touchPANEL DISCUSSION

Current management of relapsed/refractory multiple myeloma
and the future integration of BCMA-targeting agents

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About This Activity

Activity Description and Learning Objectives

In this activity, experts in multiple myeloma discuss treatment options for patients with relapsed/refractory disease and consider how B-cell maturation antigen (BCMA)-targeted agents may be incorporated into the treatment pathway in the future.

This activity has been jointly provided by Oakstone and touchONCOLOGY. Oakstone Publishing is accredited by the ACCME to provide continuing medical education to physicians.

After watching this activity, participants should be better able to:

Target Audience

This activity has been designed to meet the educational needs of oncologists and haematologists.

Disclosures

Oakstone Publishing has assessed conflict of interest with its faculty, authors, editors, and any individuals who were in a position to control the content of this CME activity. Any identified relevant conflicts of interest were resolved for fair balance and scientific objectivity of studies utilized in this activity. Oakstone Publishing’s planners, content reviewers, and editorial staff disclose no relevant commercial interests.

Faculty

Dr Popat discloses: Advisory boards for AbbVie, Celgene and GlaxoSmithKline. Travel support from Janssen and Takeda. Honoraria from GlaxoSmithKline, Janssen and Takeda.

Dr Rodríguez-Otero discloses: Consultancy/advisory boards for Abbvie, Celgene, GlaxoSmithKline, Janssen, Kite, Oncopeptides and Sanofi. Speakers bureau participation for Amgen, Celgene and Janssen.

Prof. Weisel has no financial interests/relationships or affiliations in relation to this activity.

Content Reviewer

Walter Murray Yarbrough, MD, FACP, has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Hannah Fisher has no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Oakstone Publishing and touchIME. Oakstone Publishing is accredited by the ACCME to provide continuing medical education for physicians.

Oakstone Publishing designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In order to receive credit for this activity, participants must review and complete the post-test and evaluation form. A score of 70% or higher is needed to obtain CME credit. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

Date of original release: July 9, 2020. Date credits expire: July 9, 2021.

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Q1. Which of the following statements most appropriately describes the selection of a treatment approach for patients with relapsed/refractory multiple myeloma?

  1. A. Patient age alone should be used to assess eligibility for autologous stem cell transplant
  2. B. The next line of treatment should be determined by the time since last relapse/aggressiveness of disease
  3. C. No single factor should be used to select a treatment approach
  4. D. All patients should receive palliative treatment only after three lines of therapy have failed

Please try again

When choosing an appropriate treatment approach, physicians must consider multiple criteria including both patient-related and disease-related factors; patient-specific treatment should aim to gain a clinical benefit while minimizing toxicity.

Reference
Cook G, et al. Crit Rev Onc Hematol. 2018;121:74–89.

Q2. What is the significance of y-secretase in multiple myeloma (MM) with regards to B-cell maturation antigen (BCMA)?

  1. A. y-secretase downregulates BCMA expression and is associated with good prognosis
  2. B. y-secretase cleaves membrane BCMA to shed soluble BCMA units, which correlates with disease progression
  3. C. y-secretase increases the sensitivity of MM cells to BCMA-targeted agents by promoting the expression of membrane BCMA
  4. D. y-secretase reduces the sensitivity of MM cells to BCMA-targeted agents by activating B-cell activation factor receptor (BAFF-R) signalling

Please try again

y-secretase cleaves membrane BCMA to shed soluble BCMA units; soluble BCMA plasma levels are higher in multiple myeloma patients than in healthy individuals, and soluble BCMA correlates with disease progression.

Reference
Cho S-F, et al. Front Immunol. 2018;9:1821.

Q3. Which of these modes of action is not associated with B-cell maturation antigen (BCMA)-targeting agents for relapsed/refractory multiple myeloma?

  1. A. Linked anti-BCMA and CD3 monoclonal antibodies
  2. B. DNA crosslinking to impair DNA repair and synthesis
  3. C. Cytotoxic conjugate linked to an anti-BCMA antibody
  4. D. Modified versions of a patient’s own T-cells

Please try again

Bispecific antibodies, antibody-drug conjugates and chimeric antigen receptor (CAR) T-cell therapies targeting BCMA are all being investigated in relapsed/refractory multiple myeloma. DNA crosslinking is a feature of cytotoxic chemotherapy.

Reference
Cho S-F, et al. Front Immunol. 2018;9:1821.

