What are the main classes of drugs used in myeloma?

[Music] what are the main classes of drugs used in myeloma so in myeloma we have several key classes of drugs we have the immunomodulatory drugs and these are solid amide lenalidomide and pomalidomide we have proteasome inhibitors these are bortezomib car fills emmab and examine an oral proteasome inhibitor we have of course steroids which are commonly combined with these medications then we have monoclonal antibodies these include a low to Zermatt and Dara - mmmm and we also use traditional chemotherapeutics things like cyclophosphamide vendôme ustin melphalan and then there are other drugs like H Tech inhibitors histone deacetylase inhibitors panobinostat is the approved class of drugs in that space and then there is investigational agents as well there's actually a very broad range of those and they're some of the immune drugs perhaps hold the greatest promise and maybe the next approvals for myeloma specifically I'm talking about car T cell therapies but there are also other similar somewhat similar drugs called by specifics which bring together immune cells t-cells with myeloma targets for now the most advanced there are BC ma directed by specifics in myeloma we classically think of a variety of different classes of agents that we use in different combinations we often don't combine more than one drug within each class but we often take one drug from each class and combine it with a drug from another class to form our combinations of therapies some of these include the image images short for immunomodulatory drugs this represents the lid amide Revlimid and pomalyst these are all derivatives of Follette amide they're all pills we have proteasome inhibitors there are three classes three drugs within this class bortezomib car fills mechanics as amid all cells create garbage within the cell as part of its process myeloma cells make a lot of garbage in this class of agents kind of stuffs up the garbage disposal system causes the cancer cells to explode and die so it's a very important class of drugs in myeloma there are monoclonal antibodies and these are generated immune therapies that target markers on the surfaces of the cancer cells and these are not even chemotherapy drugs but they specifically through immune mechanisms target the cancer cells themselves there's another class of agents called histone deacetylase inhibitors drugs like taina Benes that histones are these big proteins that DNA is wrapped around inside the cancer cells and by themselves these drugs don't do much but they kind of open up the genetic material to allow other drugs that come in and kill the cancer cells and then classical chemotherapy drugs like cytoxan mel Fallon very important and steroids are actually unfortunately the double-edged sword of myeloma drugs like prednisone and dexamethasone some people find them to be very helpful some people have some side effects from them as well since the recording of this video there have been three additional FDA approvals for myeloma Issa toxin lab also known as sark lisa is a monoclonal antibody administered as an infusion cell an X or also known as Expo vo is a selective inhibitor of nuclear export or sign inhibitor administered as an oral medication and sub-q teratoma mab also known as fast brow which is a monoclonal antibody administered as a subcutaneous injection you [Music]