ASH Clinical News March 2016 | Page 39

FEATURE Where does your health stand today? I was diagnosed in 2005, more than a decade ago, but have had two relapses since then. Five years after I was initially diagnosed, I had my first relapse. I was treated again with aggressive chemotherapy and went on to have a bone marrow transplant, with my younger brother as the donor. Despite that aggressive treatment approach, I did extremely well and recovered uneventfully with no significant complications. I completed my clinical portion of my fellowship and joined the lab of Timothy J. Ley, MD, to start my post-doctoral research. Three years after that, I relapsed again. I tried aggressive chemotherapy again, but it didn’t put me into remission. But, because I had the good fortune of being at Washington University and working on the genomics of leukemia, Dr. Ley and others decided to sequence my genome. Based on those sequencing results, they were able to identify a drug, sunitinib, which wouldn’t have ordinarily been used to treat my disease, but which put me into remission. I was able to get a second stem cell transplant from an unrelated donor in October 2011 and have remained in remission since. CMYK EN I haven’t been able to continue to take sunitinib due to the side effects, and only took it for a very short time after the transplant. The biggest issue is that my transplant has been complicated by moderate to severe graft-versus-host disease. What did sunitinib target? When Dr. Ley and the genomic analysts looked at the whole-genome sequencing data, there were multiple alterations that were recognized as being relevant to leukemogenesis – none of which were targetable. DE When multiple myeloma relapses AV NEW OR † ST U RESPOND with the superior power of the KYPROLIS doublet (Kd) 1 * plus dexamethasone (Kd) provided double the median PFS vs bortezomib plus dexamethasone ( Vd) in patients with relapsed multiple myeloma.1 * KYPROLIS NEW HEAD-TO-HEAD DATA VS BORTEZOMIB DOUBLET (Vd) SHOWED Median PFS1 2x INCREASED Complete response or better (≥ CR)1 • 18.7 months for Kd vs 9.4 months for Vd, one-sided P < 0.00011 • 13% for Kd vs 6% for Vd1 See more results at Kyprolis-HCP.com ENDEAVOR†: A phase 3, randomized, open-label, multicenter superiority study compared KYPROLIS plus dexamethasone (Kd) to bortezomib plus dexamethasone (Vd) in subjects with relapsed or refractory multiple myeloma. 929 patients were randomized in a 1:1 ratio to receive Kd (n = 464) for 28-day cycles or Vd (n = 465) for 21-day cycles until disease progression or unacceptable toxicity occurred. Patient stratification included prior proteasome inhibitor therapy (either bortezomib or carfilzomib, or no prior therapy), prior lines of therapy (1 versus 2 or 3), current International Staging System stage (1 versus 2 or 3), and planned route of bortezomib administration (intravenous versus subcutaneous). The primary endpoint was progression-free survival (PFS); select secondary endpoints included overall survival, overall response rate, duration of response, safety.1,2 † ENDEAVOR = RandomizEd, OpeN label, Phase 3 Study of Carfilzomib Plus DExamethAsone Vs Bortezomib Plus DexamethasOne in Patients With Relapsed Multiple Myeloma. References: 1. KYPROLIS ENDEAVOR [prescribing information]. Thousand Oaks, CA: Onyx Pharmaceuticals, Inc., an Amgen Inc. subsidiary; 2016. 2. Dimopoulos MA, et al. Lancet Oncol. 2015. Published online December 5, 2015. Accessed December 9, 2015. http://dx.doi.org/10.1016/S1470-2045(15)00464-7. DY