Ask the Expert: Strategies to Maximize Response Rates and Outcomes in Multiple Myeloma

Ask the Expert: Strategies to Maximize Response Rates and Outcomes in Multiple Myeloma

The outcome for patients with multiple myeloma has dramatically changed with the use of novel therapies such as thalidomide, lenalidomide, and bortezomib. Not only have these agents improved rates of responses—in particular, complete responses—but they have also improved overall survival. The addition of these new agents to the treatment paradigm also has implications on risk; much of what is currently understood about the association of multiple myeloma and poor outcomes is derived from experience with conventional treatment modalities (ie, chemotherapy and autologous stem cell transplantation [ASCT]) and may be becoming less clinically relevant. This activity addresses key issues currently facing clinicians who manage patients with multiple myeloma and provides guidance on the application of recent clinical trial data in making individualized, patient-specific treatment decisions.

In this Ask the Expert CME series, Drs. Thierry Facon, Sergio Giralt, Paul Richardson, Keith Stewart, and Evangelos Terpos respond to your clinical questions on a range of topics relating to the clinical management of patients with multiple myeloma.

Release date: March 2011
Expiration date: March 31, 2012
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 Bristol-Myers Squibb, Celgene, Centocor Ortho Biotech, Lilly, Millennium: The Takeda Oncology Company, Novartis, and Onyx Pharmaceuticals.

This CME-certified activity is based on information presented at a satellite symposium held on December 3, 2010 in Orlando, Florida.

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 multiple myeloma.

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

  • Interpret the latest clinical trial data and incorporate current treatment advances to achieve best possible care of patients with multiple myeloma
  • Utilize cytogenetics, fluorescence in situ hybridization (FISH), and gene expression profiling to define patient prognosis and risk stratification
  • Outline a treatment plan to achieve durable complete response and extend survival in high-risk and standard-risk myeloma patients
  • Implement evidence-based strategies to prolong the duration of response in patients with multiple myeloma

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

Thierry Facon, MD
Professor of Hematology
Service des Maladies du Sang
University of Lille
Lille, France

Sergio A. Giralt, MD
Chief, Adult Bone Marrow Transplant Service
Division of Hematologic Oncology
Department of Medicine
Memorial Sloan-Kettering Cancer Center
New York, New York

Keith Stewart, MB ChB, MRCP, FRCPC, MBA
Dean for Research, Mayo Clinic in Arizona
Vasek and Anna Maria Polak Professor of Cancer Research
Consultant, Division of Hematology/Oncology
Mayo Clinic
Scottsdale, Arizona

Evangelos Terpos, MD
Assistant Professor of Hematology
Department of Clinical Therapeutics
University of Athens School of Medicine
Alexandra General Hospital
Athens, Greece

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.

For questions about CME credit for this activity, contact Penn State at ContinuingEd@hmc.psu.edu or 717-531-6483. Reference course #G4212-11-T.

Credit Designation
Penn State College of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. 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 March 2011 to March 31, 2012, 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, including the certificate information section.

Participation should take approximately 0.25–1.00 hour.
Original release/approval date: March 2011
Expiration date: No credit will be given after March 31, 2012
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.

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:

Thierry Facon, MD, has disclosed the following relevant financial relationships:

Advisory Board/Speaker Celgene, Janssen-Cilag
Advisor Bristol-Myers Squibb

Sergio A. Giralt, MD, has disclosed the following relevant financial relationships:

Advisory Board/Speaker Celgene, Genzyme, Millennium: The Takeda Oncology Company, Novartis

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

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

Advisory Board Celgene, Johnson & Johnson, Millennium: The Takeda Oncology Company, Novartis

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

Keith Stewart, MB ChB, MRCP, FRCPC, MBA, has disclosed the following relevant financial relationships:

Consultant Celgene, Millennium: The Takeda Oncology Company, Onyx

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

Evangelos Terpos, MD, PhD, has disclosed the following relevant financial relationships:

Consultant Amgen, Janssen-Cilag, Novartis
Speaker Janssen-Cilag, Novartis

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

Curatio CME Institute
Thomas Finnegan, PhD, Associate Medical Director, Curatio CME Institute, has disclosed no relevant financial relationships.
Denise C. LaTemple, PhD, President, Curatio CME Institute, 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 faculty and staff involved in the development and review of this activity have disclosed no relevant financial relationships.

Disclaimer
The information presented at 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.

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, Bristol-Myers Squibb, Celgene, Centocor Ortho Biotech, Lilly, Millennium: The Takeda Oncology Company, Novartis, and Onyx Pharmaceuticals 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, Bristol-Myers Squibb, Celgene, Centocor Ortho Biotech, Lilly, Millennium: The Takeda Oncology Company, Novartis, and Onyx Pharmaceuticals. 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 Maintenance therapy; MM bone disease
Carfilzomib NA NA Treatment of MM
Denosumab Xgeva Prevention of skelatal-related events in patients with bone metastases from solid tumors Prevention of skelatal-related events in patients with MM
Elotuzumab NA NA Treatment of MM
Everolimus Afinitor Treatment of patients with advanced renal cell carcinoma after failure of treatment with sunitinib or sorafenib Treatment of MM
Lenalidomide Revlimid Treatment of MM, in combination with dexamethasone, in patients who have received at least one prior therapy Frontline therapy; maintenance therapy; MM bone disease
Perifosine NA NA Treatment of MM
Pomalidomide NA NA Treatment of MM
Temsirolimus Torisel Treatment of advanced renal cell carcinoma Treatment of MM
Thalidomide Thalomid Treatment of patients with newly diagnosed MM in combination with dexamethasone Relapsed/refractory MM; frontline therapy in combination with melphalan-prednisone; maintenance therapy
Zoledronic acid Zometa Treatment of hypercalcemia of malignancy; patients with MM and patients with documented metastases from solid tumors, in conjunction with standard antineoplastic therapy Treatment of MM

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Curatio CME Institute collects the information provided by the user. The information is used to notify users about upcoming programs and educational information that may be of interest. The information is not shared or used for commercial purposes unless prior permission has been granted by the user.

Curatio CME Institute may collect standard Web traffic data such as time and date of visit. Curatio CME Institute uses this information to administer its Web site. Browsing activity is recorded to form aggregate and anonymous demographic information, which is used as described above. Curatio CME Institute does not sell or offer to sell any user data, including registration and billing information, to any third parties for commercial purposes. Curatio CME Institute does, when required, provide the minimum subset of information to third parties that are responsible for accreditation of and issuance of certification for CME/CE tests. By participating in the Web-based activity, the user agrees that Curatio CME Institute has full permission to provide this minimum subset of information to the third parties as required by law.

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