Corey J. Langer, MD, FACP of the University of Pennsylvania discusses the Pacific Trial overview of Durvalumab in locally advanced NSCLC and how it presented strikingly positive data. The most important clinical trial in the last 12 months is the Pacific Trial. This assessed the role of immunotherapy, specifically durvalumab which is a PD-L1 inhibitor versus placebo on patients who have successfully completed concurrent chemoradiation for locally advanced diseases. This was a very positive trial in terms of the progression-free survival in the control arm, which is around 6 to over 16 months. Interestingly, it has a very highly significant…
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Laura Jean Bierut, MD of Washington University of Medicine discusses the three levels of smoking cessation. These levels are (1) Patient, (2) Systems and (3) Public Health. Health care providers and those who promote smoking cessation should be working in those three levels. In the provider level, counselling and medications should be provided, and this is a known fact. However, at the systems level it is very important that smoking cessation should be embedded with all the health care providers including medical assistance, nursing staff and physician. Dr. Bierut found that there is unease in doing smoke cessation when patients…
Corey J. Langer, MD, FACP of the University of Pennsylvania discusses his concerns over the PACIFIC Trial data such as the survival data not being released and how significant PFS may not be enough. The overall survival data for the Pacific Trial was not released, which might make a big difference in the curative setting. Improving overall survival cure rate is still the standard arbiter practice changing approaches and PFS may not be enough. If additional year of therapy with durvalumab will be given, of course, with its potential toxicity, in order to get an additional year of progression-free survival,…
Laura Jean Bierut, MD of Washington University of Medicine discusses the benefits of E-Cigarettes over combustible cigarettes. First and foremost, E-cigarettes are not FDA approved devices for smoking cessation. There is insufficient evidence whether or not these are safety or potentially harmful. However, what is known is combustible cigarettes are extremely dangerous that will kill 1 in 2 smokers over their lifetime and so, it is very important that smokers should quite combustible cigarettes. In the United States, citizens are doing the experiment with electronic cigarettes and they are using it. People are using e-cigs in order to quit smoking.…
Corey J. Langer, MD, FACP of the University of Pennsylvania talks about the FLAURA Trial Results and the 8-9 Month PFS in Treatment Naive EGFR patients. Based on the FLAURA Trial, Osimertinib is a game changer. The 8-9 months PFS is almost doubled. There is also equal or less toxicity with osimertinib, which means less rash, probably less diarrhea and less stomatitis compared to standard front-line EGFR TKIs and in this case, osimertinib versus either gefitinib or erlotinib. Theres an unexpected bonus as part of the presentation at ESMO in 2017 and more recently at World Lung in Yokohama. There…
Laura Jean Bierut, MD of Washington University of Medicine talks about E-Cigarettes and how they may be the greatest public health benefit this century. There are two sides of the e-cigarette controversy. The first one is on the positive side of this device, as the greatest public health benefit if people will quit combustible cigarettes and switch to electronic cigarettes. With the shift, there is a big possibility that this will improve peoples health. The flip side is, its not recommendable that kids will start using e-cigs and there is a great possibility that those who use electronic cigarettes as…
Corey J. Langer, MD, FACP of the University of Pennsylvania discusses how in EGFR Activating Mutations, Osimertinib is now the Standard of Care. FDA is often behind clinical practice. In this case, the NCCN has already cited the important role of osimertinib based on the FLAURA trial, first sign treatment in all EGFR activating mutations. Since the end of 2017, osimertinib is now the standard of care in the front-line therapy of non-small-cell patients with activating EGFR mutation. What to use in the second line is a bit of a dilemma. This will be based increasingly on tissue and plasma…
