Ask the Expert: Evolving Therapeutic Concepts in Multiple Myeloma

The potential to improve outcomes in patients with multiple myeloma has propelled the adoption of new agents in clinical practice—even before optimal strategies for their use have been established. Randomized clinical trials are only just beginning to generate the quantity and quality of data necessary to establish evidence-based treatment recommendations. The rapidly evolving nature of multiple myeloma treatment advances, coupled with the disease’s cytogenetic heterogeneity and the ongoing need to manage comorbidities and adverse effects of therapy, magnify the challenge to clinicians of delivering patient-tailored therapy. Thus, clinicians involved in the care of patients with multiple myeloma stand to benefit from learning how to use emerging treatment data to optimize treatment strategies for patients with newly diagnosed and relapsed or refractory disease.

In this Ask the Expert CME series, Drs. Kenneth C. Anderson, Jean-Luc Harousseau, Sagar Lonial, Paul G. Richardson, and G. David Roodman respond to your clinical questions.

Release date: February 2010
Expiration date: February 28, 2011
Estimated time to complete activity: 0.25–1.0 hours

Jointly sponsored by
Multiple Myeloma Research Foundation
Support for this activity has been provided through educational grants from Bristol-Myers Squibb, Celgene, Merck, and Millennium: The Takeda Oncology Company.

This CME-certified activity is based on information presented at a satellite symposium held on December 4, 2009 in New Orleans.

Hardware/Software Requirements

Javascript-enabled browser
Active Internet connection

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

Learning Objectives
At the conclusion of this activity, participants should be able to:

List patient- and disease-specific characteristics important for selecting appropriate treatment regimens
Assess the efficacy, safety, and long-term outcome associated with the use of various induction regimens for patients with multiple myeloma who receive an autologous stem cell transplant and for those who do not
Describe the rationale for use of novel combinations and investigational novel drugs for relapsed or refractory disease
Formulate a plan to prevent or minimize the impact of skeletal-related events

Faculty
Kenneth C. Anderson, MD—Activity Chair
Kraft Family Professor of Medicine
Harvard Medical School
Chief, Division of Hematologic Neoplasia
Director, LeBow Institute for Myeloma Therapeutics
Director, Jerome Lipper Center for Multiple Myeloma
Vice Chair, Program in Transfusion Medicine
Department of Medical Oncology
Dana-Farber Cancer Institute
Boston, Massachusetts

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
Department of Medical Oncology
Dana-Farber Cancer Institute
Boston, Massachusetts

G. David Roodman, MD, PhD
Professor of Medicine
Vice Chair for Research
Department of Medicine
Director, Myeloma Program
Director, Center for Bone Biology
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania

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 Curatio CME Institute and the Multiple Myeloma Research Foundation (MMRF). Curatio CME Institute is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Curatio CME Institute designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Method of Participation
There are no fees for participating in this CME activity. To receive credit during the period February 2010 to February 28, 2011, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, (3) complete the pre- and postsurvey, and (4) complete the activity evaluation form.

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:

Kenneth C. Anderson, MD, has disclosed the following relevant financial relationships:

Consultant/Research Support

Celgene, Millennium, Novartis

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

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

Bristol-Myers Squibb, Celgene, Keryx, Millennium

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

G. David Roodman, MD, PhD, has disclosed the following relevant financial relationships:

Consultant	Acceleron, Amgen, Celgene, Millennium, Novartis
Research Support/Speaker	Novartis

Curatio CME Institute
Denise C. LaTemple, PhD, Vice President, Scientific Services, has disclosed no relevant financial relationships.
Jonathan S. Simmons, ELS, Managing Editor, has disclosed no relevant financial relationships.
Derek Warnick, CME Director, has disclosed no relevant financial relationships.

Multiple Myeloma Research Foundation
Anne Quinn Young, MPH, Vice President, Communications, has 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, MMRF, Bristol-Myers Squibb, Celgene, 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, MMRF, Bristol-Myers Squibb, Celgene, Merck, and 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
Lenalidomide	Revlimid	In combination with dexamethasone in multiple myeloma patients who have received at least 1 prior therapy	Frontline therapy in combination with dexamethasone, melphalan/prednisone, or bortezomib; maintenance therapy
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

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