Welcome to the Managing Myeloma Clinical Trials Awareness Program.
All National Comprehensive Cancer Network (NCCN) guidelines state, "The best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged." However, the guidelines provide no direction for helping individual practitioners to work with their patients in choosing among a staggering number of open, currently recruiting trials.
As of June 30, 2015, there were more than 1,958 studies with the search term " multiple myeloma"or 269 additional studies over this time two years ago, of which 572 studies were listed as "recruiting" or "unknown" recruitment status on clinicaltrials.gov and 485 were confirmed to be open, recruiting studies according to the data available to the U.S. National Institutes of Health which oversees the the ClinicalTrials.gov database. Of the recruiting trials with known status, 206 included the search term "relapsed", 187 included the search term "refractory" and 162 included both "relapsed" and "refractory" reflecting the clinical need for advancements for relapsed/refractory multiple myeloma patients. As new potential strategies for multiple myeloma disease management expand, so too have clinical trial options. There are 84 open and recruiting clinical trials addressing maintenance therapy, 52 trials for newly diagnosed patients and 10 clinical trials for smoldering (asymptomatic) multiple myeloma (11 studies listed with "asymptomatic myeloma").
Myeloma practitioners in the community are often burdened for time and must wade through a sea of clinical trial listings with complex protocols and long eligibility criteria. In an effort to assist you and your patients, we have developed this program which seeks to take currently recruiting clinical trials and classify them into more easily accessible sections for more rapid access and review. We periodically download the multiple myeloma clinical trials for your convenience and then perform filtered searches based on what part of the myeloma disease life cycle they address. We then store this information under the descriptive link section.
We will also post periodic slide audio programs which randomly highlight actively recruiting clinical trials addressing different parts of the myeloma life cycle as presented by our world leading Managing Myeloma faculty of advisors. If you are a clinical investigator currenly enrolling patients in multiple myeloma trials in your institution, we invite you to contact us so we can highlight your institutional trial(s).
Much progress has been made in the treatment of multiple myeloma in the last decade. These advances are primarily attributed to developments which have been vetted through clinical trials.
Working with your patients to identify appropriate clinical trials ensures that they will receive the best standard of care while contributing to improved outcomes for future patients. Which patients should be referred? Technically, multiple myeloma is an incurable disease, therefore all patients are potential candidates at some point in the life cycle of their disease. There is a clinical need for advancements in primary treatment, consolidation and stem cell transplant therapy, and for maintenance therapy. However, as a rule of thumb, strongly consider clinical trials in patients you have determined may be of high risk for disease progression – the ones which may not respond optimally to current therapies containing novel agents and combinations of agents. Ideally, a multiple myeloma patient should be immediately referred to clinical trial at the time of first relapse but there may be a number of reasons why this is not possible. Myeloma patients who have become refractory to several lines of therapy, where other options have been exhausted, should absolutely be considered for trial referral. Importantly, you should not wait for your patient to become so ill that they will not qualify for a clinical trial.
Through your dedicated efforts and as a professional community, we can work together to improve health care for patients with multiple myeloma. The vast improvement in survival and quality of life seen in multiple myeloma over the past decade is a direct result of clinical trial advancements. If a cure is to be found for multiple myeloma, it will only be realized through clinical trials. It is the opinion of the Managing Myeloma Continuing Education Initiative Advisory Group (MMCEIAG) that clinical trial is a preferred option for multiple myeloma patients at any time in the life cycle of the disease and that this option should always be considered and discussed with your multiple myeloma patients. To assist you in overcoming barriers to achieving multiple myeloma patient referral to clinical trial, the Managing Myeloma Clinical Trial Awareness Program (MM-CTAP®) has been developed.