Peter Dreger, MD from Heidelberg University Hospital, Heidelberg, Germany gives an overview of his talk on the current role of allogeneic stem cell transplantation in lymphoma and chronic lymphocytic leukemia (CLL) held at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH) in Glasgow, Scotland. The context of the talk was the new era of lymphoma and CLL treatment, which changes the role of transplant. According to Prof Dreger, transplant will continue to be the only curative treatment option for CLL while for lymphoma, it is less clear.
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David Steensma, MD of the Dana-Faber Cancer Institute, Boston, MA gives an overview of his talk on how to treat patients with difficult forms of myelodysplastic syndromes (MDS) held at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH) in Glasgow, Scotland. Dr Steensma discusses how for some of these patients, there is no prescribed algorithm or obvious approach for treatment. This includes lower risk patients for whom erythropoietin and lenalidomide have failed and high-risk patients who have been failed by azacitidine or decitabine, as well as post-transplant relapses and patients whose…
Chng Wee Joo, MB, ChB, PhD, FRCP, FRCPath, FAMS from the National University Cancer Institute, Singapore discusses how next-generation sequencing (NGS) will change clinical practice in multiple myeloma (MM) and other cancers. According to Prof Chng, cancer treatment will move away from disease specific treatment to treatment based on molecular defects. There are still a number of gaps that need to be addressed before NGS can be applied in practice, such as the meaning of the individual genes and mutations and how doctors can interpret those to choose the right treatment. Recorded at the 2016 Annual Meeting of the British…
Mark Caulfield, MD from Genomics England and Queen Mary University, London, UK gives an overview of the 100,000 Genomes Project, which is about sequencing the genomes of patients with rare inherited diseases, cancer and infections. The focus is on transforming the National Health Service (NHS) making the UK a world leader in the application of genomic medicine to healthcare. Prof Caulfield explains the challenges associated with analyzing tissue from tumors. He further discusses a programme that sequenced 150 patients with chronic lymphocytic leukemia (CLL) and plans for working on acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) and multiple myeloma…
Gail Roboz, MD from Weill Medical College of Cornell University, New York, NY gives an overview of her talk on ‘How I use molecular genetics to guide treatment in AML’ held at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), in Glasgow, Scotland. In the US, the standard of care in terms of molecular genetics for acute myeloid leukemia (AML) is to order FLT3, NPM1 and CEBP tests. According to Dr Roboz, it is now becoming more common to order up to 200 gene panels. In terms of treatment, FLT3 guides…
David Steensma, MD of the Dana-Faber Cancer institute, Boston, MA gives an overview of his talk on precision medicine for myelodysplastic syndromes (MDS) held at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH) in Glasgow, Scotland. Dr Steensma discusses how precision medicine can be interpreted differently and more specifically, what drug therapies could be targeted to which patients with MDS. Dr Steensma discusses what is being learned about the genetics of MDS and how to refine treatment algorithms in the future. He further talks about the discovery that molecular diagnostic testing…
Chng Wee Joo, MB, ChB, PhD, FRCP, FRCPath, FAMS from the National University Cancer Institute, Singapore gives an overview of his talk on the utility of next-generation sequencing (NGS) in multiple myeloma (MM) held at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH) in Glasgow, Scotland. According to Prof Chng, a lot of progress has been made in NGS but its clinical use in MM is not well established yet. There is great potential in helping to target treatment and understanding prognosis as well as drug resistance. Further, a key point…
At the 10th European Breast Cancer Conference (EBCC), held in Amsterdam, the Netherlands, from 9 to 11 March 2016, Oleg Gluz, MD, from the West German Study Group, Mönchengladbach, Germany, discusses the 5-year disease-free survival, defined as relapse, secondary malignancy or death, of patients with node-positive and high-risk node-negative early breast cancer who omitted adjuvant chemotherapy based on an Oncotype DX® 21-gene Recurrence Score® result of 11 or less in PlanB, a prospective phase 3 trial evaluating the Recurrence Score® result. This content is supported by Genomic Health, Inc. European Medical Journal Website: http://emjreviews.com/ Twitter: https://twitter.com/EMJReviews Facebook: https://www.facebook.com/emjreviews