Laura Jean Bierut, MD of Washington University of Medicine discusses the two main nicotine responders genetic variations and metabolic enzymes. Smoking is pharmacogenetics. This means that, when they are smoking they are titrating the amount of nicotine that they are getting in their blood and in their brain. Hence, there are different responses to nicotine. Two main drivers for nicotine responses genetic variation in the nicotinic receptors and genetic variation in the enzymes that metabolize nicotine. Drivers vary from patient to patient. So, some people can quit smoking so easily and others really struggle with smoking cessation. So, it is…
Corey J. Langer, MD, FACP of the University of Pennsylvania talks about 2018 NSCLC trends in prognosticate refinement and the “tsunami” of trials assessing combinations of drugs. There are two general trends for non-small cell for 2018 and beyond. There will be refinements to predict and to prognosticate. Select patients are optimally treated with single-agent immunotherapy up front, in this case, only 50% or higher expression correlates to a clear survival advantage for pembrolizumab over standard platinum-based chemotherapy. Overtime, more markers tend to emerge and tumor mutation burden is one of them. In fact, it will eventually tramp PD-L1 testing…
Laura Jean Bierut, MD of Washington University of Medicine discusses 400,000 vs 60,000 fatalities per year lung cancer vs opioid crisis. Currently, there is an opioid epidemic with over 60,000 people dying every year because of overdoses. This is over the news and there are questions like, What to do about it? However, compared to the tobacco epidemic, this is much smaller. Tobacco epidemic caused over 400,000 people dying every year, primarily from cigarette smoking. In this light, although the opioid crisis is alarming, its also very important to keep in mind the tobacco epidemic that is still happening until…
Tracey L. Evans, MD of the University of Pennsylvania describes what determines using osimertinib in first line treatment. Dr. Evans had two patients newly diagnosed after the FLAURA results came and both of them were given osimertinib in first line. One of them was given afatinib at first, but had toxicity, which justified immediate shift to osimertinib. And, because the FLAURA data is very impressive, she is convinced to use osimertinib in the first line. However, its still not FDA approved. So, for those patients who are already on the earlier generation of the EGFR TKI, like the erlotinib or…
Lyudmila Bazhenova, MD of the University of California, San Diego discusses osimertinib & small cell transformation. There is a very important discovery in the recent years about the fact that patients who have progressed from prior EGFR TKI can transform into small cell. If the patient, at the time of diagnosis of lung cancer, has deficiencies in P53 and RB1, they are 43 times more likely to develop small-cell transformation upon progression. Hence, biopsy should be done for these patients. This is in order to exclude the small cell transformations. Patients with this kind of transformation should be given small-cell…
Tracey L. Evans, MD of the University of Pennsylvania discusses T790 mutation testing on initial diagnosis. Testing T790M before the first-line is essential and the more you look, the more you will find cells with T790M mutations in EGFR mutated lung cancer patients. This maybe important if youre going with the first or second generation EGFR TKI that doesnt have activity in the T790M setting. However, if osimertinib will be used in the first-line setting, as justified by the FLAURA data, then the testing will not be that essential since osimertinib targets those patients.
Lyudmila Bazhenova, MD of the University of California, San Diego discusses management of EGFR-resistant disease and T790M mutations. Management of patients with EGFR mutant lung cancer who has progressed on EGFR TKI. The most important thing to understand is, upon progression, you need to find if the patient has T790 M resistant mutation. If the patient has a T790M resistant mutation, the data favors very strongly with the use of osimertinib, which is a third generation EGFR TKI. Based on a randomized trial, AURA 3, osimertinib has shown improvement in both the response rate and PFS over platinum-based chemotherapy.
Laura Jean Bierut, MD of Washington University of Medicine talks about when to focus on smoking cessation. There are two most important messages that health care practitioners should give to patients and health care providers who help promote smoking cessation. One is, Counselling works, even brief counselling, less than a minute. Medications work. Both are best. The other one is, Its never too late to quit smoking. One of the most important things you could do to your health is to quit smoking. These two messages are very impactful and helpful to everyone.
