Sagar Lonial, MD, professor and chair, department of hematology and medical oncology, and chief medical officer, Winship Cancer Institute, Emory University School of Medicine, Atlanta, discusses the roles of immune-based therapies and transplantation in treating myeloma.
“We have a lot of interesting and exciting data using immunotherapeutic approaches that can be incorporated into our daily practice right now,” he said.
Lonial reviews recent findings on two monoclonal antibodies — elotuzumab (Empliciti, Bristol-Myers Squibb) directed against Signaling Lymphocytic Activation Molecule F7 (SLAMF7) from the phase 3 ELOQUENT-2 trial, and the anti-CD38-directed daratumumab (Darzalex, Janssen) from the phase 1/2 GEN503 study — and provides clinical context for their current and potential use.
He also outlines “very encouraging data” from investigations studying the combination of the checkpoint inhibitor pembrolizumab (Keytruda, Merck) with lenalidomide (Revlimid, Celgene) or the thalidomide analogue pomalidomide (Pomalyst, Celgene). He notes larger clinical trials are currently exploring the anti–PD-1 agent in conjunction with immunomodulatory agents.
Lonial touches on the potential of chimeric antigen receptor T cells, or CAR T cells, emphasizing the success of pursuing B-cell maturation antigen (BCMA) in myeloma rather than CD-19, as in other cancers.
Lastly, he tells why “it is important to continue to use and maintain autologous transplantation” as part of the treatment paradigm and highlights populations to target.