Multi-Pronged Drug Treatment with Monoclonal Antibodies Offer Expanded Options for Myeloma Patients

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Andrew Schorr:

Hello and welcome to Patient Power. I’m Andrew Schorr. So now we have a new arm of drug treatment for multiple myeloma-monoclonal antibodies. To help us understand where monoclonal antibodies come in and what they mean for patients, we’re joined by Dr. Joseph Mikhael from the Mayo Clinic in Arizona.

Dr. Mikhael:

I often say that myeloma is aptly named as multiple myeloma, meaning that it’s a very different disorder in different patients—meaning it has a lot of complexity to it. Some patients do, sadly, poorly, and others do very well. What I think we have learned is that it’s not just about the tumor itself. It’s about the environment, and understanding the tumor in its environment has given us multiple so-called targets to be able to affect the disease.

If I know the enemy is across the street and I can’t even get into that building, maybe I can shut off the power to the building or shut off the water to the building. Now we have all of these different targets. The first step is to prove that each target can actually do something—that cutting off the power does affect that enemy, but then being able to combine them together. I think that that approach is what has brought us this far in myeloma. It’s not just about one wonder drug. It’s about having several drugs and then tailoring those drugs to every patient. What is going to work best in this patient, from its so-called efficac—how well it works—but also its tolerability. So if some drugs cause certain side effects and those side effects are really tough for certain patients, then we have options. So I’m very encouraged by the fact that we have multiple options now and options that are dissimilar enough that we can start to combine them.

We’ve known for years that almost every myeloma cell has this little hook sticking out of it, what we call CD38 just like most lymphomas, for example, have a different hook called CD20. And so drugs were designed to attack, if you will, that hook or hook on to it and trigger the patient’s own immune system to destroy that cell with the real benefit where it only hits those cells that have that hook and not the others. It’s eluded us for a number of years in myeloma to be able to do the same thing as we’ve done in lymphoma.

So what we’re doing with this drug called SAR, that we’ve called it for short, which is an anti-CD38 molecule or anti-CD38 drug, is a drug that hooks onto that hook, the CD38 that’s present on almost every myeloma cell and triggers the patient’s own immune system to destroy it, and also, at the same time, just by grabbing onto the hook, also destroys the cell. I think those two properties together makes it so valuable.

What we’ve been able to show is that the drug works on its own, and we expect to be able to show that it works with combinations of the drugs that we have now. What’s perhaps most exciting about it is that this is a drug that is very well tolerated, as we say, meaning there’s very few side effects and, thankfully, no overlapping side effects with the traditional drugs in myeloma. You don’t really see people’s blood counts drop. We don’t see neuropathy. We don’t see the kinds of effects that we have with the other drugs that we’ve been using.

I think this antibody therapy is something that we’re excited about, because we can use it in combination with the drugs that we have right now, and we’re starting to see that benefit. So it’s going to make the myeloma equation, if you will, very complicated, but complex is good for patients, and that’s what we want in the sense that we want options. I tell my patients it’s not like playing a game, but I want to play the best card for them, but I want to play the card that’s going to let me play my other cards later. As we move this disease to more chronic, we look at other diseases that we’ve been able to do that, it’s because we’ve had multiple options that we’ve used appropriately and sequentially.

Andrew Schorr:

Thanks for Dr. Joseph Mikhael for helping us better understand monoclonal antibodies for myeloma. Be sure to look at related videos on our website to get the full breadth of knowledge related to multiple myeloma. And sign up for alerts on our website so you’ll know whenever we post something new. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on July 7, 2014