A new oral treatment that targets the tumor microenvironment and changes the immune system called tasquinimod is now in early multiple myeloma clinical trials. 

Tasquinimod targets myeloid-derived suppressor cells (MDSCs). MDSCs are a variety of cells that expand during cancer, inflammation and infection, and can suppress T-cell responses. They can stop myeloma killing-immune cells and at the same time form new tumor blood vessels that help myeloma spread in the body. The researchers are hopeful that tasquinimod will promote anti-tumor immune activity 

The optimal dosing of tasquinimod (by Sweden-based Active Biotech) was recently determined in an early Phase 1b/2a clinical trial for 10 heavily pre-treated patients with relapsed/refractory multiple myeloma. 

With the conclusion of the dosing determination, the second part of the trial will continue where tasquinimod will be combined with ixazomib, lenalidomide and dexamethasone (IRd). Once an optimal dose and schedule is determined with the IRd combination, the trial will be expanded and will also look at early signs of promising activity.

Importantly, eight of the 10 myeloma patients had failed to respond to immunomodulators, proteasome inhibitors and anti-CD38 monoclonal antibodies. 

Principal investigator and Director of the University of Pennsylavania's Abramson Cancer Center Dan Vogl said: 

“While none of the patients formally achieved a partial response, two patients with progressive myeloma at study entry achieved significant periods of stable disease on single-agent tasquinimod therapy.” 

Tasquinimod has been granted orphan drug designation in the U.S. for the treatment of multiple myeloma. The study is only open at the Abramson Cancer Center at UPENN in Philadelphia. Tasquinimod is currently approved for prostate cancer.