People with myeloma who will be eligible for stem cell harvest before an autologous stem cell transplant (ASCT) may need extra help to mobilize enough stem cells before the ASCT can proceed. HealthTree posted a recent summary write-up about mobilizing agents. You can click here to read it.
FDA-Approved Treatments to Increase the Stem Cell Harvest
Plerixafor (Mozobil, by Sanofi-Aventis)
- Administered as a subcutaneous injection approximately 11 hours prior to initiation of each apheresis (stem cell collection) session, for up to four consecutive days.
- The drug is ineffective in around 15 to 20% of patients.
- Cancer cells may be released from the bone marrow and subsequently collected along with stem cells during apheresis. The potential effects of infusing cancer cells during your transplant have not been well-studied.
Motixafortide (Aphexda, by BioLineRX USA)
- Administered as a subcutaneous injection 10–14 hours before the first apheresis session. No second dose is needed before the second session. If needed, a second dose can be given before a third session.
- Motixafortide + filgrastim enabled 92.5% of patients to successfully meet the primary endpoint of harvesting enough stem cells.
- Tumor cells may be released from the marrow and collected in the leukapheresis product. The effect of reinfusing tumor cells has not been well-studied.
New Treatment Under Investigation
Burixafor (GPC-100, by Exicure)
This is an ongoing trial, still recruiting. You can check for eligibility and more details here.
- A small molecule ("pill") that can be administered on the same day as the stem cell harvest, making the process potentially easier for patients.
- Preliminary Phase II study results are encouraging, with 100% of patients achieving successful CD34+ stem cell mobilization, including those previously treated with daratumumab.
If the final results of the full trial continue on the same path as the early results, and assuming that the side effects profile will be acceptable to the medical community and FDA, GPC-100 could be an advancement in ASCT for multiple myeloma. With some luck, we may be looking at this product coming into clinical practice in about two years.
If you want to learn more about stem cell transplantation, visit our complete Stem Cell Transplant Guide for myeloma patients and caregivers. Click the button below to access the free guide.
The Complete SCT Guide for Myeloma
Sources:
- An Open-Label, Multi-Center Phase 2 Study to Assess the Safety and Efficacy of Burixafor (GPC-100) and Propranolol with G-CSF for the Mobilization of Stem Cells in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplant
- What are the approved indications for Motixafortide?
- https://www.mozobil.com/