Tracey L. Evans, MD of the University of Pennsylvania discusses incomplete resections in NSCLC. What to do with incomplete resection, when resection has been attempted but has not been an R0 resection? This only means two things, either the margins are positive or the disease is still left behind. For these patients, a re-resection should be done if its feasible. If not, then a specific radiation should be taken in order to address the disease that has been left behind. If not, then patients can get chemotherapy, depending on the stage of the disease that was left behind. If the…
Lyudmila Bazhenova, MD of the University of California, San Diego discusses the FLAURA study and improvement in PFS over standard first-line chemo. The FLAURA study compared osimertinib with the standard EGFR TKI, either gefitinib or erlotinib on newly diagnosed EGFR mutant lung cancer patients. Results showed improvement in PFS over standard first-line chemotherapy. Which is more effective, starting with osimertinib or starting with first-line EGFR TKI and then switch to osimertinib upon progression? For newly diagnosed patients, Dr. Bazhenova recommends osimertinib to be used right away. This is because looking at the post-progression of EGFR TKI, only 60% of the…
Tracey L. Evans, MD of the University of Pennsylvania discusses the impact of immunotherapy in thoracic oncology. Immunotherapy data is one of the most important data that has come out for thoracic oncology. The data showed that in the second line setting, checkpoint inhibitors can improve overall survival more than chemotherapy. In the first-line setting, data showed pembrolizumab in patients that have high PD-L1 level or pembrolizumab and immunotherapy that is well tolerated actually improved outcomes for both overall survival and PFS, relative to platinum-based chemotherapy. Recently, data showed that for patients with lower PD-L1 level expression, the addition of…
Lyudmila Bazhenova, MD of the University of California, San Diego discusses T790M mutation and the role of osimertinib in the first line treatment of NSCLC. T790M mutation testing happens automatically when EGFR mutation testing is done. In EGFR mutation testing, the whole EGFR gene in exon 18, 20, 21 is usually get in sequence. So, if the patient has T790M found at the time of diagnosis and not as a resistance mechanism, this can be found with the typical EGFR sequencing. It is important to remember that, osimertinib is not just a T790M drug, but it has significant activity against…
Tracey L. Evans, MD of the University of Pennsylvania describes why Osimertinib is such an important breakthrough in EGFR mutated NSCLC. Osimertinib is a big breakthrough in the treatment of EGFR mutated non-small cell lung cancer. It was initially approved because of its efficacy in patients who developed resistance mutations to first and second generation EGFR TKIs, those were the patients who developed T790M mutation. However, recently the FLAURA study showed an improvement of the PFS for patients who started with osimertinib as opposed to erlotinib or gefitinib. In addition, osimertinib has less wild type activity on EGFR. So, it…
Lyudmila Bazhenova, MD of the University of California, San Diego discusses Metastatic EGFR mutation + Osimertinib in NSCLC first line, second line, third line setting. Dr. Bazhenova chooses osimertinib first line for patients who were just newly diagnosed with EGFR mutant Stage 4 non-small cell lung cancer. However, since osimertinib in the first line setting is not yet FDA approved, using osimertinib still depends on the insurance company. Though its already in the NCCN guidelines, but if the insurance company doesnt approve osimertinib, then the first generation EGFR TKIs of their choice will be given and biopsy upon progression. In…
Dr. Jack West reviews provocative biomarker results on the IMpower150 trial that tested atezolizumab with carboplatin/paclitaxel +/- bevacizumab & revealed strongest benefit of atezo in those with T effector gene signature high expression or high PD-L1.
Patient reported symptom burden and peripheral blood counts among PV patients.
Elderly cancer patients tend to have more complex conditions, and therefore require a strong support system to assist their needs and queries. Speaking from the UK Oncology Nursing Society (UKONS) Annual Conference 2017, held in Harrogate, UK, Antonia Lannie, PhD, from the School of Nursing & Midwifery, University of Dundee, Dundee, UK, discusses the importance of the nurse in this support system, highlighting their infleunce in accurately reflecting the patients feelings to the multidisciplinary team and understanding them as an individual.
With age being the biggest risk factor for cancer, and an ageing population in the UK, the NHS is having to treat an increasing number of elderly cancer patients who are living for longer. In this interview, Antonia Lannie, PhD, from the School of Nursing & Midwifery at the University of Dundee, Dundee, UK, gives an overview of the contributors to a more complex pathology in these patients, and discusses what constitutes good patient care in these contexts. This interview was recorded at the UK Oncology Nursing Society (UKONS) Annual Conference 2017, held in Harrogate, UK.
