Please note, these are the actual video-recorded proceedings from the live CME event and may include the use of trade names and other raw, unedited content.

Second Opinion: New Agents and Emerging Trial Data in the Management of Multiple Myeloma
Noopur Raje, MD Director, Center for Multiple Myeloma Massachusetts General Hospital Cancer Center Associate Professor of Medicine Harvard Medical School Boston, Massachusetts

Disclosures Advisory Committee Amgen Inc, Bristol-Myers Squibb Company, Celgene Corporation, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Takeda Oncology Consulting Agreements Amgen Inc, Bristol-Myers Squibb Company, Celgene Corporation, Novartis Pharmaceuticals Corporation, Takeda Oncology Contracted Research AstraZeneca Pharmaceuticals LP, Lilly

Grand Rounds Program Steering Committee
Morie A Gertz, MD, MACP Roland Seidler Jr Professor of the Art of Medicine Chair, Department of Medicine Mayo Distinguished Physician Mayo Clinic Rochester Rochester, Minnesota Joseph Mikhael, MD, MEd Professor of Medicine Mayo College of Medicine Associate Dean, Mayo School of Graduate Medical Education Deputy Director – Education Mayo Clinic Cancer Center Mayo Clinic in Arizona Phoenix, Arizona Jonathan L Kaufman, MD Associate Professor of Hematology and Medical Oncology Winship Cancer Institute of Emory University Atlanta, Georgia Nikhil C Munshi, MD Professor of Medicine Harvard Medical School Director of Basic and Correlative Science Associate Director, Jerome Lipper Multiple Myeloma Center Department of Medical Oncology Dana-Farber Cancer Institute Boston, Massachusetts

Grand Rounds Program Steering Committee
Noopur Raje, MD Director, Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center Associate Professor of Medicine Harvard Medical School Boston, Massachusetts Jeffrey A Zonder, MD Professor of Oncology Karmanos Cancer Institute Wayne State University Detroit, Michigan Jeffrey L Wolf, MD Professor of Medicine Director, Myeloma Program Division of Hematology/Oncology Blood and Marrow Transplantation University of California, San Francisco San Francisco, California Project Chair Neil Love, MD Research To Practice Miami, Florida

New Agents and Emerging Trial Data in the Management of Multiple Myeloma
Module 1: Induction and Maintenance Therapy for Newly Diagnosed MM Module 2: Management of Relapsed/Refractory Disease Module 3: Integrating Newly Approved Agents into Clinical Practice Ixazomib (Tourmaline-MM1) Daratumumab (GEN501, Sirius) Elotuzumab (ELOQUENT-2) Panobinostat (PANORAMA1) Module 4: Investigational Immunotherapy Strategies

Recommend but willing to delay Recommend but willing to delay
An otherwise healthy 60-year-old patient presents with ISS Stage II multiple myeloma (MM). Cytogenetics and FISH reveal no high-risk features. In general, which induction treatment would you most likely recommend? What are your thoughts about autologous stem cell transplant (ASCT)? INDUCTION ASCT RVd Recommend RVd Recommend RVd Recommend but willing to delay RVd Recommend RVd Recommend RVd Recommend RVd Recommend but willing to delay R = lenalidomide; V = bortezomib; d = dexamethasone

Treatment Sequence in Myeloma
Bortezomib Lenalidomide Thalidomide Carfilzomib Pomalidomide Panobinostat Daratumumab Ixazomib Elotuzumab VD Rev/Dex CyBorD VTD VRD SCT Nothing Thalidomide? Bortezomib Lenalidomide Now Relapsed disease Front-line treatment Maintenance Induction Consolidation Post- consolidation Rescue New Carfilzomib combos “More induction” Lenalidomide 2 months ? Ixazomib Oprozomib Isatuximab Bendamustine PD/PD-L1 inhibition 8 8

Autologous Transplantation for Multiple Myeloma in the Era of New Drugs: A Phase III Study of the Intergroupe Francophone Du Myelome (IFM/DFCI 2009 Trial) Attal M et al. Proc ASH 2015;Abstract 391.

IFM/DFCI 2009: A Phase III Study of RVD ± ASCT in Newly Diagnosed Multiple Myeloma (NDMM)
RVD cycles 2, 3 PBSC collection Cyclophosphamide + G-CSF RVD cycles 4-8 Eligibility (N = 700) ≤65 years old Symptomatic NDMM Treated with 1 cycle of RVD 1:1 Lenalidomide maintenance 10-15 mg/d x 12 mo R RVD cycles 2,3 PBSC collection Cyclophosphamide + G-CSF ASCT with MEL200 RVD cycles 4, 5 Primary endpoint: Progression-free survival Attal M et al. Proc ASH 2015;Abstract 391.

