5 Questions on Multiple Myeloma

Multiple myeloma accounts for just over 15% of all hematologic malignancies in the United States and is most frequently diagnosed in patients 65 to 74 years of age (median age = 69 years). Statistics show that rates are increasing an average of 0.8% annually, with death rates falling at the same percentage, a result of recent and more effective treatment options.

Question 1:

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The correct answer is: C. Lenalidomide/dexamethasone. All of the combinations are recommended as “preferred regimens” for the treatment of patients with relapsed/refractory multiple myeloma, the NCCN notes. However, only lenalidomide/dexamethasone is category 1 (high-level evidence); the others are category 2A (lower-level evidence). The guidelines also state, “triplet regimens should be used as the standard therapy for patients with multiple myeloma; however, elderly or frail patients may be treated with doublet regimens.”

Question 2:

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The correct answer is: B. 5 years. Patients in the good-risk group have an estimated median survival of 8 to 10 years, while for those at high risk, it is less than 2 years, according to the National Cancer Institute (NCI) PDQ cancer information summary on the treatment of multiple myeloma.

Question 3:

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The correct answer is: B. 3- to 6-month. The NCCN also strongly recommends “enrolling eligible patients with smoldering myeloma in clinical trials.”

Question 4:

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The correct answer is: A. True. A large randomized trial found that monthly use of a bisphosphonate decreaseed pain and bone-related complications and preserved quality of life.

Question 5:

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The correct answer is: A. 7 months. The NCI’s PDQ cancer information summary about the treatment of multiple myeloma states, “after the introduction of chemotherapy, prognosis improved significantly with median survival of 24 to 30 months and a 10-year survival rate of 3%.” With the introduction of newer therapies, median survival now exceeds 45 to 60 months.