Advances Could Lead to Curative Strategies in Myeloma

There are currently 10 FDA-approved treatments in the multiple myeloma space; however, a more personalized therapy could be key to finding a cure, said Nikhil C. Munshi, MD.

“In 5 years, we could be bold enough to say, ‘We have cured myeloma,’” said Munshi. “Combining all the drugs we have and combining what we know about CAR T-cell therapy can do this and be a surrogate for cure.”
In an interview with OncLive, Munshi, director of Basic and Correlative Science, Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, professor of Medicine, Harvard Medical School, discussed the current treatment landscape of myeloma and potential next steps to further advancing care.

OncLive: Could CAR T-cell therapy be moved into an earlier setting in multiple myeloma?

Munshi: Absolutely. In the induction treatment, our main purpose is to get good and deep responses. That is why we do stem cell transplant—to get a deep response. Transplant is associated with up to 50% complete response. Therefore, it’s very obvious to us that we will be bringing these types of treatments into early settings.

What are your thoughts on triplet and quadruplet combinations?

Triplet regimens are something we have utilized and some of them came from our group here at Dana-Farber Cancer Institute. A number of studies have shown that 3 drugs are better than 2, and that has become the standard of care. The same thing might now apply to these 4-drug regimens. We are clearly seeing deep responses; however, no groundbreaking data have been published yet. It’s just a matter of time before we have these data available. Quadruplets have not been incorporated as standard practice yet, but they will soon be for investigational purposes and for regular everyday practice.

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