Dr. Landgren on the Standard of Care in Multiple Myeloma
Ola Landgren, MD, PhD
Published Online: Monday, April 29, 2013
Ola Landgren, MD, PhD, Head, Multiple Myeloma Section, National Cancer Institute, discusses the standard of care for patients with multiple myeloma.
The standard of care in the U.S., Landgren says, includes a combination of two to three drugs administered in four cycles. Then, stem cells are collected and delivered with high-dose melphalan. Landgren says some patients are wondering if a transplant is needed, which is being examined in clinical trials.
New drugs take patients into a deeper response than ever before, Landren says. However, older patients are not candidates for procedures that include transplants, as they cannot handle the toxicities. The standard of care in this population is two to three drug cycles repeated over time followed by a more chronic treatment approach.
An improved assay for assessing MRD status in patients with multiple myeloma is contributing to the momentum for using MRD as a surrogate endpoint for survival in clinical trials and as a tool with the potential to help guide therapy choices.
With the arrival and incorporation into clinical practice of immunomodulatory drugs (IMiDs) and proteasome inhibitor therapy, patients with multiple myeloma are achieving deep, durable responses and disease control, and are living longer.