Jeffrey A. Zonder, MD, Hematologist-Oncologist from the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan, describes the treatment landscape for patients with relapsed or refractory multiple myeloma.

Multiple myeloma is a rare blood cancer associated with uncontrolled growth of plasma cells. Abnormal plasma cells – also known as myeloma cells – interfere with the production of healthy blood cells in the bone marrow. Myeloma cells also produce inactive clones of abnormal antibodies that may negatively affect the bones and kidneys. Symptoms of multiple myeloma may include: bone pain (particularly in the chest and spine), frequent infections, weakness or numbness in the legs, fatigue, confusion, excessive thirst, and constipation. While the disease is treatable, relapses are common and some patients are refractory to first line therapy.

As Dr. Zonder explains, the treatment landscape for multiple myeloma is quickly developing and relatively promising compared to other cancer landscapes. However, these patients are still susceptible to relapse or becoming refractory to treatment. As such, there is a growing need for late line therapies for this patient population. CAR T-cell therapies have been investigated for relapsed or refractory multiple myeloma for a number of years. In March 2021, idecabtagene vicleucel (a CAR T-cell therapy) was approved by the U.S Food and Drug Administration for the treatment of patients with relapsed/refractory multiple myeloma who have received at least four prior lines of therapy. There are a few toxicity concerns associated with CAR T-cell therapies, the most notable of which is cytokine release syndrome, as well as accessibility issues. Bispecific antibody therapies are also being developed for multiple myeloma and have the potential to be a safe and effective alternative.

Dr. Zonder recently discussed data from the first-in-human study of REGN5458, a BCMA x CD3 bispecific antibody that is currently being investigated as a monotherapy for relapsed/refractory multiple myeloma patients (NCT03761108). Data from the phase 1 portion of this study were recently presented at The American Society of Hematology Meeting & Exposition (ASH 2021).