Myeloma Research Progress: Anti-CD38 Monoclonal Antibodies in Development

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Recent excitement around the treatment for multiple myeloma has surrounded the emergence of monoclonal antibody immunotherapy. So what is the role of these therapies? In this video from the 2014 annual meeting of the American Society of Clinical Oncology (ASCO), Dr. Thomas Martin, of the UCSF Helen Diller Family Comprehensive Cancer Center, gives us an update into the two leading anti-CD38 drugs in development, elotuzumab and SAR650984, the latter of which he has been a key investigator in clinical research. Learn what potential this new class of drugs hold, their potential role in the current landscape of multiple myeloma treatment, and what patients with relapsed/refractory multiple myeloma need to know about getting involved with ongoing clinical trials.

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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.

Carol Preston:

Hello and welcome to Patient Power. I’m Carol Preston on location in Chicago at the 2014 American Society of Clinical Oncology. And with me right now is Dr. Tom Martin, of UCSF, a specialist in multiple myeloma. Dr. Martin, thank you so much for joining us.

Now at ASCO, you are presenting data on SAR, which is a promising new antibody targeting the CD38 development. This era, first of all, of targeted medicine is nothing short of miraculous. Can you tell us a little bit about your investigation and what you’re finding?

Dr. Martin:

Yeah, sure. So at this meeting, we’re presenting two sets of data. SAR is an anti-CD38 monoclonal antibody. CD38 is expressed on a lot of hematologic malignancies but specifically on multiple myeloma—very highly expressed on multiple myeloma—and, so, it’s a great target for us to develop for myeloma.

What happens is the antibody goes and binds to the myeloma cell, to the plasma cell, and it really sends a flag to the immune system to “come get me.” So the antibody works by engaging the patient’s own immune system to perform what’s called antibody-dependent cellular toxicity. So the cells like the NK cells and the macrophages and the other immune cells go and help kill that cell. And there’s also complement protein in circulation that sees antibodies bound to a cell like that and also helps kill it by jackhammering a hole in the surface of the cell.  So those two mechanisms together are very powerful in killing these myeloma cells.

So we’re presenting data on two things: one using the antibody alone as a therapeutic in patients who have relapsed and refractory myeloma; really patients who have no other option. We also did a similar study using the antibody together with lenalidomide (Revlimid) and dexamethasone (Decadron). There is pre-clinical data that, perhaps, if you add an IMiD like lenalidomide or Revlimid, that might actually increase the activity of some of these immune fighter cells like NK cells and macrophages. Together, there might be a more robust response. I think that our data shows that as a single agent, it works really well. As a combination, it works even better.

Carol Preston:

In terms of the development progressing nicely, what is the next step?

Dr. Martin:

We’re seeing responses with this antibody that is equivalent to some of the drugs that are already approved for use in myeloma. That’s quite exciting. This is a whole new class of drugs for myeloma. Now, when we define that, as a single agent, it works really well, we then try to combine it with all of the other medicines for myeloma. There’s a multi-pronged approach now. So it’s going to be combined with lenalidomide, with carfilzomib or Kyprolis, with pomalidomide, with bortezomib. So many more studies are going to be performed in the next three to five years. You know, eventually, with the hope that this is going to be one of the next approved agents for multiple myeloma.

Carol Preston:

So what is the bottom line for patients then?

Dr. Martin:

With this antibody, again, in combination with other medications, that we’ll help get this antibody out on the market, help get it FDA approved so that all patients will have access to this. So at the current time, it’s really participation through clinical trials that patients have access to this. The antibody itself is very safe. The toxicity profile is really quite acceptable, and I would encourage patients to try to use that mechanism to get access at the current time. This antibody has the ability to really expand its use to many blood cancers. Especially since at the current time, we’re having great responses in myeloma and little toxicity. So many other studies will be developed. I would say that patients that have other blood cancers, they should also look at ClinicalTrials.gov over the next year to two years and where these studies will be done.

Carol Preston:

Final takeaway for patients.

Dr. Martin:

I would say the final takeaway is, in my mind, there are two blockbuster medications, or groups of medications, for myeloma right now. That’s the proteasome inhibitors, bortezomib or Velcade, carfilzomib or Kyprolis; and IMiDs, that’s lenalidomide or Revlimid, Pomalyst or pomalidomide. There’s no third blockbuster until now. I think these immunotherapies, especially the monoclonal antibodies, and these anti-CD38 antibodies, the SAR drug, perhaps the Dara drug, and there’s another one from Celgene, that these antibodies are now showing single-agent responses equivalent to some of these other approved drugs. This is really a great development for patients with myeloma and other blood cancers. This is going to be, in my mind, the next blockbuster drug for myeloma.

Carol Preston:

Very exciting. The breakthroughs continue in immunotherapy in oncology. Thank you so much, Dr. Tom Martin of UCSF.

Dr. Martin:

Thank you very much.

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 June 11, 2014