Ask the Expert: Current Controversies in Myeloma Management

Ask the Expert: Current Controversies in Myeloma Management

The adverse impact of cytogenetic abnormalities on multiple myeloma (MM) patient outcome was established within the context of conventional chemotherapy and stem cell transplantation (SCT) before the advent of new treatments. However, many new treatments are highly effective and have provided improvements for patients with MM, and the potency of these drugs may compensate for adverse prognostic characteristics. Recent data and expert commentary suggest that an individualized approach to MM treatment is possible within the context of risk and the goals of therapy (cure vs control). As treatment options expand, it will be important to understand how different subgroups of patients respond to different regimens and how the nature of the response affects long-term outcomes.

In this Ask the Expert CME series, Drs. Jean-Luc Harousseau, Sagar Lonial, Paul G. Richardson, and Jesús F. San Miguel respond to your clinical questions on a range of topics relating to the clinical management of patients with MM, including assessment of risk, duration of therapy, and selection of the treatment course that will maximize the rate and durability of complete response at each stage of disease.

Release date: July 2010
Expiration date: July 31, 2011
Estimated time to complete activity: 0.25–1.0 hours

Jointly sponsored by
  Multiple Myeloma Research Foundation  Curatio CME Institute PennStae Hershey College of Medicine
Support for this activity has been provided through educational grants from Amgen, Bristol-Myers Squibb, Celgene, Centocor Ortho Biotech, Merck, and Millennium: The Takeda Oncology Company.

This CME-certified activity is based on information presented at a satellite symposium held on June 4, 2010 in Chicago, Illinois.

Hardware/Software Requirements

  •  Javascript-enabled browser
  •  Active Internet connection

Target Audience
This activity has been designed to meet the educational needs of hematologist-oncologists, medical oncologists, and other health care professionals involved in the care of patients with MM.

Learning Objectives
After completing this activity, participants should be able to:

  • Utilize the International Staging System, cytogenetics, and fluorescence in situ hybridization (FISH) to define patient prognosis and risk stratification
  • Outline a treatment plan to achieve complete response in high-risk and standard-risk myeloma patients
  • Implement evidence-based strategies to prolong the duration of response in MM patients

Faculty
Jean-Luc Harousseau, MD
Professor of Hematology
University of Nantes
Director, Cancer Center René Gauducheau
Director, Clinical Research Program
French National Cancer Institute
President, Intergroupe Francophone du Myelome
Nantes, France

Sagar Lonial, MD
Associate Professor
Department of Hematology and Medical Oncology
Director of Translational Research, B-Cell Malignancy Program
Winship Cancer Institute
Emory University
Atlanta, Georgia

Paul G. Richardson, MD
Associate Professor of Medicine
Harvard Medical School
Clinical Director, Jerome Lipper Center for Multiple Myeloma
Dana-Farber Cancer Institute
Boston, Massachusetts

Jesús F. San Miguel, MD, PhD
Head, Hematology Department
Professor of Medicine
Vice Director, Centro de Investigación del Cáncer
Hospital Universitario de Salamanca and Centro de Investigación del Cáncer
University of Salamanca
Salamanca, Spain

Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Penn State College of Medicine, Curatio CME Institute, and the Multiple Myeloma Research Foundation. Penn State College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Penn State College of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

To contact Penn State College of Medicine, the accredited provider for this activity, email ContinuingEd@hmc.psu.edu or call 717-531-6483. Please reference activity code G4173-11-T.
Method of Participation
There are no fees for participating in this CME activity. To receive credit during the period July 2010 to July 31, 2011, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, and (3) complete the presurvey, postsurvey, and activity evaluation form.

Participation should take approximately 1 hour.
Original release/approval date: July 2010
Expiration date: No credit will be given after July 31, 2011
The evaluation, posttest, and certificate can be accessed at the end of the activity. Please e-mail any questions to cmeinfo@curatiocme.com.

Medium
The Internet was selected as the instructional format to accommodate the learning preferences of a significant portion of the target audience.

Disclaimer
The information presented in this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.

Disclosure
In accordance with the ACCME Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears below:

Jean-Luc Harousseau, MD, has disclosed the following relevant financial relationships:

Advisory Board/Speaker Celgene, Janssen-Cilag

 

Dr. Harousseau discusses the unlabeled or investigational use of a commercial product.

Sagar Lonial, MD, has disclosed the following relevant financial relationships:

Consultant/Research Support Bristol-Myers Squibb, Celgene, Millennium, Novartis

Dr. Lonial discusses the unlabeled or investigational use of a commercial product.

Paul G. Richardson, MD, has disclosed the following relevant financial relationships:

Advisory Board Celgene, Millennium

Dr. Richardson discusses the unlabeled or investigational use of a commercial product.

Jesús F. San Miguel, MD, PhD, has disclosed the following relevant financial relationships:

Advisory Board Celgene, Janssen-Cilag, Millennium

Dr. San Miguel discusses the unlabeled or investigational use of a commercial product.

Curatio CME Institute
Denise C. LaTemple, PhD, President, has disclosed no relevant financial relationships.
John O’Brien, Medical Writer, has disclosed no relevant financial relationships.
Jonathan S. Simmons, ELS, Managing Editor, has disclosed no relevant financial relationships.

Multiple Myeloma Research Foundation
Anne Quinn Young, MPH, Vice President, Communications, has disclosed no relevant financial relationships.

Penn State College of Medicine
Penn State College of Medicine staff and faculty involved in the development and review of this activity have disclosed no relevant financial relationships.

Unapproved Product Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Curatio CME Institute, Penn State College of Medicine, the MMRF, Amgen, Bristol-Myers Squibb, Celgene, Centocor Ortho Biotech, Merck, and Millennium: The Takeda Oncology Company do not recommend the use of any agent outside the labeled indications.

The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Curatio CME Institute, Penn State College of Medicine, the MMRF, Amgen, Bristol-Myers Squibb, Celgene, Centocor Ortho Biotech, Merck, or Millennium: The Takeda Oncology Company. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Generic Name Trade Name Approved Use (if any) Unapproved/Investigational Use
Bortezomib Velcade Treatment of patients with MM and patients with mantle cell lymphoma who have received at least 1 prior therapy Maintenance therapy
Carfilzomib NA NA For MM
Denosumab Prolia Treatment of postmenopausal women with osteoporosis at high risk of fracture Treatment of bone disease
Elotuzumab NA NA For MM
Lenalidomide Revlimid In combination with dexamethasone in MM patients who have received at least 1 prior therapy Frontline therapy in combination with dexamethasone, melphalan/prednisone, or bortezomib; maintenance therapy
Panobinostat NA NA For MM
Thalidomide Thalomid Frontline therapy in combination with dexamethasone Relapsed, refractory myeloma; frontline in combination with melphalan/prednisone or bortezomib; maintenance therapy after autologous stem cell transplant
Vorinostat Zolinza Treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma who have progressive, persistent, or recurrent disease on or following two systemic therapies For MM

 

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