Robert Rifkin, MD, Rocky Mountain Cancer Centers, Denver, CO, discusses his abstract presented at the 64^th ASH Annual Meeting on utilizing data from the Connect MM Registry, the oldest and largest myeloma disease-specific registry, to understand changes in the patterns of multiple myeloma care due to COVID-19.

Transcript:

Hi, I'm Dr Robert Rifkin. I'm a medical oncologist at Rocky Mountain Cancer Centers in Denver, Colorado. I'm also the disease lead for US Oncology Research in multiple myeloma and now affiliated not only with US Oncology Research, but as all of you know, there's a joint venture taking place where we will merge with the Sarah Cannon Research Institute.

So, it's my pleasure to present a poster here at the ASH Annual Meeting utilizing our Connect MM Registry data. For those of you that don't know, Connect MM is one of the oldest and largest myeloma disease-specific registries, and we've now collected well over 3000 patients that we've been analyzing since 2009. As all of you know, the landscape changed dramatically when the pandemic came, and initially it was almost as if there was an overreaction; patient visits went to zero, we would go to the office, nobody would come, or sometimes nobody would go anywhere, you just stayed as part of the lockdown.

The interesting thing in Connect is we were collecting data real time, and we noticed significant changes in the patterns of care. So, all of a sudden, things that started to really emerge and become significant were agents that were all-oral agents, so you didn't have to come to a treatment, or things that were given very infrequently or very quickly.

Importantly, in this registry, we were able to, in our cohorts of patients, track the emergence of an anti-CD38 monoclonal antibody, daratumumab. And interestingly, I think the pandemic really drove the uptake of that. It's an extraordinarily effective drug, so we would've been doing some of it anyway. But when daratumumab is given on the classic schedule, you have eight weekly doses, then eight every-other-week doses, and then it goes to monthly, and then it becomes very easy to pair with an all-oral regimen, such as ixazomib, Revlimid [lenalidomide], dexamethasone as one example, and what we've seen is pretty good results.

The convenience factor definitely went way up. I think people actually were very compliant with all-oral regimens and showing up for their appointments, which became less and less frequent. Did COVID change the map of the daratumumab landscape? Probably not, because we knew it was a very effective drug and we'd started to, over the course of the Connect registry, add daratumumab to a lot of our other regimens. But I think the pandemic really taught us lessons in terms of convenience, which is a huge factor for myeloma patients because it's likely a continuous-therapy disease and you want to make whatever regimen you're using, especially daratumumab based, convenient for the patient, safe, effective, and nontoxic. So, we're delighted to present our data here showing all of that, and I think it also points the way forward for whatever the next cohort of Connect MM Registry patients that we’ll accrue.

As the cohorts have gone over time in the Connect Registry, if you look at when we started in 2009, we didn't have very many choices. There were some novel agents, but as you know from this meeting, now there's an explosion of novel agents, whether it's a new monoclonal antibody, a CAR [chimeric antigen receptor] T cell, a drug-antibody conjugate, a bispecific drug, or even a whole new class such as selinexor or nuclear protein export drugs. So, I think Connect will be an ongoing thing.

We're learning a lot of tremendous things going forward, and daratumumab was just one example, but I think overall it actually improved the care of patients, which will sound really crazy in the COVID era, because they got things that were safe, effective, nontoxic, and they didn't have to come out to offices where everybody in our practices are already immunosuppressed. So, if you can keep those touchpoint[s] down, hopefully you can prevent the spread of all the respiratory and other viruses.