Christoph Driessen, MD, PhD1, Rouven Müller, MD2*, Urban Novak, MD3*, Nathan Cantoni, MD4, Daniel Betticher5*, Nicolas Mach6*, Michael Gregor7*, Panagiotis Samaras, MD8*, Catherine Berset9*, Stephanie Rondeau9*, Hanne Hawle, MD9*, Felicitas Hitz, MD10*, Thomas Pabst, MD, PhD11 and Thilo Zander, MD12*

1Department of Oncology and Haematology, Kantonsspital St.Gallen, St.Gallen, Switzerland
2Hematology, University Hospital and University of Zurich, Zurich, Switzerland
3Universitatsspital Bern, Bern, Switzerland
4Division of Haematology, Cantonal Hospital Aarau, Aarau, Switzerland
5Hôpital Fribourgeois, Fribourg, Switzerland
6University Hospital Geneva, Geneva,, Switzerland
7Division of Hematology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
8Universitaetsspital Zurich, Zurich, Switzerland
9SAKK Coordinating Center, Bern, Switzerland
10Kantonsspital St.Gallen, St.Gallen, Switzerland
11Department of Hematology, Bern University Hospital, Bern, Switzerland
12Luzerner Kantonsspital, Luzern, Switzerland

Conclusion: Nelfinavir in combination with bortezomib and dexamethasone (NVd) is a reasonable, active, safe and widely available treatment option for patients with proteasome inhibitor-refractory multiple myeloma. The objective response rate of 65% observed in this very advanced, heavily pretreated, mostly dual-refractory patient population is exceptional. Our results warrant further development of nelfinavir as a sensitizing drug for proteasome inhibitor-based treatments and promising new agent for MM therapy.

Shaji Kumar, MD1, Ravi Vij, MD2, Jonathan L. Kaufman, MD3, Joseph Mikhael, et al.

Conclusions: VEN monotherapy has an acceptable safety profile and clear anti-myeloma activity in pts with R/R MM, primarily with t(11;14) having a high BCL-2, low BCL-XL and low MCL-1 expression levels.

Philippe Moreau, Jonathan L. Kaufman, Heather J. Sutherland, Marc Lalancette, et al. 

Conclusions: Among pts who received 1 to 3 prior lines of therapy, significantly longer PFS and higher ORR were observed with DRd vs Rd among pts who previously received bortezomib or were refractory to bortezomib or were lenalidomide-naive. Higher rates of deeper responses were observed in pts who previously received lenalidomideor bortezomib. Follow-up is ongoing to assess PFS in pts who received 1 to 3 prior lines of therapy and previously received lenalidomide. These results further strengthen the significant benefit of combining daratumumab with Rd for RRMM.

Ashraf Z Badros, Elizabeth Hyjek, Ning Ma, Alexander M. Lesokhin, et al.

CONCLUSION: Pembrolizumab, pomalidomide and dexamethasone shows promising durable therapeutic activity and an acceptable safety profile in RRMM pts.

Dan T. Vogl, David Dingli, R. Frank Cornell, Carol Ann Huff, et al.

Conclusions – Oral Sd is active in heavily pretreated pts with refractory MM, including those with MM refractory to anti-CD38 Ab and those with high-risk cytogenetic abnormalities. Response was associated with longer survival. The main toxicities of Sd are thrombocytopenia, nausea, anorexia, and fatigue. AEs were manageable with supportive care and dose interruptions/reductions. To our knowledge, this is the first report of anti-tumor activity in the penta-refractory MM population. This population of MM pts has exhausted all currently available treatment options and has an extremely poor prognosis and therefore requires new therapies. Expansion of this trial in this high unmet medical need, penta refractory population is planned.

Ajay K Nooka, Nisha Joseph, Larry H Boise, Charise Gleason, et al.

Conclusions: Our analysis shows impressive overall response rates of close to 90% among DARA and POM naïve patients. More importantly, overall response rates of close to 35% were seen with DARA-POM-D regimen among patients that are refractory to both DARA and POM.  While recapturing the responses with combination therapy DARA-POM-D among patients that are refractory to the individual agents (Figure 1) is provocative, a clear biological rationale should be investigated, which potentially can guide us to design more optimal combination salvage strategies.