Q4. Considering the current clinical trial data, which group of patients with relapsed/refractory multiple myeloma could be considered appropriate for B-cell maturation antigen (BCMA)-targeted monotherapy?

  1. A. Patients who have experienced progression with immunomodulatory agents, proteasome inhibitors and an anti-CD38 monoclonal antibody
  2. B. Patients who have experienced progression with either an immunomodulatory agent or a proteasome inhibitor, but not both
  3. C. Patients who are eligible for first-line autologous stem cell transplant
  4. D. Patients who have not received an antibody-based therapy

Please try again

Current clinical trials of monotherapy BCMA-targeted agents in relapsed/refractory multiple myeloma presented at the European Hematology Association 25th Annual Congress (EHA) 2020 relate to patients who have experienced progression with immunomodulatory agents, proteasome inhibitors and anti-CD38 monoclonal antibody.

References

  • Lonial S, et al. EHA25 Virtual 2020 [Poster EP970].
  • Mateos M-V, et al. EHA25 Virtual 2020 [Oral presentation S206].
  • San Miguel J, et al. EHA25 Virtual 2020 [Oral presentation S209].
  • Usmani SZ, et al. EHA25 Virtual 2020 [Poster EP926].
  • Mailankody S, et al. EHA25 Virtual 2020 [Poster EP927].
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touchPANEL DISCUSSION

Current management of relapsed/refractory multiple myeloma and the future integration of BCMA-targeting agents

Introduction

Watch a panel of internationally renowned experts discuss treatment options for patients with relapsed/refractory multiple myeloma, including how B-cell maturation antigen (BCMA)-targeted agents may be integrated into clinical practice.

Dr Rakesh Popat chairs a discussion with Dr Paula Rodríguez-Otero and Prof. Katja Weisel on current approaches to the management of relapsed/refractory multiple myeloma and the rationale and latest data for BCMA-targeted agents in this setting.

This activity is intended for oncologists and haematologists.

This touchPANEL DISCUSSION was recorded in June 2020.

Learning Objectives

After watching this touchPANEL DISCUSSION, you should be able to:

  • Discuss how treatment for patients with relapsed/refractory multiple myeloma can be selected based on disease- and patient-related factors
  • Describe the rationale for B-cell maturation antigen (BCMA) as a treatment target and current agents in development
  • Recall the latest data for BCMA-targeting agents in relapsed/refractory multiple myeloma and consider how they may be incorporated into clinical practice

Clinical Spotlight

  • Disease- and patient-related factors that impact treatment selection in relapsed/refractory multiple myeloma.
  • The rationale for B-cell maturation antigen (BCMA) as a treatment target.
  • The latest data for BCMA-targeting agents and consideration of their incorporation into clinical practice.

Clinical Spotlight

  • Disease- and patient-related factors that impact treatment selection in relapsed/refractory multiple myeloma.
  • The rationale for B-cell maturation antigen (BCMA) as a treatment target.
  • The latest data for BCMA-targeting agents and consideration of their incorporation into clinical practice.

The Expert Panel

DR RAKESH
POPAT

DR PAULA RODRÍGUEZ-OTERO

PROF. KATJA
WEISEL

DR RAKESH POPAT

Rakesh Popat is a consultant haematologist and Associate Professor with a specialist interest in multiple myeloma based at University College Hospital, London, UK. He leads the Myeloma Clinical Trials Program and is the Cancer Program Lead for the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Clinical Research Facility.

Dr Popat is particularly involved in novel treatments and runs clinical trials including immunotherapies such as chimeric antigen receptor T-cell therapy and new antibody approaches.

Dr Popat is the Vice-Chair of the UK Myeloma Research Alliance and is on the leadership boards of the UK Myeloma Forum and the European Myeloma Network junior board. In addition, he is the Haematology Lead for the North Thames Clinical Research Network. He previously completed a PhD in novel treatments for myeloma and was awarded a fellowship to attend the Dana Farber Cancer Institute, Boston, MA, USA, as part of this.

Disclosures: Advisory boards for AbbVie, Celgene and GlaxoSmithKline. Travel support from Janssen and Takeda. Honoraria from GlaxoSmithKline, Janssen and Takeda.

DR PAULA RODRÍGUEZ-OTERO

Paula Rodríguez-Otero studied medicine at the University of Navarra, Pamplona, Spain. She subsequently completed her residency training program in haematology at the Clínica Universidad de Navarra and then became a member of the faculty.

