There has been an increasing interest in the potential for moving beyond three-drug combinations to improve the treatment of patients with multiple myeloma in the frontline setting. In this activity, Dr. Kumar discusses the rationale, decision making, and trials that explore four-drug combinations for patients with newly diagnosed multiple myeloma. He also explains the efficacy and toxicity burden of these regimens.

It is important to assess age and fitness when formulating management approaches for a patient with multiple myeloma. In this newsletter, Dr. Tuchman explains the optimal method for assessing the impact of aging and the appropriate considerations for evaluating older patients. He also discusses the different geriatric assessments and instruments best suited to assess elderly patients with multiple myeloma.

Patients with myeloma have an increased risk of venous thromboembolism (VTE). In this activity, Dr. Kumar explains the contributing factors to VTE, how these findings relate to risk stratification, and what system is the most useful in assessing VTE risk in myeloma. He will also describe the best options for when VTE prophylaxis is warranted.

In support of the community oncology practitioner, this activity provides the most up-to-date advances and strategies for treating relapsed/refractory myeloma while supporting the translation of this information into practice through provision of applied clinical tools and resources.

There have been many changes in the treatment of smoldering and newly diagnosed multiple myeloma (NDMM). In this activity, Dr. Jonathan Kaufman explains the most important developments and how they will impact your practice. He also covers the changes in frontline treatment and the most important developments of newly diagnosed patients. Lastly, Dr. Kaufman discusses therapy options for ineligible and eligible transplant patients.

Chimeric antigen receptor (CAR) T-cell therapies have been approved for some leukemias and lymphomas, but they are also being explored as a potential treatment option for multiple myeloma (MM). In this activity, Dr. Noopur Raje discusses the mechanism of action for CAR T-cell therapies in MM and the role of conditioning chemotherapy in CAR T-cell therapy. Dr. Raje also describes the efficacy and safety of emerging CAR T-cell therapies for the treatment of MM.

With novel first-line treatments and drug combinations continuing to penetrate the therapeutic landscape in multiple myeloma, it is imperative that community oncologists stay informed and up-to-date on emerging strategies for treating newly diagnosed multiple myeloma (NDMM). In this activity, Dr. Keith Stewart discusses several new treatments for NDMM and compares efficacy and safety data associated with these emerging drugs. He also outlines strategies to ensure that NDMM patients receive the most appropriate agents based on their unique characteristics.

While evolving pharmacologic options continue to improve the management of relapsed/refractory multiple myeloma (RRMM), the selection of therapy following a first relapse and beyond is critical for improving prognoses and outcomes. This activity will address the efficacy and safety of current and emerging therapies for RRMM as well as strategies for overcoming challenges that clinicians often encounter when integrating novel agents into practice.

Despite exciting new developments in the number and kind of pharmacologic options available for multiple myeloma (MM), stem cell transplantation remains an important first-line treatment that is often underutilized. This activity will address critical factors that must be considered when making treatment decisions concerning transplant in MM patients, including safety, efficacy, and potential for long-term remission.

The evolving role of biological and molecular markers in the diagnosis and prognostication of multiple myeloma supports a more accurate and individualized assessment of a patient's risk-level and subsequent selection of treatment. Through an overview of the myeloma-defining events that comprise the revised ISS, and discussion of the correlation between specific cytogenetic abnormalities and response to treatment, participants will gain greater insight into the application of these diagnostic, prognostic and potentially predictive markers in the treatment of their patients with multiple myeloma.

In past years, several risk stratification models have been developed for prognosticating patients with multiple myeloma (MM). Recent updates and published consensus to the risk stratification process has led to recommended changes within current practice. Dr. Evangelos Terpos offers clinical expert recommendations concerning risk-adaptive therapeutic strategies in patients with MM, emphasizing how determination of prognosis is a critical component in identifying treatments specific for an individual patient’s unique risk level. Dr. Terpos also discusses clinical pearls for incorporating risk-adaptive approaches in a busy practice setting.

Provided by MediCom Worldwide, Inc.
This activity is supported by educational grants from Amgen, Celgene Corporation, and Takeda Oncology.

The treatment landscape for relapsed/refractory multiple myeloma (RRMM) has become more complex with the availability of next-generation drugs, targeted agents, and immunotherapy. In this activity, Dr. Saad Usmani, Chief of the Plasma Cell Disorders Program and Director of Clinical Research in Hematologic Malignancies at the Levine Cancer Institute, provides an overview of the novel lenalidomide-, bortezomib-, and carfilzomib-based regimens for relapsed patients. In addition to a summary of study rationales and relevant phase III clinical trial data, Dr. Usmani provides guidance for the real-world application of these regimens and recommendations for patient selection to optimize outcomes in the relapsed setting.

The revised International Myeloma Working Group (IMWG) criteria for the diagnosis of multiple myeloma have been updated to specifically identify patients who may benefit from early treatment when prognosis is more favorable. The new criteria include myeloma-defining events in the diagnosis of active myeloma, including key changes to bone assessment criteria. Dr. Evangelos Terpos, Associate Professor of Hematology at the University of Athens School of Medicine, provides an overview of the updated criteria, focusing on the impact on bone assessments, and shares clinical expertise in choosing the best imaging technique for specific patient types and assessment goals.

In multiple myeloma (MM), the emergence of several oral agents and the increased use of maintenance/continuous therapy could result in more treatment non-adherence and therefore reduced efficacy. Patient-related, treatment-related and clinician-related factors can all contribute to non-adherence and should be understood by health care providers, the goal being to gauge the patient’s risk for inadequate dosing. This CE activity discusses the potential for non-adherence to myeloma therapy and aims to identify ways that clinicians can ameliorate this risk.

Prior to developing clinical symptoms, patients with multiple myeloma will progress through the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). For asymptomatic patients, current diagnostic criteria quantify the underlying disease burden and provide insight on the risk of progression to active MM. This activity will review best practices in the diagnosis and initial monitoring of patients with MGUS, SMM, and active MM to support the delivery of timely intervention in appropriate patients.

Reviewed: January 17, 2017 for clinical relevance; CE is expired.