VIDEO: Greater awareness of multiple myeloma ‘key step forward’ in diagnosis

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In terms of diagnosis, I think awareness of myeloma has been the key step forward, and there’s a greater awareness. Obviously, the use of serum and urine protein electrophoresis and immunofixation is the gold standard. Awareness and the use of those particular tools is important. I especially want to acknowledge some of the work done by colleagues in this precursor space. My own colleague has been on the forefront of this, Irene Ghobrial. And Irene’s shown, for example, that these so-called precursor states can be detected early and then potentially, one can intervene in a way that improves patient outcome in the longer term. And we’re really looking forward to seeing her work and others in the space mature, and hopefully show us ways forward to, as it were, head off myeloma at the pass.

I would simply say to you that there’s a lot of work to be done. I mean, there’s wonderful work done by colleagues like Maria V. Mateos and others in Europe, Irene leading the charge with others here in the United States. And I think between them they’re coming together with new ideas that will, I think, change the way we view precursor myeloma. Having said that, when you’ve got active myeloma, obviously treatment options have dramatically improved. And I want to especially acknowledge the pivotal role of quadruplet therapy. This is what I call the Army, Navy, Air Force and Marines of upfront therapy where you integrate lenalidomide, for example, bortezomib or carfilzomib, steroids and an antibody like daratumumab, or perhaps even isatuximab [Sarclisa, Sanofi Aventis], which is making a major impact in the CD38 space. And this quadruplet therapy is really proving transformative in my experience. And it is not just limited to the young transplant-eligible group, it’s really making an impact in the older, frailer patients such that this construct of transplant-eligible versus transplant-ineligible is becoming less, I think. important. Arguably, it’s becoming much more tailored to the general health of the patient, and whether or not transplant is an appropriate tool or should be kept in reserve, or whether other strategies make more sense. So, I think we’re seeing a real sea change in a sort of strategic way of viewing myeloma, where we can tackle the disease strategically as opposed to just tactically.