Advances in myeloma treatments, diagnostics have specialists ‘talking about cure’

A decade ago, patients with newly diagnosed multiple myeloma typically survived 3 to 5 years.

However, the development of highly effective therapies — including proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies — has greatly improved outcomes.

In addition to extending survival, these newer agents are associated with considerably less toxicity.

“We not only have this expectation that we’re going to make the overwhelming majority of [patients with myeloma] live for a really long time … but we also have the expectation that they are going to be functional for most of that time to work, to play and to enjoy being with their families,” David S. Siegel, MD, PhD, chief of the division of multiple myeloma at John Theurer Cancer Center at Hackensack University Medical Center, told HemOnc Today.

“I think most [clinicians] assume a patient who is diagnosed with myeloma today will live for a decade,” Siegel added. “That is a much different mindset.”

However, formidable challenges remain for the clinical and research communities.

Comparative data on novel agents from randomized controlled trials are lacking, leaving only results of systematic reviews or meta-analyses to guide how to sequence or combine them. Investigators also aim to improve their understanding of how minimal residual disease testing can guide patient care, as well as how cellular therapies may fit into the treatment paradigm.

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