At the 10th European Breast Cancer Conference (EBCC), held in Amsterdam, the Netherlands, from 9 to 11 March 2016, Oleg Gluz, MD, from the West German Study Group, Mönchengladbach, Germany, explains the rationale and design of PlanB, a prospective phase 3 trial evaluating the Oncotype DX® 21-gene Recurrence Score® result for defining a low-risk subgroup of breast cancer patients with node-negative disease and high-risk clinicopathological factors as well as patients with node-positive disease who could be treated with adjuvant endocrine therapy alone. This content is supported by Genomic Health, Inc. European Medical Journal Website: http://emjreviews.com/ Twitter: https://twitter.com/EMJReviews Facebook: https://www.facebook.com/emjreviews
This Expert Perspectives activity features the clinical faculty from a symposium held at the 2016 Annual Meeting of the Oncology Nursing Society sharing highlights from the symposium and additional relevant clinical commentary. Significant advances have elevated breast cancer care to new levels of success and complexity. In particular, for women with estrogen receptor-positive (ER+) metastatic breast cancer (MBC), the availability of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor therapy is a notable recent advance. As such, clinicians who treat breast cancer need ongoing education on this topic to ensure safe and effective use of this therapy. Earn accreditation for…
In this presentation from the “CDK 4/6 Inhibitor Therapy for ER+ Metastatic Breast Cancer – Advancing Nursing Care to Improve Patient Outcomes” symposium held during the 2016 Annual Meeting of the Oncology Nursing Society, Austin Kershner discusses how to council ER+ metastatic breast cancer patients on the safety expectations and side effects of CDK 4/6 inhibitors. Earn accreditation for this activity at the following location: http://elc.imedex.com/ELC/Activity-Search.aspx?search=7208 © 2016 Imedex, LLC.
In this presentation from the “CDK 4/6 Inhibitor Therapy for ER+ Metastatic Breast Cancer – Advancing Nursing Care to Improve Patient Outcomes” symposium held during the 2016 Annual Meeting of the Oncology Nursing Society, Meg Trewhitt Discusses how to council ER+ metastatic breast cancer patients on efficacy expectations for CDK 4/6 inhibitors.
In this presentation from the “CDK 4/6 Inhibitor Therapy for ER+ Metastatic Breast Cancer – Advancing Nursing Care to Improve Patient Outcomes” symposium held during the 2016 Annual Meeting of the Oncology Nursing Society, Dr. Ruth O’Regan discusses the biological rationale, development history, and dosing and administration of CDK 4/6 inhibitors in the ER+ metastatic breast cancer setting. Earn accreditation for this activity at the following location: http://elc.imedex.com/ELC/Activity-Search.aspx?search=7208 © 2016 Imedex, LLC.
Mohamad Mohty, MD, PhD, from Saint-Antoine Hospital, Paris, France, and President of the European Society for Blood and Marrow Transplantation (EBMT), talks about the a symposium hosted at the 2016 Annual Meeting of EBMT, held in Valencia, Spain, focusing on the role of proteosome inhibitors in multiple myeloma (MM). In the last 15 years, we have lived with the 1st generation proteosome inhibitors for the treatment of MM, mainly bortozemib. However, in the recent years the research community has developped 2nd generation proteosome inhibitors, such as carfilzomib and ixazomib. This symposium focused on the mechanistic aspects of these inhibitors in…
At the 42nd Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), held in Valencia, Spain, John Murray, a Nurse Clinician at the Christie NHS Foundation Trust, Manchester, UK, discusses the importance of information availabilty for patients. With the advent of the internet patients are becoming more empowered. By learning about different treatment options, their side effects, and ongoing clinical trials patients can make informed decisions and better cope with their disease.
Chiara Bonini, MD, from San Raffaele Scientific Institute, Milan, Italy, gives an overview of the ongoing randomised Phase III trial TK008 (NCT00914628), which looks at the ability of donor lymphoctyes to recognise and kill leukemia cells and the control of graft-versus-host-disease (GvHD) via the use of a suicide gene in high-risk leukemia patients who underwent haploidentical hematopoietic cell transplantation. The aim is immunoreconstitution, a reduced relapse rate and control of GvHD. According to Prof Bonini, the killing of the gene modified cells and the control of GvHD has been reported as efficient in several studies.
