Individualizing Frontline Treatment to Get the Best Outcomes | Xavier Leleu, MD, PhD | IMS 2023

Bonjour, Xavier Laleu. I'm a hematology professor, head of department in Poitiers in France, and I'm a myeloma expert participating to the IMS International Myeloma Society meeting here in Greece, Athens, 2023. On Saturday morning, I've been invited to give a talk on individualizing the treatment for patients, because next year, we think next year, there's going to be a number of clinical trials, which data are going to be released, and that we think are going to change and make us physicians change our practice. And it's important that we explain that to you guys, the patients and their families. So in myeloma, we split the patients artificially based on transplant or non-transplant. And one thing we've learned with the transplanted patients is that once we have created these quadruplet-based regimens with the transplant, plus minus another set of quadruplet-based regimen cycles after the transplant, when we have done that in transplanted eligible patients, we have incredibly improved the response, depth of response. We also have incredibly improved the survival for the patients. So we and others have attempted to try to do the same in non-transplant eligible patients, patients that cannot benefit from the transplant, for whom it is even more important to develop regimens that could improve the survival of the patient. And that would be not creating issues safety-wise. And so next year, there's going to be several data on quadruplet-based regimen in non-transplanted eligible patients with, and we believe it is very important for the patients if their studies are positive. And we hope that at some point we can match the extraordinary results we've known and we've had with the transplanted eligible patients. And so IMROZ, which is a Sanofi registration study, BENEFIT, which is an IFM, a terrible platform myeloma study, and Cephyrus, which is a Janssen, I believe, registration study. These studies will hopefully show that some patients may benefit from a quadruplet safely with an improved MAD negative rate status at some point and therefore prolong PFS. And that will ask the question of individualizing now the treatment for non-transplanted eligible patients. Which patients should be for drugs? Some patients might just need three drugs and maybe some patients be of two drugs. And it is very important to answer these questions for you, for the patients, for the families, because we want to improve the survival. Once we will have done that, and if we can demonstrate and learn how to better treat the patients non-transplanted eligible, the next question will obviously be can we fix duration? Can we stop having the patient coming constantly, continuously, for years, every month, every two weeks to the hospital? But right now, what we want is truly to improve the MAD negative rate to the patients. And we think this quadruplet, new quadruplet-based regimen that will be demonstrated next week, show next week, next year, sorry, will really be amazing. And so rendezvous next year with the data, but we have already started to think about patient population and characteristic for four drugs, three drugs, or two drugs in anticipation to what the data will show next year.