Do Multiple Myeloma Survival Rates Finally Approach Cure with Monoclonal Antibodies?? As Discussed by Dr. Asher Chanan-Kahn of Mayo Clinic

11/19/2013

Every time we get a new drug in the multiple myeloma treatment arsenal, the life expectancy and survival rates make a jump upward. We currently have alkylating agents(melphalan), immunomodulatory drugs(Thalamid), proteasome inhibitors(Velcade), and steroids(dexamethasone). Now there is a new class of drugs called Monoclonal Antibodies(Daratumumab), which uses the body's own immune system to attack the myeloma. It is this new class of drugs which Dr. Asher Chanan-Khan of Mayo Clinic discussed at the November 21st Cure Panel Broadcast. You can listen to this broadcast about this exciting new class of drugs if you CLICK HERE. Nick Van Dyk provided a summary of this presentation on his blog, and you can see it if you CLICK HERE.

I was at an IMF meeting at Mayo Clinic where Dr. Chanan-Kahn was a presenter. He explained the biology of multiple myeloma along with his treatment philosophy, with his only prop being a RED SOLO CUP. All of the people that I talked with after the meeting were impressed with his ability to bring such a complex disease and it treatments to a level where we all understood and were quite impressed. Dr. Chanan-Kahn explained that he believes in the philosophy that "Less is Best" when it comes to treatment, and he is not a proponent of stem cell transplant. I think you will find this broadcast to be one that you will look back on as a great educational experience.

For more information on multiple myeloma survival rates and life expectancy go to the web site www.myelomasurvival.com, or you can follow me on my twitter account at: https://twitter.com/grpetersen1

7 Comments

Mark

11/19/2013 06:31:11 am

Hi Gary,

Some great allo transplant data at ASH as well. This study has 44% of the patients progression free at 10 years. Do not forget to include immunotherapy (allo transplant) when discussing cure in myeloma. There is more to myeloma therapy than just never ending cycles drugs!

"High Progression-Free Survival At 10 Years After Tandem Autologous/Nonmyeloablative Allogeneic Transplants For Multiple Myeloma In a Cohort Of 93 Patients: Impact Of Disease Remission Status At Transplant and Chronic Graft-Versus-Host Disease"

We report a very high PFS of 44% at 10 years in a large cohort of 93 NMA alloHSCT recipients. Despite the high incidence of chronic GVHD, we observed a low NRM of 10% and an acceptable prevalence of immunosuppressive therapy of 15% at 10 years. Chronic extensive GVHD and achievement of disease control before HSCT were both associated with better PFS. Patients with progressive disease do not seem to benefit from NMA alloHSCT and efforts to reduce chronic GVHD could increase the risk of relapse. Agents active against both MM and GVHD might allow better long-term remission while reducing the burden of GVHD.
https://ash.confex.com/ash/2013/webprogram/Paper62647.html

There is also some great data showing only 8% of patients that use Velcade before the allo have chronic GVHD. Great progress toward a cure and excellent quality of life in the allo setting! Note the flat overall survival curve and this study has 41% high risk patients in it. I think high risk younger patients might want to consider a trip to Moffitt for an opinion!
https://ash.confex.com/ash/2013/webprogram/Paper64926.html

Mark

Gary Petersen link

11/20/2013 12:44:20 am

Mark, thanks for your allo research. We know you will be up to date on the most recent allo information. It does seem that Moffitt has unlocked the key to success from the mini allo transplant. I also think that your statement "high risk younger patients might want to consider a trip to Moffitt for an opinion" has merit. I know that Dr. Hari in Milwaukee has recommended the auto/mini allo to a very young high risk patient.

One thing in the data for both studies is that the patients were quite young, and the matches were exact sibling match, or 6/6(Canada), or 8/8(USA) match donor match. Velcade seems to be a key to reduced GVHD. One thing for sure is that some locations have found the key to success for the mini allo. Gary

4/28/2014 12:59:27 am

I know it has been awhile since Dr. Khan's monoclonal antibody cure talk discussion participation but I recently listened to the program and in the last few minutes thereof, in response to the last listener question posed regarding monoclonal antibody therapy relative to non-secreters, Dr. Khan mentioned a trial and/or antibody that seemed to have particular effectiveness vs "light chains". Do you have any further info and/or can direct me to where I may be able to acquire more info regarding this particular antibody? I'm presently being treated by Dr. Barlogie at UAMS for Lambda Light Chain MM on TT4 "like" protocol. Dx'ed in 3/2011.

Gary Petersen link

4/28/2014 09:43:57 pm

Ed, I listened to the part of the broadcast you mention, and Dr. Chanan-Khan mentioned a new antibody but did not name it. I will forward your email to him and hopefully he will provide you the name. Gary

4/29/2014 12:45:37 am

Gary, thanks for your quick response.

Gary Petersen link

4/29/2014 09:47:46 pm

Dr. Chanan Kahn provided the following reply: "That is a drug from Genentech that is being investigated in phase 1study and too early to make and strong conclusions However, preliminary work so far look promising" I did a little followup research and found the attached clinical trial of a monoclonal antibody called SGN-40 and a link is:http://www.cancer.gov/clinicaltrials/search/view?cdrid=362069&version=HealthProfessional&protocolsearchid=12549660

Gary Petersen link

9/22/2014 12:53:32 am

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Do Multiple Myeloma Survival Rates Finally Approach Cure with Monoclonal Antibodies?? As Discussed by Dr. Asher Chanan-Kahn of Mayo Clinic

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