Program Director Dr. Brian Durie has just introduced tonight’s panel: Dr. Mario Boccadoro from Italy, Dr. Philippe Moreau from France, Dr. Robert Orlowski with M.D. Anderson Cancer Centers and Dr. Vincent Rajkumar from Mayo Clinic.
400+ docs, researchers, drug reps, oncology nurses and a few of us patients, fill the room.
The presentations have begun. A bit dry. Dr. Rajkumar from Mayo opens the meeting by discussing how to deal with patients in the grey areas in a pre-myeloma state–MGUS or smoldering. One major point I found significant: Dr. Rajkumar feels it doesn’t really matter which novel therapy agent (Thalomid, Revlimid, Velcade), along with dex, a newly diagnosed patient uses at the start of their treatment. No, he feels the real difference maker with newly diagnosed patients is timing–when the treatment starts. He feels strongly that the most important and difficult decision a patient and their oncologist needs to make is when to start treatment–and that serious mistakes are sometimes made–either by treating the smoldering patient too soon, or delaying treatment in a patient who is transitioning to actual myeloma too late.
Next up, the European docs are giving us a different perspective on myeloma therapies. Why? The French and Italians are more conservative and strict about how the new novel therapies are used. For example, Thalomid is not approved for maintenance therapy in France. Revlimid is just starting to be used there. Dr. Rajkumar and Dr. Orlowski are, at this minute, involved in a spirited debate with Dr. Moreau about when to transplant, if at all. No punches are being thrown! But it is clear Europeans, at least the French, transplant sooner and more often than docs at Mayo or M.D. Anderson.
Slides are starting and the lights are down. Still the discussion about transplant is continuing. French and Italians don’t use maintenance therapy after transplant very often. M.D. Anderson does.
Dr. Orlowski is speaking now. He is covering therapies for relapsed patients, and giving us a “sneak peek” into this week’s most exciting ASH data. Velcade by itself works well. Add dex, better. Combine Velcade with Doxil and it works even better. Revlimid and dex has similar positive results. Carfilzomid, it is hoped, will work even better than Velcade and with less neuropathy. The updated presentation about Carfilzomid will be made Monday morning. Dr. Orlowski’s insider look at the data (there is an embargo on releasing some data prior to actual presentation) is very exciting, he is saying. Pomalidomide is expected to yeald even better results, including a better than 55 percent good response rate in refractory, or relapsed, resistant patients. That is exciting!
Dr. Orlowski is calling Monday a “banner day” in the world of myeloma. How cool is that! Looks like most difficult part of all of this is getting these drugs fast-tracked and FDA approved. Stay tuned.
Vorinostat in combo with Revlimid and dex showing response rate of 50 percent in refractory patients in Stage One study.
Next year, anti-body therapy along with novel therapy agent combinations will be presented and looks very, very promising! How can something so dry and technical be so exciting and uplifting? Because I have multiple myeloma, of course. I’m feeling the years coming back to me–I’m literally feeling like my life expectancy is increasing by years and years as I sit here, typing and fumbling in the dark–partially because I can’t see–but more so because I am so excited I am having trouble slowing my fingers down as I listen to this hopeful, incredible news!
The presentations are over and all are filing out in a rush to beat the snow. (Yes, snow tonight in New Orleans!) I’m going to have trouble sleeping tonight…
Feel good and keep smiling! I sure am! Pat