Every year, more than 130,000 people worldwide receive the life-altering diagnosis of multiple myeloma, the second most common form of blood cancer. While there is unfortunately no existing cure for multiple myeloma, there have been important advances over the past two decades resulting in effective new treatment options for those living with this cancer.
Sanofi has continued to significantly strengthen its commitment to oncology, including expanding a range of drug development platform technologies with the potential to develop novel therapeutics for patients with hematologic malignancies, including multiple myeloma. In this Q&A, the Global Head of Oncology Development & Pediatric Innovation at Sanofi, Peter Adamson, MD, discusses a number of scientific developments, as well as some of the challenges that still remain, for patients diagnosed with multiple myeloma.
Q: How have you seen the multiple myeloma treatment landscape evolve throughout your career in medicine and now at Sanofi?
A: Peter Adamson: Two decades ago, the median survival for people diagnosed with multiple myeloma (MM) was approximately three years. Now, people are surviving an average of eight to ten years thanks to the availability of newer, innovative therapies, which have transformed the treatment landscape and outlook for patients and families.
Some new treatments that leverage rapid advances in science include highly targeted monoclonal antibodies, immunomodulatory drugs,  proteasome inhibitors that can impact malignant cell survival pathways, and personalized cell therapies that genetically engineer a patient’s own immune cells aiming to improve their ability to detect and destroy myeloma cells.
Oncologists have also played a key role by embracing increasingly sophisticated data-driven approaches, including the exploration of artificial intelligence tools and predictive analytics to help inform treatment decisions based on individual patient variables. The ability to tolerate current day therapy is impacted by a number of variables, including age or comorbidities, which must be factored into treatment paradigms. The introduction of new, scientific advances can indeed broaden the therapeutic options for a spectrum of patients with MM.
These efforts to double down on next generation approaches and therapies have contributed to durable survival gains.
Q: What would you say are the best ways to shorten the development timeline for clinical trials?
A: As the outcome for patients with MM improve, one key area of interest is developing further evidence to support the use of surrogate endpoints, which are endpoints that can be strongly correlated with long term survival. Beyond progression free survival (PFS), which can still take a significant period of time to determine, establishing minimal residual disease (MRD) negativity is key – where highly sensitive measures of cancer burden no longer can detect malignant cells in the bone marrow of patients with MM. Data is accumulating that shows sustained MRD negativity is associated with more favorable outcomes for those undergoing treatment. Such measures are increasingly being incorporated into clinical trials as well as clinical practice.
Currently, MRD may be used as an endpoint to accelerate drug development, however, the use of this endpoint to drive treatment decisions is under investigation. Results of current Phase III trials underway will hopefully help clarify the role of MRD in decision-making for MM treatments.
Q: What are steps you have seen taken to ease some of the burdens on people living with multiple myeloma?
A: While treatment outcomes have improved in MM, minimizing the burden of receiving treatment remains a focus. Certain treatments may require patients to receive lengthy intravenous (IV) infusions of medication. We have been working on patient-centric approaches and developing administration methods that may not only decrease the time it takes to receive medication, but also in the future potentially allow for home administration of medication.
It is important that we continue to prioritize quality of life for those living with MM, such as giving them time back in their day through these improved treatment administrations. Because there is currently no cure for the disease, people with MM will continue to be on therapy and be burdened with the challenges of doing so. Continuing to find ways to improve their daily living, such as reducing the time it takes for them to receive treatment, can go a long way in improving their quality of life.
Q: What other steps is Sanofi taking to advance the treatment paradigm for people living with multiple myeloma?
A: Cancer is too great a hurdle to tackle alone, and we’re pleased to partner with key organizations to help advance our drug development programs. One recent example is our collaboration with Blackstone Life Sciences to accelerate global pivotal studies and the clinical development program for our subcutaneous therapy, hopefully bringing more advancements to those living with MM.
As our industry presses forward in pursuit of a shared goal to achieve a long-term cure for patients with MM, we will continue to advance research, explore ways to shorten the cancer drug development timeline, and develop methods that can minimize the burden of cancer treatment.
To learn more about the progress being made in the treatment of multiple myeloma, visit TransformMyeloma.com.
 International Myeloma Foundation. Myeloma Action Month. https://mam.myeloma.org/learn-more-about-multiple-myeloma/. Accessed September 2022.
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