"New treatments will also emerge in the treatment of myeloma. However, its importance is still expected to continue when Kypris compares combined therapy features with a single formulation and other formulations." As multiple myeloma is difficult to completely heal and many recurrences occur, recurrence and non-responsive polymyeloma is considered the key to treatment.

In the domestic treatment situation, Kyprolis-focused KRd therapy (Carfilzomib, Lenalidomide, and Dexamethasone) became the main treatment strategy, as third-generation proteasome inhibitors (PI drugs) became the standard of treatment.

However, since March, IRd therapy (Ixazomib+Lenalidomide+Dexamethasone), which is centered on the oral PI drug Ninlaro, has become convenient, and the market for prescribing recurrent and non-responsive multiple myeloma has begun to become active.

Accordingly, let's listen to the strategies and perspectives of treating multiple myeloma through Joseph Mikhael, a professor of applied genomics at the Korean Society of Hematology International Conference. First of all, what he emphasized in his presentation at the Korean Society of Hematology conference is the importance of early treatment strategies for patients with recurrent and unresponsive multiple myeloma.

As recurrence and non-responsive multiple myeloma have various options not only in the U.S. but also in Korea, optimal measures that take into account the characteristics of patients should be considered first. Professor Joseph Mikhael said, "It is very encouraging that there are more treatment options to choose from now on compared to the past. We expect more options for treating recurrent and unresponsive multiple myeloma in the future."

Professor Joseph Mikhael pays attention to the fact that Kyprolis has achieved a 12-month extension of the PFS (Present Progressive Survival Period) compared to conventional treatments in treatment of recurrent and non-responsive multiple myeloma.

"The improvements in the duration of the existing treatment are significant, compared to four to six months and eight months at the most," he said. "It's a great achievement in that about six months is a common improvement in other treatments." Professor Mikhael emphasized that Kypris clearly has an advantage in terms of efficacy compared to other PI agents, Velcade (Bortezomib) and Ninlaro (Ixazomib).

"Kyprolis still has the greatest effectiveness of PI drugs used to treat multiple myeloma," he said. "A study directly compared to Velcade concluded that Kyprolis is the most effective treatment needed by medical staff and patients."

Treatment options for increased myeloma. What's the situation in the U.S.?

In Korea, as IRd therapy has recently been reimbursed, options for clinical doctors have also increased. In the United States, where both KRd and IRd therapy were available, how would the choice of prescription between the two treatments appear? Professor Mikhael said that KRd therapy is preferred, assuming that there are many options.

"If a patient has an autologous hematopoietic stem cell transplant, there is a maintenance therapy based on Levlimide, and Kyprolis and Ninlaro are available options," He said. "KRd therapy is mainly chosen because Kyprolis is more effective." IRd therapy can be selected if patients want to avoid Kyprolis because they are concerned about abnormal reactions related to the heart, but IRd therapy is less used in the United States than KRd therapy.

However, as Professor Mikhael mentioned earlier, Kyprolis' biggest concern is that patients with heart-related comorbidities require attention. Considering that multiple myeloma comes from older people aged 65 or older, concerns about heart failure and hypertension abnormalities of Kyprolis cannot be ruled out. Professor Mikhael acknowledged the abnormal response that could appear as Kypris, but evaluated it as manageable.

"After more than 10 years of use of Kyprolis, experience in abnormal reactions can be accumulated and reduced to 2%," he said. "2% of patients should stop taking medication, but this situation is very small in the actual field."