My name is Rakesh Popat and I'm a hematologist at University College Hospital which is based in London in the UK. And I'm here at the IMS meeting in Athens and I've been speaking about how to augment the immune system to try and get some of these immune therapies to work better for patients with multiple myeloma. So what we already know is that some of these new treatments such as CAR T-cell therapy and bispecific antibodies seem to work really well for patients with relapsed multiple myeloma. And that in itself is fantastic news and we're all super excited about developing these treatments. But unfortunately, despite them being really effective, patients are unfortunately relapsing after these treatments. So what we know is that most of the time they're not curable. So the question is what can we do to further enhance the effects of these immune therapies? And this is really where I've been thinking a lot about because the immune system is very complex. Often we talk about T-cells as being the major component of the immune system to kill myeloma cells, but actually there's a lot more to the immune system apart from T-cells. So for example, there's another group of cells called B-cells, there's another group called NK cells, and there's a whole raft of other cells that sit within the bone marrow. And the problem with myeloma is that the bone marrow is quite a hostile place and it's been made into a hostile place by the myeloma cells to prevent the immune system from attacking it. So really what we're thinking about is how can we bring and draw in these T-cells into the myeloma and activate them so that they can be killed. Unfortunately one of the drugs that we're developing are these new agents called cell mods and what a cell mod is is that it's a new drug which is based on drugs that you might be aware about like Revlimid and Pomalidomide, but they are specifically designed to work more effectively than those agents. And what we find is that if you give those drugs to patients and then follow it up with one of our new immune therapies, then it brings those immune cells right inside the myeloma environment, so it draws them in and that seems to be much more effective. The other bit that they're very helpful with is that these immune cells, once they start attacking the myeloma cells, stop working and we call that exhaustion. And what these cell mods are able to do is that they're able to activate and almost refresh them so that they can start working. So we have some really good laboratory data which is supporting this, but we don't yet have sufficient data in patients to know if it's working. So that's the next step is that we're going to start running trials to start combining these sorts of agents to really see if they're going to work. But of course if you're going to do this you need to be careful because any combination has side effects and we need to work out when's the best time to be doing these combinations Should you have these new drugs ahead of the immune therapies, during the immune therapies or after and is the side effects going to be worse or better depending on how you do it? So these are the bits that we need to unravel and try and work out and watch this space for more information.
HealthTree • October 6, 2023