VIDEO: How the COVID-19 pandemic has impacted multiple myeloma care

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First thing I would say is, how has COVID-19 not impacted our field? I mean, it's of course impacted every facet of our lives. And myeloma therapy is, and myeloma clinical research are, unfortunately have not been exceptions to that. I think it all depends on at what point in the pandemic we're talking about. In the immediate, the initial surge, at least in the US, I guess as I remember them now, the battle days, things were really shutting down. We temporarily, almost exclusively, almost completely, sorry, shut down our autologous stem cell transplant program for myeloma for a few months. I mean, again, these were the days where we were worried about hospitals being completely overrun and non-functional. And so that was a fairly big impact. And again, patients were not coming in, not getting their treatments, staying home with active myeloma. I mean, quite understandably, given what was happening and what we knew and what we didn't know back then. And patients were just not getting treated for their disease. And I think there was a lot of harm that probably came to a lot of patients, unfortunately, because of that. I think that it was quite understandable that all of those things happened. But again, as we move forward, we gain more knowledge and more insight about the virus and about the pandemic and about it's, how different aspects of it that are relevant to our patients. And I think one of the biggest things that came out of last year in terms of myeloma was the international data set that was put together by the IMS, led by Nikhil Munshi here and other partners internationally, that put together a, it was a 650 patient data set of multiple myeloma patients with COVID. Trying to identify correlations between different aspects of the patients, the disease, the treatments, and outcome, to include severe COVID and fatal COVID. And I think one of the most important things that came out of that data set was the identification of poorly controlled myeloma as being one of the biggest risk factors for severe and fatal COVID. Having uncontrolled myeloma essentially doubling a patient's chance of dying from COVID as opposed to being in a good remission. So I think that was kind of a watershed moment for me where I kind of stopped telling my patients, yeah, it's probably fine and maybe even ideal if you sit out the next couple of months and stay at home. And I started saying, hey, we got to figure out a way to treat your myeloma effectively that both of us are comfortable with. And I think that's the point that I kind of continue to stress whenever I can, is that I think we know confidently now that treating somebody's myeloma is an important part of protecting them from COVID. And I think that wasn't immediately apparent, and I think there may be in some cases, I'm not sure how widespread that point has been made so far. So I think that that's important. Last year, I think we really all came to value even more the availability of oral drugs for myeloma. I definitely had patients, even after the initial surge was over and when risk mitigation was really effectively put in place and I was comfortable having patients come in for every other week or weekly infusions. But patients, some patients just still weren't comfortable. And I think being able to have effective combination regimens of orally available drugs was huge in that sense. And again, I'm the last one who is gonna try to predict the future. I certainly hope COVID goes away. As we're seeing right now, it's not. And even if it does, I think one of the lessons that I think COVID has taught us is that this can happen. Hopefully it won't happen again for many, many years. But who knows? At least in the US, this is kind of the first time that most of us have had to have the responsibility of treating patients for life-threatening oncologic diseases in the setting of an overwhelming existential threat. Even if we're all back to infusional therapy and therapies that require inpatient stays or frequent visits, and even if life returns to completely normal in the next year or two, I think COVID-19 has taught us that we have to be ready for the possibility that something similar might happen again. And I think just contingency plan as best as we can. And again, have multiple good options. Some of which are infusional, some of which require brief hospitalizations, but others of which could be pills that patients could get in a month or two supply at a time. And I think it's important to kind of remember what happened last year to allow us to look at our current and future therapies maybe in a little bit of a different light moving forward.