But elotuzumab is pushing response rates extremely high.
But it is partially due to in combination with Revlimid in Revlimid naiive patients. So that high response rate doesn't mean as much. We already know Revlimid is a very effective drug.
There's also carfilzomib, oral velcade, oral carfilzomib, pomalidomide.
These are essentially slightly different versions of existing drugs. I like ONXX and carfilzomib. Carfilzomib is potentially a better version of Velcade due to better safety profile, thus patients can take higher dose for longer period of time. Pomalidomide is a different version of Revlimid.
The opportunity in relapsed refractory is going to get smaller and smaller and harder to develop
Contrary, MM relapsed and refractory population are getting bigger and bigger due to patients living longer and longer. MM is one field where more drugs with different mechanism action benefit each other. Velcade and Revlimid helped each other growing the market. Patients treated by one, then got treated by the other, then return to get retreated again. There is need to have new drug with different mechanism action in MM after treatments and retreatments off existing similar drugs.