IFM/DFCI 2009: Response and Survival Analyses
RVD  ASCT (n = 350) RVD 3-year PFS* 61% 48% HR = 1.5, p < Complete response (CR) 58% 46% p < 0.001 * Benefit observed was uniform across all the following subgroups: Age (≤ or >60 years) Sex Ig isotype (IgG or others) ISS stage (I or II or III) Cytogenetics (standard or high risk) Response after the first 3 cycles of RVD (CR or not) The ongoing Phase III DETERMINATION trial (DFCI ) is the parallel US trial and will continue maintenance lenalidomide until disease progression. Attal M et al. Proc ASH 2015;Abstract 391.

Getting to Minimal Residual Disease (MRD)
Newly diagnosed 1×1012 S.S. Patient Disease burden CR 1×108 Stringent CR 1×104 Molecular/Flow CR ?Cure? 0.0

Predictive Value of MRD by Next-Generation Sequencing (NGS) in the IFM/DFCI 2009 Trial
Bone marrow MRD evaluation before and after maintenance therapy in patients with very good partial response (VGPR) or better MRD assessment by flow cytometry (FCM) and NGS Prediction of PFS by MRD status as determined by NGS Comparison of MRD sensitivity of NGS and FCM Sensitivity: FCM = 10-4; NGS = 10-6 Of 163 patients MRD-negative by FCM, 84 (51%) were positive by NGS Three-year PFS for patients achieving complete response p-value MRD-negative by NGS (<10-6) MRD-positive by NGS (≥10-6) Before maintenance 87% 63% 0.0075 After maintenance 92% 64% <0.0001 Avet-Loiseau H et al. Proc ASH 2015;Abstract 191.

Bortezomib, Lenalidomide and Dexamethasone vs Lenalidomide and Dexamethasone in Patients with Previously Untreated Multiple Myeloma without an Intent for Immediate Autologous Stem Cell Transplant: Results of the Randomized Phase III Trial SWOG S0777 Durie B et al. Proc ASH 2015;Abstract 25.

SWOG S0777: A Phase III Trial of RVd versus Rd in NDMM
8 cycles of 21 days each Eligibility (N = 525) Previously untreated NDMM Immediate ASCT not intended R Rd maintenance until toxicity or withdrawal Rd 6 cycles of 28 days each Primary endpoint: Progression-free survival Durie B et al. Proc ASH 2015;Abstract 25.

Months from Registration Months from Registration
Survival Analyses PFS OS 100% 100% 80% 80% 60% 60% RVd 40% 40% Rd RVd 20% 20% HR = (0.560, 0.906)* Rd HR = (0.516, 0.973)* Log-rank P value = (one sided)* Log-rank P value = (two sided)* 0% 0% 24 48 72 96 24 48 72 96 Months from Registration Months from Registration * Stratified RVd (n = 242) Rd (n = 229) HR One-sided p-value Median PFS 43 mo 30 mo 0.712 0.0018 RVd (n = 242) Rd (n = 229) HR Two-sided p-value Median OS 75 mo 64 mo 0.709 0.025 Durie B et al. Proc ASH 2015;Abstract 25.

Maintenance lenalidomide Maintenance lenalidomide
ECOG/ACRIN E1A11 (ENDURANCE): A Phase III Trial of Bortezomib or Carfilzomib with Lenalidomide/Dexamethasone in NDMM Trial Identifier: NCT Estimated Enrollment: 756 (Open) Maintenance lenalidomide x 2 years RVd R R Eligibility Newly diagnosed, symptomatic standard-risk MM KRd Maintenance lenalidomide X until PD Primary endpoint: Overall survival for the maintenance analysis Accessed March 2016.

