According to the American Cancer Society,
about 12,640 deaths from multiple myeloma are expected to occur in the U.S. in
2022. The cancer is uncommon, affecting less than 1 percent of the population.
Myeloma is currently not curable, and despite advances in treatment, all
patients see their cancers relapse after initial treatment and other early
lines of therapy.
A first-of-its-kind drug known as modakafusp
alfa has shown early potential in combating multiple myeloma, in a study
presented by researchers from the University of Pennsylvania’s Abramson Cancer
Center at the 2022 American Society of Hematology (ASH) Annual Meeting
(Abstract 565).
Patients in the Phase I/II multicenter trial
(NCT03215030) receiving 1.5 milligrams of modakafusp every four weeks, 43
percent saw a partial response, or a decrease in their cancer by over 50
percent. Patients enrolled in the study had received at least three prior lines
of treatment and had their disease relapsed or stopped responding following the
previous therapy.
“We are excited by these findings and continue
to be optimistic about the potential this treatment holds for patients with
multiple myeloma,” said presenting author Dan Vogl, MD, an expert in blood
cancers, medical director of the Clinical Research Unit at Penn Medicine’s
Abramson Cancer Center, and an associate professor of Hematology-Oncology at
the Perelman School of Medicine of the University of Pennsylvania. “We have
been working with this new medication at Penn since we gave it to the first
patient ever to receive it five years ago. We now see that a substantial number
of patients benefit from modakafusp as a single agent, including patients whose
myeloma has become resistant to other treatments, which is really impressive.”
Modakafusp (developed by Takeda
Pharmaceuticals) is fusion protein that targets interferon (a pro-inflammatory
hormone that is also used for treating viral infections and other cancers) to
cells that have CD38, a surface marker present on myeloma cells and a variety
of immune cells.
In this trial, modakafusp made a positive
difference in people for whom drugs aimed at the same target, including
well-established monoclonal antibodies like daratumumab and isatuximab, were no
longer effective.
Preliminary results from the study were presented
during the 2021 ASH Annual Meeting. The final safety and efficacy results
presented this year confirm the drug has a manageable side effects and produces
strong anti-myeloma responses.
“Modakafusp has a truly novel mechanism of
action, delivering a hormonal signal directly to target cells that
simultaneously is toxic to cancer cells while stimulating an immune response.
We saw responses in patients whose cancer did not respond to or who experienced
a relapse after receiving the anti-CD38 antibody drugs that are currently on
the market,” Vogl said. “We also saw responses in patients whose myeloma had
developed resistance to all currently available effective therapies.”
Most patients (87 percent) on the study
experienced treatment-related adverse events, as expected for this heavily
pre-treated population. The most common side effects among study participants
included neutropenia, or a decrease in white blood cells and thrombocytopenia,
or low blood platelet count; and about one third of patients had mild reactions
after infusion of the medication.
Vogl and his colleagues are now enrolling
patients in a randomized phase II study, which is designed to identify the
optimal dose of modakafusp and provide more information about its effectiveness
in people with myeloma.
Reference:
Dan Vogl, MEETING ASH Annual Meeting