Biologic Therapies for Patient With Both Lung Cancer and Multiple Myeloma
Posted: Friday, June 19, 2020
Although recent advances in cancer therapy have improved survival outcomes for patients, the risk of developing secondary cancers has become more relevant, especially with life-extending therapies such as lenalidomide for multiple myeloma. A case study, published in the British Journal of Haematology, suggested that targeting respective tumors appears to be safe and effective. Martin F. Kaiser, MD, of The Institute of Cancer Research (ICR), London, and colleagues stress that the work supports further development for managing simultaneously active cancers.
The researchers reported on a 68-year-old man who was treated for multiple myeloma at ICR since 2006. In 2017, the patient was diagnosed with non–small cell lung cancer (NSCLC). At the time of the new diagnosis, the myeloma was reasonably under control, with ongoing fifth-line triplet therapy: carfilzomib, daratumumab, and dexamethasone. The patient had been previously treated with lenalidomide, bortezomib, high dose melphalan plus autologous stem cell transplant, pomalidomide plus dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, and etoposide.
The clinicians treated the NSCLC with pembrolizumab, to which the patient showed a partial response after 3 months. No immune-related adverse events were reported, other than a mild skin rash with pruritus. However, the myeloma did not respond to pembrolizumab, and the patient’s paraprotein levels continued to increase during the 10 months of concurrent pembrolizumab and antimyeloma therapy.
In July 2018, the patient began combined treatment of venetoclax, daratumumab, and dexamethasone in addition to pembrolizumab. He began responding shortly thereafter. No clinically significant infections were reported, and the patient achieved a good performance status. Both the multiple myeloma and the NSCLC have remained in ongoing stable remission for 12 months and 18 months, respectively. The patient has continued ongoing venetoclax and pembrolizumab therapy, with no major safety concerns.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.