Bortezomib ± lenalidomide
A 60-year-old patient with ISS Stage II MM receives RVd induction and ASCT. What would be your choice of post-transplant maintenance therapy? No high-risk features, CR after induction/ASCT Del(17p), VGPR after induction/ASCT Lenalidomide Modified RVd Lenalidomide Weekly RVd Lenalidomide Bortezomib ± lenalidomide Lenalidomide Lenalidomide Lenalidomide RVd Lenalidomide R = lenalidomide; V = bortezomib; d = dexamethasone

You recommend bortezomib/lenalidomide maintenance for the 60-year-old patient with ISS Stage II, high-risk (del 17p) MM in the previous scenario. However, the patient has a very busy schedule and would like to minimize visits and asks about using ixazomib. Cost and reimbursement issues aside, would you use ixazomib as post-transplant maintenance therapy in this patient? Yes Yes Yes, hesitantly Yes Yes Yes Yes

What is your usual induction regimen for a frail but otherwise healthy 75-year-old, transplant-ineligible patient with ISS Stage II MM and no high-risk features? What if the patient were an 85-year-old? 75-YEAR OLD 85-YEAR OLD Rd Rd Rd Rd Rd or RVd-lite Rd RVd-lite Rd RVd-lite RVd-lite Rd Rd Rd or RVd-lite Rd or Vd R = lenalidomide; V = bortezomib; d = dexamethasone

TOURMALINE-MM2: A Phase III Trial of Ixazomib with Lenalidomide/Dexamethasone in NDMM
Trial Identifier: NCT Enrollment: 701 (Closed) Ixazomib + lenalidomide/dexamethasone Eligibility Newly diagnosed MM Not eligible for stem cell transplant due to: Age ≥ 65 years Age < 65 years but with significant comorbidities R Placebo + lenalidomide/dexamethasone Primary endpoint: Progression-free survival Accessed March 2016.

Treatment Sequence in Myeloma
Bortezomib Lenalidomide Thalidomide Carfilzomib Pomalidomide Panobinostat Daratumumab Ixazomib Elotuzumab VD Rev/Dex CyBorD VTD VRD SCT Nothing Thalidomide? Bortezomib Lenalidomide Now Relapsed disease Front-line treatment Maintenance Induction Consolidation Post- consolidation Rescue New Carfilzomib combos “More induction” Lenalidomide 2 months ? Ixazomib Oprozomib Isatuximab Bendamustine PD/PD-L1 inhibition 23 23

A 70-year-old patient who initially received RVD followed by ASCT experiences limited, asymptomatic relapse 18 months after transplant while receiving lenalidomide maintenance at 10 mg daily. Which systemic treatment would you most likely recommend? Pomalidomide Ixazomib-Rd or Elotuzumab-Rd Carfilzomib-dex + Cyclophosphamide or Pomalidomide Increase lenalidomide to standard dose and add dex Pomalidomide-dex or Ixazomib-Rd Increase lenalidomide dose and add dex or Vd Elotuzumab-Rd R = lenalidomide; V = bortezomib; d = dexamethasone

What would be your treatment recommendation for a 70-year-old patient with MM who received RVd followed by transplant and experiences extensive, symptomatic relapse 18 months after transplant and while receiving maintenance? Bortezomib-cyclophosphamide-dex Carfilzomib-Rd or Pomalidomide-dex + Carfilzomib or Bortezomib or Daratumumab Carfilzomib-pomalidomide-dex Bortezomib-cyclophosphamide-dex Bortezomib-pomalidomide-dex or Carfilzomib-pomalidomide-dex Carfilzomib-cyclophosphamide-dex Ixazomib-Rd or Carfilzomib-Rd R = lenalidomide; V = bortezomib; d = dexamethasone

Survival Analyses PFS OS NE = not estimable
Carfilzomib (n = 396) Len/dex (n = 396) Median PFS 26.3 mo 17.6 mo HR (p-value) 0.69 (0.0001) OS Carfilzomib (n = 396) Len/dex (n = 396) Median OS NE HR (p-value) 0.79 (0.04) NE = not estimable Stewart AK et al. N Engl J Med 2015;372(2):

Cardiovascular Effect of Carfilzomib (N = 62)
Pretreatment elevations in NT-proBNP and blood pressure and abnormal cardiac strain were common A rise in NT-proBNP occurred frequently after carfilzomib treatment, but development of cardiopulmonary symptoms was not common Ideal strategy for identifying patients at risk for cardiac events and parameters for monitoring early toxicity remain to be established Rosenthal A et al. Blood Cancer J ;e364.

Weekly Carfilzomib with Dexamethasone for Patients with Relapsed or Refractory Multiple Myeloma: Updated Results from the Phase 1/2 Study Champion-1 (NCT ) Berenson J et al. Proc ASH 2015;Abstract 373.

