Dr Robert Rifkin Outlines Recent Treatment Advances in Multiple Myeloma

Although there haven't been as many new drug approvals for multiple myeloma as there were last year, there are many new agents entering the market and exciting new discoveries, said Robert Rifkin, MD, FACP, medical director, biosimilars and associate chair, hematology research, McKesson Specialty Health.

What are the most recent treatment advances in multiple myeloma?

This year’s [American Society of Hematology Annual Meeting & Exposition] has many significant advances in multiple myeloma. Everybody will hear a lot about CAR [chimeric antigen receptor] T-cell therapy, but unfortunately, we’re not curing anybody with that, and the responses are lasting sometimes long, sometimes short. Another big focus will be the bispecific antibodies, or the BiTE molecules. Several of these are in development—early clinical trials.

Probably the hottest target of the whole meeting will be the BCMA target in multiple myeloma, which is the B-cell maturation antigen. So, there will also be many presentations on agents directed for BCMA, some monoclonal antibodies, some antibody drug conjugates. So, it’s exciting in terms of the advances that we’ve made.

In terms of new drug approvals, it’s not quite the banner year it was a year ago, but there’s still many new agents entering the market, and many exciting things to come.

How are these advances impacting clinical outcomes?
So, a lot of these are really new. In most of the trials, we barely know progression-free survival. There will be some early overall survival data being presented with new chemotherapy regimens, but we really have to wait and see the impact. I think it will also be extraordinarily important to control cost as all of these new agents come out.

There was one oral presentation yesterday on a quadruple combination of therapy, which works very, very nicely, but there was little, if any, mention of the financial impact on the patient and the healthcare system. So, in multiple myeloma, we’re going to have to get more responsible as all of these new agents march quickly to the forefront.
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