Beyond SC Daratumumab: Emerging Therapeutic Approaches for Smoldering Myeloma

In an interview with Targeted Oncology, Peter Voorhees, MD, Atrium Health Levine Cancer Institute and Wake Forest University School of Medicine, offers his thoughts on the evolving treatment paradigm of smoldering multiple myeloma (SMM) beyond the recent FDA approval of subcutaneous daratumumab (Darzalex Faspro), the first approved treatment in this indication.

Watch part 1, part 2, and part 3 of Dr Voorhees’ interview.

Dr Voorhees views the recent success of daratumumab and the supporting phase 3 AQUILA trial (NCT03301220) as only the “beginning” of an evolution in this historically limited therapeutic landscape. He remarks a general growing interest in the myeloma community in applying “more traditional myeloma therapy” for high-risk SMM patients, as evidenced by an ongoing ECOG investigation exploring 2 different treatment regimens for patients with high-risk SMM: lenalidomide (Revlimid) plus dexamethasone vs daratumumab, lenalidomide, and dexamethasone.

Additionally, beyond adapting existing drug combinations, cutting-edge therapies such as bispecific antibodies and CAR T-cell therapy are entering the SMM space. The exploration of these potent treatments signals a push toward therapeutic interventions on top of active monitoring for progression to active multiple myeloma (MM).

Critically, as the treatment paradigm in SMM shifts and patients increasingly receive treatment for SMM as a result of the daratumumab approval, Dr Voorhees stresses that patients who have already received treatment should not be excluded from participation in subsequent clinical trials if they develop active MM later. Allowing these previously treated patients to enroll in frontline studies for active MM is essential to ensure continued research and optimization of myeloma care pathways.

Read the full interview here.