ORR by Prior Treatment, % Objective Response (%)
CHAMPION-1: Efficacy Carfilzomib 70 mg/m2 (N = 104) Median PFS 14.3 mo ORR by Prior Treatment, % 100 77% 80 74 75 sCR: 5% 69 71 63 CR: 13% 60 55 Objective Response (%) Pts Achieving VGPR: 30% 40 20 PR: 30% Overall (N = 104) BTZ Exposed (n = 87) BTZ Refractory (n = 54) LEN Exposed (n = 56) LEN Refractory (n = 35) BTZ/LEN Exposed (n = 45) BTZ/LEN Refractory (n = 20) Berenson J et al. Proc ASH 2015;Abstract 373.

Weekly Carfilzomib + Dexamethasone: Grade ≥3 AEs
Fatigue 11% Hypertension 8% Pneumonia 7% Acute kidney injury Thrombocytopenia Anemia Dose reduction due to AE 17% Discontinuation due to AE 13% Grade ≥3 cardiac failure (2%) and peripheral neuropathy (1%) Berenson J et al. Proc ASH 2015;Abstract 373.

FDA Approval of Ixazomib November 20, 2015
Today the US Food and Drug Administration granted approval for ixazomib in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy. Dosage and Administration Recommended starting dose of 4 mg taken orally on days 1, 8, 15 of a 28-day cycle (at least 1 h before or at least 2 h after food) Warnings and Precautions Thrombocytopenia GI toxicities (severe diarrhea, constipation, nausea, vomiting) Peripheral neuropathy

The indication for ixazomib is in combination with lenalidomide/dexamethasone. Are there any other agents that you would combine with ixazomib? Cyclophosphamide or pomalidomide Pomalidomide-dex or pomalidomide-cyclophosphamide-dex or dex Pomalidomide Pomalidomide-dex or cyclophosphamide-dex or bendamustine-dex Pomalidomide-dex Pomalidomide-dex Almost anything if covered

Ixazomib, an Investigational Oral Proteasome Inhibitor, in Combination with Lenalidomide and Dexamethasone, Significantly Extends Progression-Free Survival for Patients with Relapsed and/or Refractory Multiple Myeloma: The Phase 3 Tourmaline-MM1 Study (NCT ) Moreau P et al. Proc ASH 2015;Abstract 727.

Tourmaline-MM1: Survival and Response of Ixazomib, Lenalidomide and Dex (IRd)
Endpoint IRd Rd Hazard/ odds ratio p-value Median PFS (n = 360, 362) 20.6 mo 14.7 mo 0.742 0.012 Median PFS – del(17p) (n = 75, 62) 21.4 mo 9.7 mo 0.596 NR Confirmed ORR (n = 360, 362) 78.3% 71.5% 1.44 0.035 CR 11.7% 6.6% 1.87 0.019 PR 66.7% 64.9% VGPR 36.4% 32.3% NR = not reported OS data not yet mature Moreau P et al. Proc ASH 2015;Abstract 727.

Tourmaline-MM1: Select Adverse Events
IRd (n = 361) Rd (n = 359) Any serious AE 47% 49% Discontinued due to AEs 17% 14% Gr ≥3 neutropenia 23% 24% Gr ≥3 thrombocytopenia 19% 9% Gr ≥3 upper respiratory tract infection <1% PN (any grade/Gr 3) 27% / 2% 22% / 2% Rash (any grade/Gr 3) 36% / 5% 23% / 2% GI events (any grade/Gr3) Diarrhea 45% / 6% 39% / 3% Nausea 29% / 2% 22% / 0 Vomiting 23% / 1% 12% / <1% Moreau P et al. Proc ASH 2015;Abstract 727.

What would be your choice of treatment for a 60-year-old patient who received RVD followed by ASCT, experienced disease progression after 9 months of lenalidomide maintenance, received carfilzomib/pomalidomide/dexamethasone and then experienced disease progression after 7 months? Daratumumab Daratumumab ± IMiD Daratumumab Daratumumab-Rd Daratumumab-Rd Daratumumab Daratumumab R = lenalidomide; V = bortezomib; D = dexamethasone

FDA Approval of Daratumumab November 16, 2015
Today the US Food and Drug Administration granted accelerated approval for daratumumab to treat patients with multiple myeloma who have received at least three prior treatments, including a proteasome inhibitor (PI) and an IMiD or who are double-refractory to a PI and IMiD. Dosage and Administration Pre-medicate with corticosteroids, antipyretics and antihistamines Recommended dose is 16 mg/kg body weight Warnings and Precautions Infusion reactions Interference with cross-matching and red blood cell antibody screening

Daratumumab Mechanism of Action
ADCP ADCC Apoptosis CD 38 CDC DARATUMUMAB Adapted from Lonial S et al. Proc ASCO 2015;Abstract LBA8512.

