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IMF Support Group Leaders Summit – Dallas, Texas (Part Two)

Posted on July 29 2012 by Pat Killingsworth | 2,008 views

More notes and news from the IMF Group Leaders’ Summit in Dallas…

The IMF is ratcheting-up focus and funding to study minimal residual disease (MRD)   Most experts agree that this could be one of several keys to a “cure.”

Dr. Durie: “One more major drug class could also get us to a cure. IMiDs (thalidomide, lenalidomide, pomalidomide) and protease inhibitors (bortezomib, carfilzomib) are doing a great job, but it’s not quite enough. “Maybe one more strong, broad class of drugs might do the trick.” He added.

Better understanding high risk patients is vitally important.  Much more about this at this year’s ASH conference in Atlanta.

One explanation might be that high risk patients probably have more “clones” (different types of myeloma cells) than low risk patients.  So treatment wipes-out a most myeloma, but misses one or more types of clones.

As a patient’s treatment progresses, myeloma tends to develop more clones, making the cancer much harder to treat.  This happens in all patients, but especially high risk patients.

Researchers feel treating early–and throwing every thing they’ve got at myeloma early–has a better chance of wiping out all or most of the myeloma clones, leading to a longer remission and/or potentially a cure.

Another point of emphasis is for researchers to create a way to know sooner if a treatment will work for five or ten years without having to wait that long for study results.

What a great idea!  It takes currently takes too long to know if a new therapy works–or what the overall survival benefits are -five or ten years out.

Dexamethasone came-up often during the conference.  I had always suspected that long term use of dex negatively effects muscle strength and bone density.  Turns-out I was right!

Finding “dex-free” therapy options will be a key to improving a patient’s quality of life.

Occasionally patients that have been receiving chemotherapy over a long period of time can develop MDS or plasma cell leukemia.  If the a patient isn’t a candidate for a stem cell transplant, CyborD (Velcade, Cytoxan and dex) is very good treatment for plasma cell leukemia.

I felt that this was a great point to make with your docs who are reluctant to order PET scans.  Full body PET scans for patients with active myeloma are recommended by the IMF a minimum of once a year.

Researchers are working to help osteoblast function work better.  Osteoblasts help bones heal.  Increasing their numbers can help myeloma patients with bone damage heal more quickly.

Experts are beginning to change their views on treating late stage smoldering (pre-crab) patients.  Newly emerging research might justify jumping-in to treat these patients earlier.

Here’s a good tip I picked-up late Saturday afternoon:

Ask your doctor whenever he or she prescribes any new drug is safe for your kidneys.  PROTECT THOSE KIDNEYS!

On that note, I’m going to pause and continue with more news from the conference tomorrow.  Sorry, but you are going to have to wait one more day to learn more about Celgene’s new research, focused on a promising new pathway to a cure.

Until then, feel good and keep smiling!  Pat

4 Comments For This Post

  1. Lovey Beth Says:

    Thank you for mentioning the kidneys, Pat. Kidney failure led to my diagnosis of MM. My nephrologist told me to always protect my kidneys – the first words out of my mouth whenever any new drug, procedure, etc. is mentioned should be, “How will this affect my kidneys?”

  2. Pat Killingsworth Says:

    Dr. Durie’s words, exactly!

  3. Tim Says:

    Pat – I find this statement interesting. “Researchers feel treating early–and throwing every thing they’ve got at myeloma early–has a better chance of wiping out all or most of the myeloma clones, leading to a longer remission and/or potentially a cure.”

    Does this mean they might be leaning towards transplant early on instead of harvest and wait. This is kind of the phylosify my doctor had, I achieved CR through 4 cycles of RVD, but he still pushed to do a ASCT right away. The other extreme is Arkansas, were they keep thowing everything at the Myeloma for 3 years or more. Only time well tell…

  4. Pat Killingsworth Says:

    I’m glad that you picked-up on that, Tim. Very important treatment angle. If you buy into this myeloma clone theory–where more, different types of clones evolve over time and treatment–then hitting myeloma with everything you’ve got (including SCT) makes a lot of sense. This becomes the explanation for patients who are concerned about using RVD early. Does that mean myeloma becomes resistant to both Rev and Velcade? So isn’t that a mistake? Emerging studies say no.

    BUT… Two or more studies show same SCT results if you wait. And so far, it looks like overall survival is about the same if you use RVD early or use the drugs one at a time until they stop working.

    Doesn’t seem to be any right or wrong way–at least so far.

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