Bruno Paiva, PhD, from the University of Navarra, Pamplona, Spain discusses open questions in the assessment of response in multiple myeloma (MM). According to Dr Paiva, we should see overall response rates of around 70-80% in a relapsed/refractory setting and complete remission (CR) rates of around 20-30%. In future, a deep response, including minimal residual disease (MRD) negativity, may be a goal for fit relapsed/refractory patients. Other areas that require research are biomarkers and ultra chemotherapy-resistant MRD cells. Recorded at the 2016 Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT) in Valencia, Spain.
Bruno Paiva, PhD, from the University of Navarra, Pamplona, Spain discusses the current status of novel treatments in multiple myleoma (MM). According to Dr Paiva, the last three years have seen important advances for transplant eligible and ineligible MM patients. There are two questions that need to be addressed: how to combine the new agents with the current backbone therapy and how to combine the various individual novel drugs. Recorded at the 2016 Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT) in Valencia, Spain.
Arnon Nagler, MD, from Sheba Medical Center, Tel Hashomer, Israel, discusses why immunotherapy is his highlight from the 2016 Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), held in Valencia, Spain. Prof Nagler explains the importance of chemotherapy in clinical practice at the moment but also, that it is a very crude treatment. Then he discusses the new developments in immunotherapy, such as monoclonal antibodies and chimeric antigen receptors (CARs) and their promise for the future of cancer therapy.
Ali Bazarbachi, MD, from the American University of Beirut, Beirut, Lebanon explains his research into the use of FLT3 inhibitors in acute myeloid leukemia (AML). FLT3 inhibitors are tyrosine kinase inhibitors and in the first-line treatment of AML combined with chemotherapy, they have shown a survival advantage. Further, they can be used in relapsed AML in transplanted and non-transplanted patients. The most promosing setting for FLT3 inhibitors is in maintenance therapy after allogeneic stem cell transplantation to avoid relapse. Prof Bazarbachi further discusses the implications of these results and the ongoing clinical trials in this area. According to Prof Bazarbachi,…
Arnon Nagler, MD, from Sheba Medical Center, Tel Hashomer, Israel, discusses the use of drugs and transplantation in acute leukemias. Prof Nagler describes how drug therapy and transplantation are used together in order to achieve the best outcomes for the patients. For example, with the help of the drugs, the mass of a tumor can be reduced pre-transplant, which in turn means, that less chemotherapy may be required. Recorded at the 2016 Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), held in Valencia, Spain.
Ann Leen, PhD, from Baylor College of Medicine, Houston, TX, US, provides an overview of the safety and effectivness of virus-specific T cells and their use in transplant patients. According to Dr Leen, there is a lot of research focusing around the use of algorithms to help phyisicans choose the right product for their patients and the next step would be a registration trial. She further describes how referrals usually come from transplant physicians. In order to provide the virus-specific T cells to the patients, they require the HLA characteristics of the patient and the details of their infection. Recorded…
Ali Bazarbachi, MD, from the American University of Beirut, Beirut, Lebanon provides an overview of FLT3 mutations in acute myeloid leukemia (AML) at the 2016 Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT) in Valencia, Spain. FLT3 is a tyrosine kinase and FLT3 mutations are seen in over 30% of AML patients according to Prof Bazarbachi. FLT3 mutations are associated with a poor prognosis and currently, researchers are investigating the use of tyrosine kinase inhibitors to target FLT3 mutations.
