Welcome to The Myeloma Sessions brought to you by the Video Journal of Hematological Oncology (VJHemOnc). This exclusive session features roundtable discussions from the 19th International Myeloma Society (IMS) Annual Meeting held in Los Angeles, CA, with leading experts in the field. Our experts discuss several topics, including the identification and management of high-risk multiple myeloma and the optimal management of intermediate-fit and frail patients, the evolving role of MRD in multiple myeloma, as well as the role of super-enhancers in this disease.
Identifying high-risk multiple myeloma & improving treatment strategies in this patient population
In this discussion, Heinz Ludwig, MD, Wilhelminen Cancer Research Institute, Wilhelminenspital, Vienna, Austria, and Meral Beksac, MD, Ankara University, Ankara, Turkey, explore the different parameters that can be used to define high-risk multiple myeloma, including genetic, clinical, and biological features, and discuss optimal treatment strategies for this patient population, commenting on the possibility of incorporating bispecific antibodies and CAR-T therapy in the treatment regimen of patients with high-risk disease, and briefly discussing the prognostic value of sustained measurable residual disease (MRD) negativity in these patients.
Management of high-risk and frail patients, MRD & teclistamab
In this discussion, Charlotte Pawlyn, BA, MBBChir, MRCP, PhD, FRCPath, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK, and Rakesh Popat, MD, PhD, University College London Hospitals NHS Foundation Trust, London, UK, comment on the identification and management of patients with newly diagnosed high-risk multiple myeloma, highlighting data from various UK clinical trials. Dr Pawlyn and Dr Popat then discuss the prognostic value of MRD, debating the different techniques and thresholds currently used in clinical practice. Finally, Dr Pawlyn and Dr Popat talk on the optimal management of frail patients with multiple myeloma and comment on the recent approval of teclistamab by the European Comission, questioning how to best deliver this agent.
The evolving role of MRD in multiple myeloma
In this discussion, Bruno Paiva, PhD, University of Navarra, Pamplona, Spain, and Ola Landgren, MD, PhD, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, delve into the role of MRD in multiple myeloma, commenting on a wide range of topics, including MRD assessment techniques in the US and in Europe, and the prognostic value of MRD negativity and sustained MRD negativity in newly diagnosed and relapsed/refractory (R/R) patients, as well as in patients treated with CAR-T therapy. The experts also share their perspectives on MRD-tailored treatment in the context of transplantation and novel therapies.
Optimal management of intermediate-fit and frail elderly patients & refining frailty indexes
In this discussion, Claudia Stege, MD, and Sonja Zweegman, MD, PhD, Amsterdam UMC, Amsterdam, Netherlands, comment on the management of intermediate-fit and frail elderly patients with multiple myeloma, outlining current and emerging therapeutic strategies, and comparing frailty indexes (FIs) including the simplified frailty score and the IMWG frailty score.
The role of super-enhancers in multiple myeloma & mechanisms of resistance to IMiDs and T cell-directed therapies
In this discussion, Leif Bergsagel, MD, and Marta Chesi, PhD, Mayo Clinic, Phoenix, AZ, comment on the important role of super-enhancers in multiple myeloma, highlighting the potential of targeting those elements to treat this disease. In addition, Prof. Bergsagel and Dr Chesi discuss the mechanisms of resistance to IMiDs and T cell-directed therapies, talking on the use of animal models to better understand and overcome these mechanisms.
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