After completing her PhD, she focused her clinical interests on the management and biology of allogeneic stem cell transplant, which brought her to undertake a clinical fellowship in the bone marrow transplant division at the Hôpital Saint-Louis, Paris, France. In 2011, she returned to the Department of Hematology at the University of Navarra, where she has since become a member of the Myeloma Unit and leads the clinical trials and immunotherapy programme under the direction of Professor Jesús San-Miguel.

Disclosures: Consultancy/advisory boards for Abbvie, Celgene, GlaxoSmithKline, Janssen, Kite, Oncopeptides and Sanofi. Speakers bureau participation for Amgen, Celgene and Janssen.

PROF. KATJA WEISEL

Katja Weisel received her medical degree from the Medical School of the University of Ulm, Germany, and did her clinical residency in internal medicine at the University of Tübingen. She did a postdoctoral research fellowship in the laboratory of Developmental Hematopoiesis at the Memorial Sloan-Kettering Cancer Center in New York, NY, USA. She completed her medical fellowship in internal medicine and haematology and oncology at the University of Tübingen. From 2006, Prof. Weisel led the Tübingen myeloma programme before moving in 2019 to Hamburg, where she serves as the Deputy Director and Associate Professor of Haematology/Oncology at the University Medical Center Hamburg-Eppendorf, the Co-Director of the University Cancer Centre Hamburg and is leading the myeloma and lymphoma programme. Her myeloma research interests focus on treatment optimization for high-risk myeloma, renally impaired patients with myeloma, patients with refractory myeloma and radiographic methods for disease monitoring of myeloma.

Prof. Weisel is a member of the German Speaking Myeloma Multicentre Group (GMMG) steering committee. She is co-investigator in all GMMG trials and is the lead investigator of three GMMG trials, including the GMMG-CONCEPT trial. Furthermore, she was the principle investigator in several national and international phase I–III trials. Prof. Weisel has contributed to more than 100 publications on multiple myeloma treatment and biology.

Disclosures: No financial interests/relationships or affiliations in relation to this activity.

About This Activity

Activity Description and Learning Objectives

In this activity, experts in multiple myeloma discuss treatment options for patients with relapsed/refractory disease and consider how B-cell maturation antigen (BCMA)-targeted agents may be incorporated into the treatment pathway in the future.

This activity has been jointly provided by Oakstone and touchONCOLOGY. Oakstone Publishing is accredited by the ACCME to provide continuing medical education to physicians.

After watching this activity, participants should be better able to:

  • Discuss how treatment for patients with relapsed/refractory multiple myeloma can be selected based on disease- and patient-related factors
  • Describe the rationale for BCMA as a treatment target and current agents in development
  • Recall the latest data for BCMA-targeting agents in relapsed/refractory multiple myeloma and consider how they may be incorporated into clinical practice

Target Audience

This activity has been designed to meet the educational needs of oncologists and haematologists.

Disclosures

Oakstone Publishing has assessed conflict of interest with its faculty, authors, editors, and any individuals who were in a position to control the content of this CME activity. Any identified relevant conflicts of interest were resolved for fair balance and scientific objectivity of studies utilized in this activity. Oakstone Publishing’s planners, content reviewers, and editorial staff disclose no relevant commercial interests.

Faculty

Dr Popat discloses: Advisory boards for AbbVie, Celgene and GlaxoSmithKline. Travel support from Janssen and Takeda. Honoraria from GlaxoSmithKline, Janssen and Takeda.

Dr Rodríguez-Otero discloses: Consultancy/advisory boards for Abbvie, Celgene, GlaxoSmithKline, Janssen, Kite, Oncopeptides and Sanofi. Speakers bureau participation for Amgen, Celgene and Janssen.

Prof. Weisel has no financial interests/relationships or affiliations in relation to this activity.

Content Reviewer

Walter Murray Yarbrough, MD, FACP, has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Hannah Fisher has no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Oakstone Publishing and touchIME. Oakstone Publishing is accredited by the ACCME to provide continuing medical education for physicians.

Oakstone Publishing designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In order to receive credit for this activity, participants must review and complete the post-test and evaluation form. A score of 70% or higher is needed to obtain CME credit. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

Date of original release: July 9, 2020. Date credits expire: July 9, 2021.