ASCO 2012 – Blog Post # 4

Immunotherapy for myeloma – three papers

All three describe studies with agents having names ending in “mab,” which means monoclonal antibody.

Siltuximab with Velcade:

Dr Robert Z Orlowski. In this Phase II study, siltuximab did not provide benefits sufficient to outweigh its side effects. However, Dr Orlowski is still hopeful that siltuximab might be of benefit in different in combination with other agents. Such a study is currently underway with high-risk patients.

“There is no failure, only feedback.” – Robert Allen

Daratumumab:

Dr Torben Plesner described the results of a Phase I study with a small number of patients who had received at least two prior therapies, most of them including a stem cell transplant. The early data showed a good response, and the maximum tolerable dosage has not yet been found. This is a good one to watch.

Elotuzumab:

Dr Philippe Moreau. Elotuzumab is a humanized monoclonal antibody targeting a protein which appears almost exclusively on myeloma cells. In this Phase I/II study with patients having 1 to 3 prior therapies, elotuzumab was added to Revlimid/dex and the combination produced a very good overall response rate of 84% with only modest side effects. This drug shows no benefit when given alone, but substantially increases the effectiveness of Revlimid, and quite likely other drugs. Further, there is an optimum dosage; the study showed that a dose of 10 mg (per meter squared) actually produced better results than 20 mg. Makes you wonder if 5 would be even better.