Ivan Borello, MD from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Batlimore, MD discusses the highlights in immunotherapy and in particular CAR T-cells for multiple myeloma (MM) from the Myeloma 2016 meeting held in Boston, MA with Edward Stadtmauer, MD from the University of Pennsylvania, Philadelphia, PA, James Kochenderfer, MD from the National Cancer Institute, Bethesda, MD and Michael Hudecek, MD from the University of Würzburg, Würzburg, Germany. Prof Stadtmauer discusses his talk on the CD19 targeted T-cells and the rationale behind targeting tumors that are not expressing CD19. They further talk about the B-cell maturation antigen (BCMA) and…
Stephen Russell, MD, PhD from the Mayo Clinic, Rochester, MN discusses highlights from the session ‘Environment biology insights’ in multiple myeloma (MM) held at the Myeloma 2016 meeting in Boston, MA with Dirk Hose, MD from the University of Heidelberg, Heidelberg, Germany and Suzanne Lentzsch, MD, PhD from the Columbia University Medical Center, New York, NY. Prof Russell first highlights the talk by Madhav Dhodapkar from the Yale Cancer Center on monoclonal gammopathy of undetermined significance (MGUS). Dr Hose then discusses his talk on the evolution of MGUS to multiple myeloma (MM). According to Dr Hose, the main factors driving…
Philippe Moreau, MD from the University Hospital of Nantes, Nantes, France gives an overview of the Cassiopeia trial on daratumumab in transplant eligible multiple myeloma (MM) patients. The trial compares bortezomib, thalidomide, dexamethasone (VTD) followed by stem cell transplantation, followed by two cycles of consolidation therapy with VTD with or without daratumumab (NCT02541383). The primary endpoint is stringent complete remission (CR). Within the same study, there is a second randomization with daratumumab maintenance for two years versus no maintenance. The goal is to show that the addition of daratumumab will improve the quality of response and therefore progession-free survival and…
Paul Richardson, MD from the Dana-Farber Cancer Institute, Boston, MA discusses his talk on ‘Perspectives on future paths to cure’ in multiple myeloma (MM) held at the Myeloma 2016 meeting in Boston, MA. Dr Richardson discusses monoclonal antibodies, proteasome inhibitors, immunomodulatory drugs (IMiDs), HDAC inibitors as well as the role of transplants. He first discusses daratumumab, which is considered a breakthrough drug in MM. While daratumumab is used in monotherapy, elotuzumab needs to be combined with proteasome inhibitors or IMiDs. Further isatuximab, which targets CD38, appears to very promising. In terms of the new proteasome inhibitors, Dr Richardson discusses ixazomib,…
Ola Landgren, MD, PhD from the Memorial Sloan Kettering Cancer Center, New York, NY gives an overview of his talk on the applications of minimal residual disease (MRD) testing in multiple myeloma (MM) held at the Myeloma 2016 meeting in Boston, MA. Dr Landgren outlines how two years ago, around 30% of institutions conducted flow based MRD testing while now, it is 60%. He further discusses the work that remains to be done in this field. According to Dr Landgren, MRD has arrived in MM due to the various new therapies that are now available. In terms of applications for…
Nikhil Munshi, MD from the Dana-Farber Cancer Institute, Boston, MA gives an overview of the data presented on the Dana-Farber Cancer Institute (DFCI) genomics program in multiple myeloma (MM) at the Myeloma 2016 meeting held in Boston, MA. The summary of the DNA data shows many mutations whereby no single mutation is more frequent that 20%. The data provides information on potential new targets, such as in the RAS, RAF and p53 pathway. Further, there are multiple clones in myeloma, which change over time which means that genomic analysis at diagnosis may not be adequate. Moreover, Dr Munshi discusses the…
At the Myeloma 2016 meeting held in Boston, MA, Daniel Auclair, PhD, from the Multiple Myeloma Research foundation (MMRF) discusses highlights from the meeting for patients with Kenneth Anderson, MD from the Dana-Farber Cancer Institute, Boston, MA, Keith Stewart, MB, ChB from the Mayo Clinic, Scottsdale, AZ and Sagar Lonial, MD from the Winship Cancer Institute, Atlanta, GA. Prof Anderson highlights immune therapies and in particular, check-point inhibitors, CAR T-cell therapy and immunomodulatory drugs (IMiDs) such as pomalidomide and lenalidomide. According to Prof Anderson, the main message is that there are many immune therapies now and drug combinations will play…
Lawrence Boise, PhD, from the Winship Cancer Institute, Atlanta, GA, discusses the mechanism of action of venetoclax and next steps for the drug in multiple myeloma (MM). Venetoclax is an inhibitor of BCL-2 and has recently been approved for the treatment of chronic lymphocytic leukemia (CLL). According to Prof Boise, only a small fraction of multiple myeloma patients appear to be sensitive to venetoclax and the next step is to find a marker that can identify those patients. Another area of research concerns drug combinations, i.e. finding drugs such as dexamethasone, that can be combined with venetoclax. Recorded at the…
