Multiple Myeloma

Patients with multiple myeloma who underwent autologous stem cell transplantation may have a continued response to the treatment even after the traditional disease assessment at 100 days. A new study indicates that this continued response maintained prognostic value and should be taken into account when considering post-transplant therapies.

Researchers in London have identified a number of new genetic variants that are linked to myeloma, and one specifically linked to a telomerase RNA component gene called TERC, that helps to control the aging process by acting as a cell’s internal clock.

Early treatment with lenalidomide and dexamethasone in patients with high-risk smoldering myeloma significantly delayed progression to symptomatic disease and prolonged survival with a good safety profile.

Older multiple myeloma patients exposed to novel agents prior to autologous peripheral blood stem cell transplantation were at increased risk for engraftment syndrome.

The International Myeloma Working Group recently released new recommendations to aid physicians in the treatment of bone disease related to multiple myeloma.

Results from a first-in-human trial of daratumumab indicate that the investigational drug reduced paraprotein and bone marrow plasma cells at doses greater than 4 mg/kg in patients with advanced multiple myeloma.

Pomalidomide in combination with low-dose dexamethasone had a highly significant benefit on progression-free survival and overall survival compared with single-agent high-dose dexamethasone in patients with relapsed or refractory multiple myeloma, according to updated results of the MM-03 trial presented at the ASCO 2013 Annual Meeting.

Multiparameter flow cytometry and deep sequencing were both able to accurately identify patients with multiple myeloma who were negative for minimal residual disease, a factor that was found to better predict prolonged survival compared with complete response as measured by traditional response criteria.

Multiple myeloma patients are at increased risk of developing myelodysplastic syndrome or acute leukemia after maintenance lenalidomide or thalidomide treatment, according to a new study.

A majority of patients with multiple myeloma are being treated with novel agents such as thalidomide, bortezomib, and lenalidomide within a year of diagnosis instead of the chemotherapeutic regimens that were more prevalent a decade ago, according to a new study.

An ongoing phase III study comparing the efficacy and safety of perifosine in patients with relapsed or relapsed/refractory multiple myeloma has been discontinued.

African American men with multiple myeloma had a significantly lower frequency of IgH translocations, a signal of nonhyperdiploid multiple myeloma, compared with European American men, according to the results of a new study published in Blood.

The FDA has approved pomalidomide (Pomalyst) to treat patients with relapsed or refractory multiple myeloma who have received at least two prior therapies.

In this interview we discuss the current management and latest treatments and agents in development for multiple myeloma with Dr. Kenneth Anderson of the Dana-Farber Cancer Institute.

Last week the US Food and Drug Administration approved carfilzomib (Kyprolis) to treat patients with multiple myeloma who have received at least two prior therapies, including treatment with bortezomib (Velcade) and an immunomodulatory therapy.

Three studies published this week show that lenalidomide improves progression-free and overall survival as a maintenance therapy in multiple myeloma, despite its link to other primary cancers.

The rational development of novel targeted therapies is expanding treatment options for patients with relapsed/refractory (R/R) multiple myeloma (MM). The first-in-class proteasome inhibitor (PI) bortezomib (Velcade), the immunomodulatory agents thalidomide (Thalomid) and lenalidomide (Revlimid), and liposomal doxorubicin are currently the major approved therapeutic agents in this setting.[1]

Multiple myeloma (MM) is a malignant, progressive plasma cell tumor characterized by overproduction of monoclonal immunoglobulins, osteolytic bone lesions, renal disease, and immunodeficiency.[1] Before the 1980s, patients with MM experienced a slow, progressive decline in quality of life until death approximately 2 years after diagnosis.

Observation is the standard of care. However, clinical trials are ongoing to determine whether early therapy with newer agents can prolong the time to progression-and most importantly, prolong survival.

In this issue of ONCOLOGY, Dr. Robert Kyle and colleagues provide their clinical and epidemiological perspective on monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM)-a perspective that is based on more than three decades of experience.

Monoclonal gammopathy of undetermined significance (MGUS) is the most prevalent of the plasma cell dyscrasias and is characterized by a low level of production of serum monoclonal (M) protein (classically less than 3 g/dL).

The availability of a wide variety of treatments for multiple myeloma allows healthcare providers to tailor treatments to individual patient needs, and has enabled prolonged survival of patients with the disease.

Multiple myeloma (myeloma) is a highly treatable disease, but it remains incurable in the majority of cases. It is a heterogeneous disease with variability in its clinical presentation, treatment options, and prognosis.

Experimental drugs from ImmunoGen, Seattle Genetics, and S*BIO advance therapeutic options in multiple myeloma, anaplastic large-cell lymphoma, and relapsed lymphoma.

Clinical outcomes data for all of oncology include those from trial after trial demonstrating poor outcomes in older patients with cancer. Whether these are the result of limited biologic reserve, poor performance status, or inherently worse biological disease at the time of diagnosis, such age-based disparities have continued unabated for decades. However, for the first time, older patients with multiple myeloma (MM) are starting to enjoy the kinds of remission durations and overall survival (OS) seen in younger patients. In this review by Dr. Harousseau, we see that through the use of regimens such as MPV (melphalan and prednisone plus bortezomib), MPT (melphalan and prednisone plus thalidomide), MPR (melphalan and prednisone plus lenalidomide), VMPT (bortezomib, melphalan, prednisone, and thalidomide), and Rd (lenalidomide and low-dose dexamethasone), we can begin to provide older patients with MM with a median OS approaching the 4- to 5-year mark-a far cry from the median OS of 2.5 to 3 years seen with MP just 15 years ago. So what are the remaining hurdles and challenges to be addressed in the upcoming 10 years?