Up-Front Management of Multiple Myeloma

The management of multiple myeloma (MM) has undergone rapid change with the recent emergence of several effective novel agents that have added complexity to individualized treatment decision-making. This paper reviews the initial management of 276 patients with MM diagnosed and treated by 43 US-based community oncologists since January 1, 2008. The case survey data obtained are evaluated within the broad context of published findings from major phase III randomized trials and as such reveal potential education gaps and implications for oncology CME. Overall, the results reveal that most patients were symptomatic at diagnosis and were risk-stratified by fluorescene in situ hybridization (FISH) and/or cytogenetics. When analyzed by age, the overall symptomatology and biomarker-defined risk profiles appeared similar in the three age groups studied (<65, 65-74, ≥75 years). Moreover, the short-term clinical benefits and toxicity associated with the induction regimens described did not vary by age group, and the physician-reported response rates broadly corresponded to those documented in the literature for the respective treatments employed. The findings also illustrate that both proteasome inhibitors and immunomomodulataory agents are widely utilized for patients who are and are not eligible for transplant, suggesting that the rapid development of newer management strategies in MM is being effectively translated into community-based patient care.

As described in the introduction to this supplement to ONCOLOGY, this article highlights findings obtained from a cross-sectional case survey (CCS) consisting of 276 patients newly diagnosed and treated for multiple myeloma (MM) since January 1, 2008, from the practices of 43 community-based medical oncologists. The results are discussed in the context of broadly accepted MM management guidelines and recent findings from major clinical trials.

Multiple Myeloma: Top-Line Findings from the CCS

TABLE 1

Cross-Sectional Case Survey: How Symptomatic (Disease-Related) Was This Patient at the Time Treatment Was Initiated?

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