15th International Myeloma Workshop

Prof Ho (The University of Sydney, Sydney, Australia) chairs an expert discussion at the 15th International Myeloma Workshop, along side Prof Hatake (Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan), Prof Hou (Shanghai Changzheng University Hospital, Shanghai, China), Prof Yoon (Seoul National University Cancer Hospital, Seoul, Korea), Prof Lee (Chonnam University Hwasun Hospital, Hwasun, Korea) to discuss their practices regarding transplant eligible myeloma patients, with a focus on the variation of care between the countries they work within. They also discuss countries where fewer patients receive transplantation and the challenges these areas face.

Prof Lonial (Emory University, Atlanta, USA) chairs a discussion for ecancertv at the 15th International Myeloma Workshop with Prof Sonneveld (University Hospital Rotterdam, Rotterdam, Netherlands) and Prof San Miguel (University Hospital, Salamanca, Spain) about the interesting data on the use of monoclonal antibodies in combination with lenalidomide or bortezomib and their possible role in maintenance therapy for multiple myeloma. They start by talking about the use of monoclonal antibodies as single agent therapy before looking at their use in combination with other treatments and some of the practicalities of using them clinically. During the discussion they also look at the potential and pitfalls for proteasome inhibitors, such as carflizomib and newer oral agents including ixazomib, and comment on the histone deacetylase (HDAC) inhibitors’ potential in relapsed and refractory disease. They also provide comment on the use of genomics and minimal residual disease (MRD) assessment. MRD could be important for prognosis, Prof Sonneveld suggests. Finally they talk about the new definition and revised international staging system for multiple myeloma.

Prof Antonio Palumbo (University of Torina, Torina, Italy) and Prof Philippe Moreau (Centre Hospitalier Universitaire de Nantes, France) discuss clinical developments and experience with monoclonal antibodies in the treatment of multiple myeloma at the 15th International Myeloma Workshop. In particular, they talk about the promising results being seen with monoclonal antibodies that target SLAM (signalling lymphocyte activation molecule) F7, a glycoprotein present on multiple myeloma and natural killer but not normal cells. Results of the phase II ELOQUENT-2 trial of elotuzumab in patients with relapsed or refractory disease were presented at the meeting and suggest that this monoclonal antibody could improve upon progression-free survival when added to the standard of care, which is currently lenalidomide in combination with dexamethasone, versus the standard of care alone. They also highlight the results of studies with CD38-targetting monoclonal antibodies, such as daratumumab. This investigational drug has been tested as monotherapy, with results from a Dutch trial recently being published in the New England Journal of Medicine. It is also showing promise in combination with other drugs in the relapsed/refractory setting. Finally, Prof Moreau comments about what backbone regimens may be appropriate to use with these new agents and suggests that daratumumab could be used in a similar manner as rituximab in non-Hodgkin lymphoma, with studies also looking at its as a maintenance therapy.