COMy 2022 | Recent advances in newly diagnosed multiple myeloma and the importance of patient perspectives
Kwee Yong, PhD, FRCP, FRCPath, University College London, London, UK, discusses recent advances in the treatment of myeloma, as well as the importance of drawing focus on elderly, more frail patients. First, Prof. Yong discusses the standard of care (SOC) for patients who are transplant ineligible and further highlights the importance of using the best available tools to assess frailty. Following this, Prof. Yong shares some insights into the FiTNEss (Myeloma XIV) study (NCT03720041), and the promising future for newly diagnosed multiple myeloma. To conclude, Prof. Yong emphasizes the importance of getting a patient’s perspective during treatment, as this factor plays a major role in a patient’s overall experience. This interview took place at the 8th World Congress on Controversies in Multiple Myeloma (COMy) 2022, held in Paris, France.
Transcript (edited for clarity)
I think, particularly now, with all these advances in treatment for multiple myeloma, a focus should increasingly be on the elderly patient population, because we know that more than three quarters of patients are diagnosed over the age of 75.
So we were talking about standard of care regimens for patients with non-transplant-eligible newly diagnosed myeloma, and Alessandra Larocca was talking about frailty assessments...
I think, particularly now, with all these advances in treatment for multiple myeloma, a focus should increasingly be on the elderly patient population, because we know that more than three quarters of patients are diagnosed over the age of 75.
So we were talking about standard of care regimens for patients with non-transplant-eligible newly diagnosed myeloma, and Alessandra Larocca was talking about frailty assessments. So we have, now, an increasing number of tools for assessing frailty in patients. What we don’t know yet is which one is the best to use, and also how to use them optimally in order to stratify how we treat patients and to modify our treatment regimens.
So the FiTNEss study in the UK is trying to answer those sort of questions. We also have new tools for assessing frailty, for example sarcopenia, and really understanding the contribution of physical fitness to frailty. The standard of care regimens for newly diagnosed myeloma are of course outstanding today. Dara, len, dex is able to give a progression-free survival of 60 months, which I think is outstanding for those patients. So a great deal to look forward to for newly diagnosed patients who are not eligible for transplantation.
But of course the patient’s perspective is key here, really. We have to understand patient’s priorities and their goals. And the perspective is influenced not only by their understanding of the disease, but also their perception of what treatment can offer, what the side effects might be, their cultural background, their families and loved ones, and what they hear today. We hear so much on the internet and patients lay great store by stories and other people’s stories on the internet. Finally, their spirituality. That is very important for patients; obviously for some patients and not others.
But there was a good study from the King’s College Group in London, in the UK, that looked at patients’ priorities, really asking patients what matters to them. And three broad areas matter: emotional approach. Secondly, activity and participation. And thirdly, the amount of support patients get from the clinical team and from their family.
So I think, in summary, although we have great advances in treatment regimens for newly diagnosed patients, these older ones, it’s important to remember to ask patients what their priorities are, to agree mutually agreed goals for treatment, and to make sure patients understand what the treatment side effects might be, and also have a realistic expectation of disease response and what the future holds for them. Thank you.
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