The American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, presented cutting-edge updates in hematology. Discover the top picks of this years meeting with Keith Stewart, MD, ChB, of the Mayo Clinic, Scottsdale, AZ. Dr Stewart highlights Phase III trials, antibody-drug conjugates and CAR T-cells, emphasizing key data showing the promise of particular therapies. He also discusses where he forsees CAR T-cell therapy moving in the next year.
In this exciting interview, Claire Harrison, MD, DM, FRCP, FRCPath, of Guy’s and St Thomas’ NHS Foundation Trust, London, UK, discusses the data on myeloproliferative neoplasms (MPNs) from the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA. For essential thrombocythemia (ET) and polycythemia vera (PV), Prof. Harrison highlights recent interferon study data and nutlin antagonists as a novel therapy. For myelofibrosis (MF), she discusses the promising update on fedratinib from the meeting, as well as activin receptor ligand traps and the SMAC mimetic LCL161. She emphasizes the need to dissect the molecular events of transformation…
The primary thrombocythemia (PT)-1 trial (NCT00175838) comprises a series of three studies, which have been running since 1997 and include very large cohorts. PT, also known as essential thrombocythemia (ET), is a chronic disease, so long-term studies like this are essential. Speaking from American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, Claire Harrison, MD, DM, FRCP, FRCPath, of Guy’s and St Thomas’ NHS Foundation Trust, London, UK, discusses the results of one of the arms of the study, which was presented at the meeting. This arm explored the pre-emptive addition of hydroxycarbamide (hydroxyurea) to aspirin…
There was a long period of time without new acute myeloid leukemia (AML) treatments, but now there are a number of promising therapies on the horizon. Speaking from the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, Charles Craddock, CBE, FRCP (UK), FRCPath, DPhil, of the University of Birmingham, Birmingham, UK, discusses the novel AML therapies presented at the meeting. Prof. Craddock highlights the promising clinical data for CPX-351, a liposomal mixture of cytarabine and danorubicin. He also emphasizes data for IDH-1/2 inhibitors, translational studies investigating the clonal structure of patients in complete remission and…
This is an incredibly exciting time for multiple myeloma (MM) research. In this video, some of the most interesting topics presented at the Myeloma 2017 meeting in Edinburgh, UK, are discussed by Daniel Auclair, Senior Vice President of Research, MMRF, Irene Ghobrial, MD from the Dana-Farber Cancer Institute, Boston, MA, Jonathan Keats, PhD of the Translational Genomics Research Institute, Phoenix, AZ, Nina Shah, MD of UCSF Medical Center, San Francisco, CA and Larry Boise, PhD from Emory University School of Medicine, Atlanta, GA. The developing reality of liquid biopsies, emerging novel subtypes of MM, ground-breaking advances in immunotherapies and exciting…
Dr. Jack West reviews the preliminary clinical results on the IMpower150 trial that tested the value of adding the immune checkpoint inhibitor atezolizumab to carbo/paclitaxel/bevacizumab in patients with chemo-naïve advanced non-squamous NSCLC.
The University of Birmingham has partnered with Leuka, NHS Blood and Transplant, and Anthony Nolan to deliver the UKs first large-scale clinical trials programme for patients who receive stem cell transplants; IMPACT. In this interview, Charles Craddock, CBE, FRCP (UK), FRCPath, DPhil, of the University of Birmingham, Birmingham, UK, discusses the aims of IMPACT, highlighting the huge unmet need it will fill, as well as the potential insights into the biological mechanisms of transplant it could provide. Prof. Craddock also provides an overview of the structure of IMPACT, including the first three studies that are taking place as part of…
Understanding the biology of human disease is of the utmost importance to advancing treatment. We are now making excellent headway in the bench-to-bedside translation of knowledge in acute myeloid leukemia (AML), as discussed here by Charles Craddock, CBE, FRCP (UK), FRCPath, DPhil, of the University of Birmingham, Birmingham, UK. Speaking from the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, Prof. Craddock discusses these breakthroughs.
