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Looking to the Future of Myeloma Care

Panelists: A. Keith Stewart, MB, ChB, Mayo Clinic; Cristina Gasparetto, MD, Duke University Medical Center; Parameswaran Hari, MD, MRCP, MS, Medical College of Wisconsin; Robert Orlowski, MD, PhD, MD Anderson Cancer Center; Noopur Suresh Raje, MD, Massachusetts General Hospital
Published: Monday, Mar 19, 2018



Transcript: 

A. Keith Stewart, MB, ChB: Well, thank you to all of the panelists. This has been an extremely informative discussion. And before we end, I’d just like to get final thought from each of you, perhaps a topic we haven’t covered or a summary of one that you would like to convey. Christina, any last thoughts?

Cristina Gasparetto, MD: Well, I think the message here at ASH is that we have to start thinking about early treatment. Of course, we need to gather more information on a clinical trial before we do that and not messaging and not saying that we need to treat the smoldering myeloma. It’s something to think about, impacting the depth of response earlier, too, which is very important.

A. Keith Stewart, MB, ChB: So, you’re quite excited about early treatment. Bob, what are you most excited about?

Robert Orlowski, MD, PhD: I think the MRD data and the increasing utility of that approach are really exciting. I hope to be able to have more utility in the future in terms of making treatment decisions on that. One quick mention that I think we should cover is the fact that there are some data at the meeting being presented about flu vaccinations, because we talked about how infections are really one of the major reasons we still lose myeloma patients. And there are some data, actually, from a colleague of yours, Noopur, now at MGH (Massachusetts General Hospital), about maybe doing 2 high-dose influenza vaccinations because the myeloma folks tend to lose their titers after just the first one. So, that could be a great benefit to a lot of people without a lot of cost and without the need for chemotherapy.

A. Keith Stewart, MB, ChB: Yes, very good point. Hari, what’s exciting to you before we leave?

Parameswaran Hari, MD, MRCP MS: I’m very excited for our patients. So, at this meeting, we have data for our patients who are nontransplant eligible with the quadruplet. For transplant-eligible patients, there are various studies that show MRD negativity. And we have a new target that is being attacked by 3 different means: the BCMA target with the BiTE antibodies, the ADC, and also the CAR T cell on the same target. So, whenever we get a new single agent that is active in myeloma, we see tremendous progress, and I think that bodes really well for our patients.

A. Keith Stewart, MB, ChB: Good summary. Noopur?

Noopur Suresh Raje, MD: I couldn’t agree more, and I think it’s so exciting not only with all of the therapies, but, as Bob has pointed out, with our diagnostics also getting better with MRD and other stuff that you’ve heard about with circulating DNA, circulating tumor cells. A lot is happening in the myeloma world.

A. Keith Stewart, MB, ChB: Just to summarize then, quadruplet therapies with an antibody, MRD negativity, BCMA as a target, and better supportive care are going to result in better outcomes for all of our patients. I’d like to thank all of you for your contributions to this discussion. On behalf of our panel, we thank you for joining us and we hope you found this Peer Exchange® discussion to be both useful and informative. Thank you.

Transcript Edited for Clarity

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Transcript: 

A. Keith Stewart, MB, ChB: Well, thank you to all of the panelists. This has been an extremely informative discussion. And before we end, I’d just like to get final thought from each of you, perhaps a topic we haven’t covered or a summary of one that you would like to convey. Christina, any last thoughts?

Cristina Gasparetto, MD: Well, I think the message here at ASH is that we have to start thinking about early treatment. Of course, we need to gather more information on a clinical trial before we do that and not messaging and not saying that we need to treat the smoldering myeloma. It’s something to think about, impacting the depth of response earlier, too, which is very important.

A. Keith Stewart, MB, ChB: So, you’re quite excited about early treatment. Bob, what are you most excited about?

Robert Orlowski, MD, PhD: I think the MRD data and the increasing utility of that approach are really exciting. I hope to be able to have more utility in the future in terms of making treatment decisions on that. One quick mention that I think we should cover is the fact that there are some data at the meeting being presented about flu vaccinations, because we talked about how infections are really one of the major reasons we still lose myeloma patients. And there are some data, actually, from a colleague of yours, Noopur, now at MGH (Massachusetts General Hospital), about maybe doing 2 high-dose influenza vaccinations because the myeloma folks tend to lose their titers after just the first one. So, that could be a great benefit to a lot of people without a lot of cost and without the need for chemotherapy.

A. Keith Stewart, MB, ChB: Yes, very good point. Hari, what’s exciting to you before we leave?

Parameswaran Hari, MD, MRCP MS: I’m very excited for our patients. So, at this meeting, we have data for our patients who are nontransplant eligible with the quadruplet. For transplant-eligible patients, there are various studies that show MRD negativity. And we have a new target that is being attacked by 3 different means: the BCMA target with the BiTE antibodies, the ADC, and also the CAR T cell on the same target. So, whenever we get a new single agent that is active in myeloma, we see tremendous progress, and I think that bodes really well for our patients.

A. Keith Stewart, MB, ChB: Good summary. Noopur?

Noopur Suresh Raje, MD: I couldn’t agree more, and I think it’s so exciting not only with all of the therapies, but, as Bob has pointed out, with our diagnostics also getting better with MRD and other stuff that you’ve heard about with circulating DNA, circulating tumor cells. A lot is happening in the myeloma world.

A. Keith Stewart, MB, ChB: Just to summarize then, quadruplet therapies with an antibody, MRD negativity, BCMA as a target, and better supportive care are going to result in better outcomes for all of our patients. I’d like to thank all of you for your contributions to this discussion. On behalf of our panel, we thank you for joining us and we hope you found this Peer Exchange® discussion to be both useful and informative. Thank you.

Transcript Edited for Clarity
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