High-risk myeloma has been historically defined by patients who do not do well with early treatments, have early relapses or even die from the disease. But that definition has always been quite heterogeneous, you know, sometimes related to disease burden, other times, you know, some clinical features such as circulating tumor cells or extramedullary disease. And then you’ve got a host of biologic features that we can detect by doing cytogenetics or FISH analysis...
High-risk myeloma has been historically defined by patients who do not do well with early treatments, have early relapses or even die from the disease. But that definition has always been quite heterogeneous, you know, sometimes related to disease burden, other times, you know, some clinical features such as circulating tumor cells or extramedullary disease. And then you’ve got a host of biologic features that we can detect by doing cytogenetics or FISH analysis. So, we are now moving into an age where we have genomic tools and can understand that disease biology better. However, there hasn’t been a dedicated meeting just focused on high-risk disease. And we know that as therapeutics and myeloma get better, that definition will change. We’d be able to overcome that high-risk prognostic or poor prognostic implication from that biologic marker with some of the therapies that we currently have in our pipeline. So we’re trying to develop those recipes. So this workshop is kind of a nidus for that. It’s a platform where all of us come and talk about these nuances, both on the basic science side, translational science side, and also figure out what would be the best way of, you know, doing the clinical trials that will make an impact for these patients. And so, you know, this year, you know, it’s been an outstanding meeting. There has been a lot of genomic and microenvironment focus. We are learning more and more about this. I think, you know, in the second day session, the discussions have been more around how do we rationally design clinical trials for high-risk patients: is it all high-risk patients that we should be focused on, or certain subsets that we consider high-risk right now, and also, you know, what will be the future definition of high-risk? So I think, you know, this again generates a lot of enthusiasm amongst the participants, and you know, many good ideas have already come out, so we’re really looking forward to working on those ideas and coming back next year and sharing with the rest of the group.
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