Relapse remains the main obstacle for patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) after allogeneic stem cell transplantation and novel therapeutic strategies are urgently required. Now, researchers are pioneering the concept of delivering pharmacological agents, such as azacitadine, post-transplant to reduce the risk of relapse. However, better delivery methods are needed. Speaking from the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, Charles Craddock, CBE, FRCP (UK), FRCPath, DPhil, of the University of Birmingham, Birmingham, UK, discusses the data presented at the meeting from a Phase I/II trial (NCT01835587) of oral azacitadine,…
For high-risk acute myeloid leukemia (AML), azacitidine monotherapy is typically utilized. However, there is a low overall response rate and relapse typically follows. In this interview, Charles Craddock, CBE, FRCP (UK), FRCPath, DPhil, of the University of Birmingham, Birmingham, UK, discusses the promising results of the Phase I/II ROMAZA study (ISRCTN69211255), which combines azacitadine with the histone deacetylase inhibitor romidepsin. Prof. Craddocks highlights the scalability of the results of this study moving forwards. This video was recorded at the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA.
The outcome for patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) after allogeneic stem cell transplantation remains poor. In this interview, Charles Craddock, CBE, FRCP (UK), FRCPath, DPhil, of the University of Birmingham, Birmingham, UK, discusses the Phase I/II VIOLA study (ISRCTN98163167), which is combining azacitidine and hide dose lenalidomide. Prof. Craddock explains the biological mechanisms underlying the anticipated effects of this combination therapy, and how this new salvage treatment could fill an unmet clinical need. This video was recorded at the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA
Dr. Susanne Osanto discusses the use of chemotherapy plus androgen deprivation therapy (ADT) for newly diagnosed men with advanced stage prostate cancer.
The Multiple Myeloma Research Foundation (MMRF) has been very active throughout 2017. Here, Daniel Auclair, PhD, of the MMRF, Norwalk, CT, discusses the exciting work of the organization that was presented at the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA. Dr Auclair discusses important findings from the CoMMpass study (NCT145429), big machine learning, validating the impact of transplant on outcomes depending upon the molecular type, and the molecular profiling protocol created. He also highlights the organization’s investments in prevention and early disease understanding.
Clinical trials and research, regardless of their degree of success, provide useful lessons that can be applied to a range of areas, including future trial design and treatment preconceptions. In this interview, Keith Stewart, MD, ChB, of the Mayo Clinic, Scottsdale, AZ, discusses important lessons learned from the successful overall survival results of the ongoing ASPIRE trial (NCT01080391). Dr Stewart highlights what the results tell us about adding a third drug to combination therapies for relapsed multiple myeloma (MM) patients and at what stage of relapse patients should be treated. This video was recorded at the American Society of Hematology…
The ongoing Phase III ASPIRE trial (NCT01080391) comparing carfilzomib, lenalidomide and dexamethasone (CRd) vs. lenalidomide and dexamethasone (Rd) in patients with relapsed multiple myeloma (MM) has been producing promising results thus far. In this interview, Keith Stewart, MD, ChB, of the Mayo Clinic, Scottsdale, AZ, discusses the updates on the trial that were presented at the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA. These included updates on progression-free survival, as well as results for overall survival that were presented for the first time.
Venetoclax is a BCL-2 inhibitor used in the treatment of chronic lymphocytic lymphoma (CLL), which works through increasing the apoptosis of CLL cells. In this interview, Constantine Tam, MD, FRACP, FRCPA, of the Peter MacCallum Cancer Centre, Melbourne, Australia, discusses studies of venetoclax combination therapies, such as the MURANO trial (NCT02005471), which is showing promising results for the treatment of relapsed CLL with venetoclax and rituximab, as well as effect of the combination of venetoclax and ibrutinib on MRD in CLL patients. This interview was recorded at the American Society of Hematology (ASH) Annual Meeting 2017, held in Atlanta, GA.
Phase I studies investigating a new monoclonal antibody that works through the inhibition of PD-1 have shown similar levels of efficacy and safety as the current PD-1 inhibitors pembrolizumab and nivolumab, as explained here by Constantine Tam, MD, FRACP, FRCPA, of the Peter MacCallum Cancer Centre, Melbourne, Australia. However, the main area of interest in this drug would be to see its efficacy when combined with a BTK inhibitor, which is currently happening in a Phase Ib study (NCT02795182). This interview was recorded at the American Society of Hematology (ASH) Annual Meeting 2017, held in Atlanta, GA.
