What is extramedullary disease?

What is extramedullary disease?

When plasmacytoma happen outside the bone, we call that extramedullary disease. That's typically considered more of a feature of kind of more aggressive myeloma or high risk myeloma, whether that's at the time of diagnosis or later on. We do see it in some people when they get diagnosed, but it's more commonly seen when people have had multiple myeloma for a really, really long time or when the myeloma is becoming more aggressive. Those extramedullary plasmacytomas can occur. We treat them with the tools that we have to treat myeloma. The challenge with extramedullary disease has been that many of the therapies are not as good at treating them when they occur, especially later on.

Myeloma cells are really sensitive to radiation. So radiation is often utilized, especially if we need pain control or symptom management. But sometimes we can get multiple plasmacytomas. And so finding effective therapies for these has been kind of a long-standing goal. Recently there was some data presented at some of the large meetings, combining two bispecific antibodies when targeting BCMA, the at the target and GPRC5D. What was really exciting about this was they saw really high response rates for people with extramedullary disease, which is typically we don't really even with bispecific antibodies, we don't normally see response rates that are that good. I usually would tell people, you know, the odds of this working are a little bit less, but now we've for the first time, really we have a therapy that's really effective for this disease. That's a really exciting.