Imaging and Treatment Advances in Multiple Myeloma

Insight From: Noopur Raje, MD, Dana-Farber and Sagar Lonial, MD, Winship
 
Published Online: Thursday, July 10, 2014
For High-Definition, Click
There have been substantial advancements in the diagnosis and treatment of multiple myeloma over the past decade. Older diagnostic practices include obtaining a skeletal survey via x-ray imaging. While this is a useful tool, says Raje, it was only positive in about 60% to 70% of people with multiple myeloma.

Better diagnostic procedures have contributed to the improved prognosis of those with multiple myeloma. With the advent of computed tomography (CT) scans, positron emission tomography scans (PET), and magnetic resonance imaging (MRI), practitioners are beginning to move away from solely x ray imaging and incorporating innovative imaging techniques in their diagnostic workup. Raje notes that not every patient undergoes each of these imaging modalities, but adds that it is helpful to have these options available for specific circumstances, such as in patients with smoldering myeloma, plasmacytoma, macrofocal disease, or oligosecretory disease.

A skeletal survey is usually insufficient in distinguishing smoldering myeloma from multiple myeloma. Raje says more specific imaging tools, such as PET scans and MRI, are valuable in this context. In patients with a plasmacytoma, which is an isolated collection of plasma cells, a PET scan or MRI can be used to check whether a patient has other signs of disease. In macrofocal and oligosecretory diseases, it can be challenging to follow the disease course without these imaging tools. As a result, Raje comments that she would certainly use a PET scan in these patients.

Similarly, multiple myeloma treatment approaches have evolved from earlier standards of care such as VAD (vincristine, doxorubicin, dexamethasone) or thalidomide and dexamethasone-based inductions to regimens that involve triple and sometimes quadruple combinations of more advanced therapies. As a result, there has been tremendous benefit in patient outcomes, where new treatment improvements have dramatically changed the overall survival of multiple myeloma patients, according to Raje. As a result of these advances, median overall survival has increased from 2.5 years to more than 10 years in many cases, Lonial adds.

Raje and Lonial both comment that the diagnosis and treatment practices in multiple myeloma have come a long way in the past decade. Due to advances in the past 10 years, Lonial estimates that around 15-20% of patients are cured of multiple myeloma due to current standard therapies such as lenalidomide, bortezomib, dexamethasone with or without maintenance therapy, and high dose therapy with autologous stem cell transplant.
View More From This Discussion
Episode 1 Imaging and Treatment Advances in Multiple Myeloma
Episode 2 High-Risk and Smoldering Multiple Myeloma
Episode 3 Treatment Options in Newly Diagnosed Multiple Myeloma
Episode 4 Treatment Decisions in Relapsed/Refractory Myeloma
Episode 5 Pomalidomide in Refractory Multiple Myeloma
Episode 6 Pomalidomide and Carfilzomib in Multiple Myeloma
Episode 7 Maintenance Therapy for Patients With Multiple Myeloma
Episode 8 Management of Adverse Events in Multiple Myeloma
Episode 9 Emerging Agents for Multiple Myeloma

 
Online CME Activities
Free CME from PER
Highlights From the 13th Annual International Congress on the Future of Breast Cancer®
Pancreatic Cancer: Novel and Emerging Approaches to Early Detection and Treatment
OncoLogue: Breast Cancer Cases
Update From ASCO: Advances in Immunotherapy for Non–Small Cell Lung Cancer and Melanoma
The content contained in this video is for general information purposes only. The viewer is encouraged to confirm the information presented with other sources. OncLiveTV Peer Exchange makes no representations or warranties of any kind about the completeness, accuracy, timeliness, reliability, or suitability of any of the information, including content or advertisements, contained in this video and expressly disclaims liability for any errors and omissions that may be presented in this video. OncLiveTV Peer Exchange reserves the right to alter or correct any error or omission in the information it provides in this video, without any obligations. OncLiveTV Peer Exchange further disclaims any and all liability for any direct, indirect, consequential, special, exemplary, or other damages arising from the use or misuse of any material or information presented in this video. The views expressed in this video are those of the panelists and do not necessarily reflect the opinion or policy of OncLiveTV Peer Exchange.
 
More Reading
Publications
$auto_registration$