Percent Change from Baseline (%)
Daratumumab Monotherapy (Median 4 Prior Treatments) Relative Change from Baseline in Paraprotein Level 8 mg/kg 16 mg/kg ORR (n = 30) = 10% ORR (n = 42) = 36% Percent Change from Baseline (%) Patients Infusion-related reaction (IRR) in part 2 of the study: 71% (Gr 1-2), 1 pt Gr 3 No patient discontinued due to IRR Majority of IRRs occurred during the first infusion Lokhorst HM et al. N Engl J Med 2015;373(13):

Swim-Lane Plot of Data from Patients with a Response
Lokhorst HM et al. N Engl J Med 2015;373(13):

Early Studies of Daratumumab Combination Therapy in Relapsed/Refractory MM (R/R MM)
GEN503 – Part 2 of Phase I/II study of daratumumab combined with len/dex for patients sensitive to len and who received ≥1 line of therapy1 MMY1001 – Phase Ib study of daratumumab combined with pom/dex for patients who received ≥2 lines of therapy2 Clinical parameter GEN503 (n = 32) MMY1001 (n = 75) ORR ≥VGPR 26 (81%) 20 (63%) 53 (71%) 32 (43%) 6-month PFS rate NR 66% 18-month PFS rate 72% NR = not reported No additional safety signals were observed in either combination study 1 Plesner T et al. Proc ASH 2015;Abstract 507. 2 Chari A et al. Proc ASH 2015;Abstract 508.

D: 16 mg/kg IV weekly, cycles 1-3; q3wk cycles 4-8 and q4wk thereafter
CASTOR (MMY3004): A Phase III Trial of Daratumumab-Vd versus Vd in R/R MM Daratumumab-Vd (DVd) D: 16 mg/kg IV weekly, cycles 1-3; q3wk cycles 4-8 and q4wk thereafter V: 1.3 mg/m2 SC d1, 4, 8, 11 x 8 cycles d: 20 mg d1, 2, 4, 5, 8, 9, 11, 12 x 8 cycles Trial Identifier: NCT Eligibility ≥1 prior therapy for MM R 1:1 Vd V: 1.3 mg/m2 SC d1, 4, 8, 11 x 8 cycles d: 20 mg d1, 2, 4, 5, 8, 9, 11, 12 x 8 cycles Palumbo A et al. Proc ASCO 2016;Abstract LBA4.

CASTOR Primary Endpoint: Progression-Free Survival
1.0 1-year PFS Median: not reached 0.8 0.6 60.7% DVd Proportion surviving without progression 0.4 26.9% Median: 7.2 months 0.2 Vd HR: 0.39 (95% CI, ); p < 3 6 9 12 15 Months 61% reduction in the risk of disease progression or death for DVd versus Vd Palumbo A et al. Proc ASCO 2016;Abstract LBA4.

Percent of patients progression-free and alive
POLLUX: A Phase III Study of Daratumumab, Lenalidomide and Dexamethasone versus RD in Relapsed/Refractory MM — Reduction in Risk of Disease Progression or Death DRd 100 Rd 80 DRd: Estimated median (95% CI) PFS: NE (NE-NE) 60 Percent of patients progression-free and alive 40 Rd: Estimated median (95% CI) PFS: 18.4 months (13.9-NE) 20 N = 569 HR: 0.37, p < 3 6 9 12 15 18 21 Months Dimopoulos MA et al. Proc EHA 2016;Abstract LB2238.

Comments on Daratumumab Infusion Reactions (IRs)
“IRs are common, easily managed with dose holding, premedication, slow restart. Very common for 1st dose to take full day; subsequent doses in one-half day.” – Jonathan L Kaufman “IRs occur in 60% of patients and delays infusion in most. We plan for a 9-hour first infusion, which improves with subsequent infusions.” – Joseph Mikhael “More IRs than I expected, but manageable. Infusion time longer, particularly initially.” – Jeffrey A Zonder

FDA Approval of Elotuzumab November 30, 2015
Today the US Food and Drug Administration granted approval for elotuzumab in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received one to three prior therapies. Dosage and Administration Premedicate with dexamethasone, diphenhydramine, ranitidine and acetaminophen 10 mg/kg IV every week for the first 2 cycles and every 2 weeks thereafter until PD or unacceptable toxicity Warnings and Precautions Infusion reactions Infections Second primary malignancies Hepatotoxicity

Elotuzumab Mechanism of Action

Dimopoulos MA et al. Proc ASH 2015;Abstract 28.

