“Now, patients who have bone marrow plasmocytosis of 60% or greater; a free light-chain ratio abnormality greater than 100; or bone lesions detected on sensitive imaging are eligible for treatment even if they do not have CRAB features. Avet-Loiseau H, Corre J, Lauwers-Cances V. Evaluation of minimal residual disease by next generation sequencing is highly predictive of progression free survival in the IFM/DFCI 2009 trial [abstract]. Elotuzumab is approved for use with lenalidomide and dexamethasone based on data from a study demonstrating superior PFS to lenalidomide/dexamethasone, whereas daratumumab is approved as a single agent. to save searches and organize your favorite content. <>/FirstChar 32/LastChar 169/Widths[278 0 0 0 0 0 0 0 0 0 0 0 278 0 278 278 556 556 556 0 556 556 0 556 556 0 278 0 0 0 0 0 0 667 0 722 0 0 611 0 0 278 0 0 0 833 722 0 667 0 722 0 0 0 0 0 0 667 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 0 500 222 833 556 556 556 0 333 500 278 556 500 722 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737]>> “The standard of care is to follow expectantly off all therapy, but patients with smoldering disease should now consider these clinical trials,” Dr. Anderson told the audience.
If you could achieve an immune response and a memory immune response in patients against their own myeloma, it is possible that the immune system could overcome these changes that multiple myeloma uses to evade therapy,” he commented. The heterogeneity of relapsed/refractory multiple myeloma (MM) and an increasing number of therapeutic options in this setting has resulted in a complex environment for treatment decisions. 3 0 obj
Blood 2015;126:Abstract 191. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) Multiple Myeloma Version 1.2011 NCCN.org The NCCN Guidelines™ are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment.
Attal M, Lauwers-Cances V, Marit G. Lenalidomide maintenance after stem-cell transplantation for multiple myeloma. Bortezomib, lenalidomide, dexamethasone vs. lenalidomide and dexamethasone in patients with previously untreated multiple myeloma without an intent for immediate autologous stem cell transplant: results of the randomized phase III SWOG S0777 [abstract], Lenalidomide maintenance after stem-cell transplantation for multiple myeloma, Lenalidomide after stem-cell transplantation for multiple myeloma, Evaluation of minimal residual disease by next generation sequencing is highly predictive of progression free survival in the IFM/DFCI 2009 trial [abstract], Carlfilzomib and dexamethasone versus bortezomib and dexamethasone for patients with relapsed or refractory multiple myeloma (ENDEAVOR): a randomized, phase 3, open-label, multicentre study.
Lancet Oncol 2016;17:27–38.
“Immune therapies are being studied in a randomized trial where a vaccine is added to lenalidomide versus lenalidomide posttransplant to determine whether the combination increases MRD and the immune response.” Additionally, Dr. Anderson said that “We now have multiple options to induce the patient's own immune response in the context of posttransplant with minimal disease. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Multiple Myeloma Version 3.2020 — March 10, 2020 Continue.
Clinical Trials: NCCN believes that the best management of any patient with cancer is in a clinical trial. Early studies are currently exploring these immune approaches. “Either gene sequencing or immunophenotypic analysis multiparametric flow can detect 1 myeloma [cell] in 1 million cells,” he noted. In the future, novel targeted therapy combined with immune therapies will improve patient outcome even further,” Dr. Anderson concluded. 2 0 obj
NCCN Guidelines Version 3.2017 Multiple Myeloma Updates UPDATES-1 Updates in Version 2.2017 of the NCCN Guidelines for Multiple Myeloma from Version 1.2017 include: MYEL-1 • Initial diagnostic workup Combined bullet for albumin and calcium testing with BUN/creatinine, electrolytes. You will find ‘patient guidelines’ for Multiple Myeloma, Waldenströms macroglobulinemia, and MDS. These NCCN Guidelines ® are currently available as Version 2.2019..
Participation in clinical trials is especially encouraged.
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