Jesús San Miguel, MD, PhD, from the University of Navarra, Navarra, Spain gives an overview of his talk on ‘Immunotherapy checkpoint inhibitor trials’ presented at the Myeloma 2016 meeting in Boston, MA. First, Prof San Miguel discusses the lenalidomide and pembrolizumab KEYNOTE-023 trial (NCT02036502). The treatment was well tolerated and the response rate was 76% for the overall population and 50% for the double refractory population. Then, he discusses the trial of pembrolizumab plus pomalidomide (NCT02289222); the response rate was 60% for the overall population and 50% for the double refractory population. Recorded at the Myeloma 2016 meeting held in…
Michel Delforge, MD, PhD from the University Hospital Leuven, Leuven, Belgium gives an overview of the mechanism of action of proteasome inhibitors. Prof Delforge gives a detailed outline of how the proteasome is targeted. He further discusses the different classes of proteasome inhibitors, i.e. the boronic acid derivatives (bortezomib, ixazomib), epoxyketone derivatives (carfilzomib, oprozomib)and salinosporamide derivatives (marizomib). Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Carlos Fernandez de Larrea, MD, PhD from the Hospital ClÃnic de Barcelona, Barcelona, Spain discusses the definition of complete remission (CR) in multiple myeloma (MM). The current definiton of CR requires a negative serum and IFE and less than 5% bone marrow plasma cells (BMPCs). However, two-thirds of patients with CR still relapse and the aim is to be able to identify those patients who are really cured. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
MarÃa-Victoria Mateos, MD, PhD, from the University Hospital of Salamanca, Salamanca, Spain gives an overview of the challenges associated with assessing and treating smouldering myeloma. Smouldering myeloma is a heterogeneous disease and Dr Mateos explains how the difficulty in assessing whether a patient is at risk of progressing to symptomatic myeloma, can vary from case to case. She explains the use of the Mayo Clinic model and monitoring strategies in case of low, intermediate and high risk of progression to myeloma. For high risk patients, Dr Mateos suggests that in future, they will be offered an early treatment. Recorded at…
Michel Delforge, MD, PhD from the University Hospital Leuven, Leuven, Belgium gives an overview of the two trials on second generation proteasome inhibitors. First, Prof Delforge discusses the ENDEAVOUR trial (NCT01568866), which compared carfilzomib plus dexamethasone (Kd) with bortezomib plus dexamethasone (Vd). Progression-free survival doubled in the Kd arm compared to the Vd arm and further, the depth of response was superior in the Kd arm. Prof Delforge also discusses the occurence of side effects such as peripheral neuropathy and cardiovascular toxicity. Prof Delforge further discusses the ASPIRE trial (NCT01080391) comparing carfilzomib, lenalidomide and dexamethasone (CRd) vs lenalidomide and dexamethasone…
Thierry Facon, MD, PhD, from Hospital Claude Huriez, Lille, France provides an overview of the topics and sessions covered at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) held in Paris, France. Some of the areas covered at the meetings were the biology and genetics of the disease as welll as imaging techniques and minimal residual disease assessment. Prof Facon further discusses the approval of new drugs for multiple myeloma (MM), which include pomalidomide, panastinomab, ixazomib, elotuzumab and daratumumab. According to Prof Facon, it may be possible to cure patients with MM in future. He further discusses PD-1…
Michel Delforge, MD, PhD from the University Hospital Leuven, Leuven, Belgium discusses the role of bortezomib in relapsed/refractroy multiple myeloma (MM). Prof Delforge, discusses the various trials that showed the superiorty of the proteasome inhibitor bortezomib in terms of response and time to progression. According to Prof Delforge, bortezomib is an ideal backbone and is combined with dexamethasone alone, or dexamethasone and a third agent, for example chemotherapy or immunomodulatory drugs (IMiDs) such as thalidomide, lenalidomide, pomalidomide. Bortezomib can further be combined with histone deacetylase (HDAC) inhibitors like vorinostat and panobinostat. Prof Delforge discusses trials results for the various combinations.…
Sagar Lonial, MD, from Emory University Winship Cancer Institute, Atlanta, GA, USA provides an overview of monoclonal antibodies and checkpoint inhbitors for multiple myeloma at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) held in Paris, France. Currently, two antibodies are approved for routine use in the USA: elotuzumab, which targets SLAMF7 and is combined with lenalidomide and dexamethasone, and daratumumab, which is currently approved as a single agent. Checkpoint inhibitors are another important class of drugs according to Prof Lonial. Several trials have been launched looking into nivolumab and pembrolizumab, which target PD-1, in combination with lenalidomide…
Paula RodrÃguez, MD, PhD from the University Clinic of Navarra, Pamplona, Spain gives an overview of her talk on anticancer immunity in multiple myeloma (MM) held at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France. Cancer cells have varied mechanisms to evade immune control and the basis of anticancer immunity is to disrupt these mechanisms. According to Dr RodrÃguez, there are four approaches to disrupt these mechanisms: monoclonal antibodies, boosting the effector cells with adoptive therapy such as CAR T-cells, vaccination or using drugs like checkpoint inhibitors to overcome the immune suppression. Dr RodrÃguez further…
