I’ve been a myeloma caregiver to my husband Michael for longer than half our married lives together. For 17 of our 28 years of marriage, myeloma has been a part of our lives. When I visit with support groups and talk with caregivers, many times I’ll give the analogy of holding a glass of water. It’s really not the weight of it, but the length of time you hold it. Well, in the myeloma world, time is getting much better! With all the options we now have available, better side effect management and quality of life, I’m feeling pretty hopeful for all our futures!
At this year’s ASH, one of the newer and exciting presentations for me was from GlaxoSmithKline (GSK). GSK presented promising new data from their dose expansion phase of their DREAMM-1 study. This is an anti-B-cell maturation antigen (BCMA) drug “conjugate” to treat myeloma. So that’s a lot of words and what do they mean?
Well, my dear friend and myeloma patient, Jim Omel, explained it to me like this:
“mAbs are attracted to a cell surface antigen (such as CD38). They attach to it and thereby draw attention to the cell from monocytes, natural killer cells, and other aggressive T cells. That attention, and the killers who are drawn to the scene, phagocytize the myeloma cell and kill it.”
Jim continued, “Conjugates go one step further. They do all the mAb does, but they also carry and bring along a drug deadly to the myeloma cell too. So, the myeloma cell is tagged for attack by the mAb and also injured by the drug.” Pretty cool, huh? Thanks for that explanation Jim!
Also, if you like cartoons, Cindy Chmielewski found a great one to help understand just what “conjugate” means.
You may now be asking yourself, why all this explanation and excitement? Well, first, this is a monotherapy! One drug to fight myeloma! Second, this study of 35 heavily pre-treated multiple myeloma patients resulted in 60% ORR for RRMM patients! 57% of the patients had at least five prior lines of treatment and 40% having prior daratumumab treatment.
The most commonly reported adverse events were corneal events and thrombocytopenia, with no dose-limiting toxicities reported. Also, infusion related reactions (IRRs) occurred in 23% of patients without premedication on the first infusion, and no infusion-related events occurred on subsequent infusions.
To me, this is very exciting because these patients in DREAM-1 trial had very limited options for further treatment. BTW, I love the name of this trial, it’s like a very good “dream”. (Yes, I’m just too corny!)
Sleep well my friends!