ELOQUENT-2: Progression-Free Survival
Outcome ELO + len/dex (n = 321) Len/dex (n = 325) HR Median PFS 19.4 mo 14.9 mo 0.70 1-yr PFS 68% 57% — 2-yrs PFS 41% 27% 3-yrs PFS 26% 18% Median PFS: 19.4 vs 14.9 mo ORR: 79% vs 66%, P < 0.001 Lonial S et al. N Engl J Med 2015;373(7): Dimopoulos MA et al. Proc ASH 2015;Abstract 28.

ELOQUENT-2: Elotuzumab-Associated Infusion Reactions
Infusion reactions, including pyrexia, chills and hypertension occurred in 10% of patients receiving elotuzumab No patient had Grade 4-5 infusion reactions 70% of infusion reactions occurred with the first dose Infusion reactions resolved in 31/33 patients Lonial S et al. N Engl J Med 2015;373(7):

FDA Approval of Panobinostat February 23, 2015
The US Food and Drug Administration today approved panobinostat in combination with bortezomib and dexamethasone for patients with multiple myeloma who have received at least two prior standard therapies, including bortezomib, an immunomodulatory agent. Dosage and Administration 20 mg, taken orally once every other day for 3 doses per week (d1, 3, 5, 8, 10 and 12) of weeks 1 and 2 of each 21-day cycle for 8 cycles Consider continuing for an additional 8 cycles for patients with clinical benefit Warnings Severe diarrhea Severe and fatal cardiac ischemic events, arrhythmias and ECG changes GI and pulmonary hemorrhage Embryo-fetal toxicity Hepatotoxicity

In which scenario would you be likely to use panobinostat?
Progression on lenalidomide maintenance after RVd induction and transplant Refractory MM progressing on proteasome inhibitor Rarely — late stage if bortezomib sensitive After disease progression on lenalidomide, bortezomib, pomalidomide, carfilzomib and daratumumab Progression on lenalidomide maintenance and another line of treatment 5th line with carfilzomib Heavily treated who can tolerate bortezomib or carfilzomib

Lancet Oncol 2014;15(11):

PANORAMA1: Survival Analyses
BTZ/dex + panobinostat (n = 387) BTZ/dex + placebo (n = 381) PFS 11.99 mo 8.08 mo HR = 0.63, p < OS 33.64 mo 30.39 mo HR = 0.87, p = 0.26 San-Miguel JF et al. Lancet Oncol 2014;15(11):

Select Adverse Events (Gr 3-4)
PAN + BTZ/dex (n = 381) Placebo + BTZ/dex (n = 377) Serious AEs 60% 42% Thrombocytopenia 67% 31% Lymphopenia 53% 40% Diarrhea 26% 8% Nausea 5.5% <1% Vomiting 7% 1% Fatigue/asthenia 24% 12% Peripheral neuropathy 18% 15% San-Miguel JF et al. Lancet Oncol 2014;15(11):

All response-evaluable pts Pts with lenalidomide-refractory MM
KEYNOTE-023: A Phase I Study of Pembrolizumab with Lenalidomide/Low-Dose Dex in R/R MM Clinical variable All response-evaluable pts (n = 17) Pts with lenalidomide-refractory MM (n = 9) ORR VGPR PR 13 (76%) 4 (24%) 9 (53%) 5 (56%) 2 (22%) 3 (33%) Disease control rate 15 (88%) 7 (78%) Median time to first response 1.2 mo — No deaths or treatment-discontinuations due to toxicity occurred Few low-grade immune-related adverse events were observed (no infusion-related reactions) KEYNOTE-185: A phase III study of lenalidomide and low-dose dexamethasone with or without pembrolizumab in NDMM is ongoing San Miguel J et al. Proc ASH 2015;Abstract 505.

Have you attempted or would you attempt to access a PD-1 antibody for a patient with MM?
Yes, after 3 prior lines of therapy Not yet Yes, in clinical trial only Yes, in relapsed quadruple-refractory patients Yes, with lenalidomide or pomalidomide for relapsed disease Yes, 5th line for relapsed disease Yes, in clinical trial only

Please note, these are the actual video-recorded proceedings from the live CME event and may include the use of trade names and other raw, unedited content.

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Please note, these are the actual video-recorded proceedings from the live CME event and may include the use of trade names and other raw, unedited content.

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