Hervé Avet-Loiseau, MD, PhD from the Cancer Research Center of Toulouse, Toulouse, France talks about the progress that has been made in treatment of multiple myeloma (MM). According to Prof Avet-Loiseau, in five years from now, it may be possible to cure around 50% of patients with MM with intensive therapy. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Jean-Luc Harousseau, MD, from the University of Nantes, Nantes, France gives an overview of his talk on the access to novel drugs in multiple myeloma (MM) held at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France. Prof Harousseau argues that it is important to take into consideration, that several new drugs have been approved in recent years and life expectancy for patients has improved. He further discusses the issue of drug prices and the sustainability of healthcare systems as well as the strategies employed by various countries, such as Germany and France, to assess the…
Hervé Avet-Loiseau, MD, PhD from the Cancer Research Center of Toulouse, Toulouse, France discusses the impact of next-generation sequencing (NGS) on the treamtment of multiple myeloma (MM). First, NGS may be used to assess the prognosis for patients in future. It may also be used to identify molecular targets for individual patients and help physicians choose the right drug for their patient. According to Prof Avet-Loiseau, it may also be used for the assessment of minimal residual disease (MRD). Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Evangelos Terpos, MD, PhD, University of Athens, Athens, Greece discusses the open issues in the use of imaging techniques for the assessment of response in multiple myeloma (MM). One question concerns the MRI and how to better define complete response and further how often the MRI needs to be repeated. The same questions apply to PET-CT. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Jean-Luc Harousseau, MD, from the University of Nantes, Nantes, France discusses the role of the patient in the debate around the access to and affordability of novel drugs in multiple myeloma (MM). Prof Harousseau argues that patients should be aware of novel drugs and their benefit, which may not always be significant. He further argues that like doctors, patients should take into consideration the cost-effectiveness ratio and further, that patients should be involved in the evaluation of novel drugs. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Evangelos Terpos, MD, PhD, from the University of Athens, Athens, Greece discusses the limitations and challenges associated with using various imaging techniques to assess disease response in multiple myeloma (MM). According to Dr Terpos, with MRI it is possible to decide which patients to treat at diagnosis based on focal lesions while the PET-CT has the advantage of being able to better depict the living cells. Dr Terpos further discusses the benefits of diffusion weighted imaging MRI. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Antonio Palumbo, MD, from the University of Turin, Turin, Italy provides an overview of the diagnostic criteria for smouldering myeloma. According to Dr Palumbo, hematological test plus a M-protein evaluation are the starting point and if indicated, this is followed by a bone marrow biospy and low-dose CT scan. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Carlos Fernandez de Larrea, MD, PhD from the Hospital ClÃnic de Barcelona, Barcelona, Spain discusses which techniques can be used to establish disease response in multiple myeloma (MM). For the detection of minimal residual disease (MRD), the most established technique is flow cytometry. In terms of imagng, clear criteria for the evaulation of PET/CT are required. Dr de Larrea further discussses the importance of standardizing the various techniques. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Antonio Palumbo, MD, from the University of Turin, Turin, Italy provides treatment advice for smouldering myeloma. The key message, according to Dr Palumbo, is that today, smouldering myeloma is defined by the presence of 3g/dL of M-component and at least 10% bone marrow plasma cells. Further, Dr Palumbo discusses ultra high-risk smouldering myeloma and high-risk smouldering myeloma. Recorded at the 2016 World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
Antonio Palumbo, MD, from the University of Turin, Turin, Italy provides advice on how to treat multiple myeloma (MM). For patients younger than 75, autologous transplantation remains the standard of care and Dr Palumbo also suggests a three-drug combination induction therapy. For patients who are not eligible for a transplant, the advice is also a three-drug combination, which includes proteasome inhibitors plus an alkylating agent or a proteasome inhibitor plus IMiDs. For frail patients who are not transplant eligible and also have co-morbidities, Dr Palumbo suggests a two-drug combination therapy. Recorded at the 2016 World Congress on Controversies in Multiple…