approaches, explained Adam J. Waxman, MD, MS.

“In the last year or so, there was a real explosion of randomized data for patients with multiple myeloma, including new data for newly diagnosed patients with the addition of daratumumab (Darzalex) and of carfilzomib (Kyprolis) as initial therapies on the transplant-eligible and -ineligible patients. The addition of daratumumab showed progression-free and, in some cases, overall survival (OS) benefits,” said Waxman. “We need to find better ways to manage the toxicities of the drug classes we're using with additional drugs, as well as developing new classes [of drugs] to treat patients where we have efficacy issues.”

Additionally, selinexor (Xpovio) was approved by the FDA in July 2019 after showing an overall response rate of 25.3% (95% CI, 16.4-36.0) in patients whose disease was refractory to bortezomib (Velcade), carfilzomib, lenalidomide (Revlimid), pomalidomide (Pomalyst), and daratumumab. However, the data did raise safety concerns after treatment-emergent AEs and serious AEs resulted in patient deaths.

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