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and the Common Terminology Criteria for
Adverse Events v4.0 criteria, respectively.
At the end of cycle two, 10 patients had a
partial response (PR), three had very good partial responses (VGPR), one had stable disease
(SD), and one had a molecular response (MR).
After cycle four, eight patients had PR, six had
VGPR, and one had MR.
The authors observed no serious adverse
events, but two patients experienced grade
2 infusion reactions after the first dose of
MEDI-551.
Relative to baseline levels, bone marrow
derived CFU-MM increased by a median of
2.5-fold (range = 0.01-7.4-fold) after cycle
two, then decreased in 14 patients after cycle
four, when MEDI-551 was administered
(median = 4.8-fold; range = 0.14-0.85-fold).
However, in five patients who received standard treatment with Rd, CFU-MM increased
9.3-fold (range = 4-14-fold) at a median of
four months (range = 2-4 months), despite
clinical responses of PR or better in all
patients.
Similarly, following cycle two with Rd,
circulating myeloma CSCs increased by 1.6-fold
(range = 0.4-8.6fold) in 14 patients,
then decreased
0.6-fold (range =
0.01-7.4-fold) in 13
patients after cycle
four.
Ten patients
who completed the
combination therapy
regimen remained
on Rd and, at the end
of cycle seven, eight
—CAROL ANN HUFF, MD
patients achieved
”The frequency of myeloma
CSCs uniformly increased
in patients receiving Rd,
suggesting that CSCs are
enriched by standard therapy.”
New Model Predicts Multiple
Myeloma Survival Rates Will
Significantly Improve in the
Era of Modern Therapy
The unprecedented number of new drug approvals in multiple myeloma
will lead to an increase in the number of patients living longer with
myeloma, according to an analysis by Philip S. Rosenberg, PhD, and
colleagues from the National Cancer Institute in Bethesda, Maryland,
that was presented at the AACR Annual Meeting.
Multiple myeloma is the second most common hematologic malignancy in the United States, representing 1.4 percent of all newly diagnosed cancers and, as the U.S. population continues to age, that number
is expected to increase, the study authors explained. With the introduction of new therapies, including ixazomib, elotuzumab, and daratumumab, Dr. Rosenberg and researchers expect that future numbers of
myeloma survivors will increase, as well.
Using a proportional hazards absolute risk model and age-, period-,
and cohort-forecasting models derived from Surveillance, Epidemiology, and End Results (SEER) Program data between 1992 to 2010,
”Driven by access to modern
therapies with unprecedented
efficacy, overall survival
for patients with myeloma
will continue to improve
significantly [through 2022].”
—PHILIP S. ROSENBERG, PhD
ASHClinicalNews.org
VGPR, one a complete response, and one a PR.
At the end of cycle five (approximately 55 days
after the last dose of MEDI-551), myeloma CSCs
subsequently increased in four of 10 patients; at
the end of cycle seven (approximately 110 days
after the last dose of MEDI-551), eight of 10
patients had increased myeloma CSCs.
Circulating myeloma CSCs increased by
the end of cycle four in two patients, and both
experienced PD by the end of cycle seven.
“The frequency of myeloma CSCs uniformly
increased in patients receiving Rd, suggesting
that CSCs are enriched by standard therapy,” the
authors noted. Following three doses of MEDI551, however, myeloma CSCs decreased in most
patients. “Notably, the two patients with increasing myeloma CSCs after MEDI-551 experienced
PD,” they added, suggesting that myeloma CSCs
rebound following the completion of MEDI-551
treatment and prolonged treatment might be
necessary. Follow-up to assess the long-term
outcomes associated with MEDI-551 is ongoing.
REFERENCE
Huff CA, Gladstone D, Borrello I, et al. Clinical cancer stem cell targeting in
multiple m