18th International Myeloma Workshop

Novel therapies in multiple myeloma

Prof Joseph Mikhael - Translational Genomics Research Institute, Pheonix, USA

I’ve had the privilege of being involved in multiple myeloma now for nearly 25 years and I don’t think I have ever lived in a time where there have been more exciting molecules as we see now in multiple myeloma. The list is almost endless of now BCMA-engaging molecules, whether they be antibody-drug conjugates, CAR T-cell therapy or even bispecific antibodies, have really given us a tremendous foothold on this disease, especially in the more heavily pre-treated patients. We’re seeing response rates with CAR T-cell therapies that are almost unheard of – 70%, 80%, over 90% of patients responding and, indeed, having durable responses of over a year and, in some cases, over two years median.

So we really are seeing a tremendous wave of immunotherapy in multiple myeloma in the form of CAR T-cell therapies, bispecific therapies. But not only so but now being able to learn to match these and marry these, if you will, to many of the treatments that we currently have. Using our three main pillars of proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies we now can not just introduce these new novel agents but begin to use them in combination.

Furthermore, we have new classes of drugs that are being generated and, indeed, improvements on the bispecifics and CAR T-cell therapies that we have by employing new targets, not only BCMA but GPRC5D and FcRH5. So I really see a tremendous future in myeloma where we will not only introduce these new agents in the most heavily pre-treated patients but bring them earlier and earlier in the disease course and pair them and match them with some of the therapies we’re using now to have even greater efficacy, both in depth and duration of response.