There were many advancements presented at the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, that are directly relevant to patients. In this interview, the 2017 ASH President, Kenneth Anderson, MD, of the Dana-Farber Cancer Institute, Boston, MA, eloquently describes the two overarching themes of the meeting and, along with examples, highlights the impacts that these advances will have for the treatment of hematological malignancies.
The scientific advances reported at the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, were extraordinary. This years meeting saw first-time attempts at integrating multiple levels of biological data analysis, including genomics, epigenetics and immunological profiling, which were exciting from both a biological and clinical standpoint. Speaking from the meeting, Kenneth Anderson, MD, of the Dana-Farber Cancer Institute, Boston, MA, and 2017 ASH President, gives his top picks of the most exciting areas of hemonc to look out for over the coming year.
The American Society of Hematology (ASH) Annual Meeting and Exposition has become the go-to place for hematology updates for scientists, clinicians, those in the industry and other stakeholders. As described by this years ASH President, Kenneth Anderson, MD, of the Dana-Farber Cancer Institute, Boston, MA, the meeting is known to be a place where highly anticipated information is always presented, including novel drug approvals and clinical updates. Dr Anderson describes the major topical updates at the meeting this year, as well as the last 2 years. This years meeting presents 20 novel approved agents spanning different therapy types, which are…
This years American Society of Hematology (ASH) 2017 Annual Meeting and Exposition in Atlanta, GA, presented major advances in hematology, with >6,000 abstracts submitted. In this video, Kenneth Anderson, MD, of the Dana-Farber Cancer Institute, Boston, MA, this years ASH President, discusses the highlights of the meeting. Dr Anderson emphasizes the number of approved novel treatments and paradigm-changing agents, including those presented in late-breaking abstracts. He also draws attention to the focus on CAR T-cell therapy at the meeting this year, with this therapy now being investigated for many types of leukemia and lymphoma, as well as multiple myeloma, with…
The American Society of Hematology (ASH) 2017 Annual Meeting and Exposition, held in Atlanta, GA, showcased the most cutting-edge data in the field of hematology by research groups from all over the world. Speaking from the conference, Anas Younes, MD, of Memorial Sloan Kettering Cancer Center, New York City, NY, gives an overview of the most anticipated data to be presented. These include details of the ECHELON-1 trial (NCT01712490), the efficacy of acalabrutinib in relapsed mantle cell lymphoma, follow up data on the LyMa trial (NCT00921414), and an evaluation of current PET scanning practices.
Athough new molecules have advanced the treatment of Hodgkin lymphoma considerably in recent years, research is still ongoing to achieve the best possible outcomes for patients. Speaking from the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition, held in Atlanta, GA, Anas Younes, MD, of Memorial Sloan Kettering Cancer Center, New York City, NY, discusses the key treatments for Hodgkin lymphoma currently, including pembrolizumab, nivolumab and brentuximab.
Although the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition, held in Atlanta, GA, may not have had as much coverage of multiple myeloma (MM) as in previous years, there has still been a lot of progress made in the field, as explained here by Bruno Paiva, PhD, from the University of Navarra, Pamplona, Spain. He touches upon some of the biggest updates in MM, including anti-BCMA CAR T-cell therapy, and the potential addition of daratumamab to VMP as the standard of care for patients with newly diagnosed MM (ALCYONE trial; NCT02195479).
The monitoring of minimal residual disease (MRD) is important in predicting relapse and giving a more sensitive measurement to clinicians as to whether a cancer has been fully eradicated. In this interview, from the American Society of Hematology (ASH) 2017 Annual Meeting and Exposition, held in Atlanta, GA, Bruno Paiva, PhD, of the University of Navarra, Pamplona, Spain, describes the recent Phase III GEM2012MENOS65 trial (NCT01916252), where MRD monitoring was performed using next generation flow (NGF) in newly diagnosed multiple myeloma (MM) patients after VRD and high dose chemotherapy. Dr Paiva also discusses the clinical questions arising from the results…