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Second Opinion: New Agents and Emerging Trial Data in the Management of Multiple Myeloma
Released November 2016

Featuring perspectives from Dr Noopur Raje. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical oncologists, hematologists and other healthcare providers involved in the treatment of multiple myeloma (MM).

    OVERVIEW OF ACTIVITY
    MM is a plasma cell neoplasm that accounts for approximately 10% of all hematologic cancers and carries with it the worst death to new cases ratio (3:4). In addition, the disease course for advanced myeloma is uniformly aggressive. However, the introduction of new agents with substantial activity has improved outcomes and allowed patients to experience longer periods of remission. Both novel proteasome inhibitors and immunomodulatory agents have effectively transformed standard care for patients with newly diagnosed and relapsed/refractory MM. Therefore, the current challenge facing the oncology community is identification of those patients who will enjoy the greatest benefit from a specific regimen while incurring the least toxicity. In this regard, hematologic oncologists must be apprised of the unique risks and benefits accompanying each evidence-based treatment strategy, as well as the acceptable monitoring and supportive management techniques that enable early recognition of safety concerns and effective interventions to address side effects. Several consensus- and evidence-based treatment guidelines are available and aim to assist clinicians with making clinical management decisions related to these diseases. But despite the existence of these tools, many areas of controversy persist within academic and community settings.

    To bridge the gap between research and patient care, this video presentation by Dr Noopur Raje uses a review of recent relevant publications and presentations, ongoing clinical trials and clinical investigator treatment preferences to assist medical oncologists, hematologists and other healthcare providers involved in the treatment of MM with the formulation of up-to-date clinical management strategies.

    LEARNING OBJECTIVES

    • Appraise recent data on therapeutic advances and changing practice standards in MM, and integrate this information, as appropriate, into current clinical care.
    • Compare and contrast the benefits and risks of immunomodulatory agents, proteasome inhibitors or both as systemic treatment for active MM.
    • Use patient- and disease-related factors, including cytogenetic profile, to customize the use of induction and maintenance therapeutic approaches in the post-transplant and nontransplant settings.
    • Consider available research data and other clinical factors in the best-practice selection, sequencing or combining of carfilzomib and pomalidomide in the nonresearch care of patients with relapsed or refractory MM.
    • Recognize the recent FDA approvals of panobinostat, elotuzumab, ixazomib and daratumumab, and effectively identify patients for whom treatment with these novel agents may be appropriate.
    • Develop an understanding of emerging efficacy and safety data with novel monoclonal antibodies under evaluation for MM.
    • Assess the ongoing clinical trials evaluating innovative developmental approaches for MM, and obtain consent from appropriate patients for study participation.

    ACCREDITATION STATEMENT
    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity enables the participant to earn up to 1.25 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive credit, the participant should watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/GrandRoundsMM16/CME.

    CONTENT VALIDATION AND DISCLOSURES
    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Presenting Faculty Member

    Noopur Raje, MD
    Director, Center for Multiple Myeloma
    Massachusetts General Hospital Cancer Center
    Associate Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts

    Advisory Committee: Amgen Inc, Bristol-Myers Squibb Company, Celgene Corporation, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Takeda Oncology; Consulting Agreements: Amgen Inc, Bristol-Myers Squibb Company, Celgene Corporation, Novartis Pharmaceuticals Corporation, Takeda Oncology; Contracted Research: AstraZeneca Pharmaceuticals LP, Lilly.

    Project Steering Committee Members

    Morie A Gertz, MD, MACP
    Roland Seidler Jr Professor of the Art of Medicine
    Chair, Department of Medicine
    Mayo Distinguished Physician
    Mayo Clinic
    Rochester, Minnesota

    Consulting Agreements: Amgen Inc, GlaxoSmithKline, Novartis Pharmaceuticals Corporation.

    Jonathan L Kaufman, MD
    Associate Professor of Hematology and Medical Oncology
    Winship Cancer Institute of Emory University
    Atlanta, Georgia

    Advisory Committee: ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Pharmacyclics LLC, an AbbVie Company; Consulting Agreement: Celgene Corporation.

    Joseph Mikhael, MD, MEd
    Professor of Medicine
    Mayo College of Medicine
    Associate Dean, Mayo School of Graduate Medical Education
    Deputy Director – Education
    Mayo Clinic Cancer Center
    Mayo Clinic in Arizona
    Phoenix, Arizona

    Contracted Research: AbbVie Inc, Celgene Corporation, Onyx Pharmaceuticals, an Amgen subsidiary, Sanofi.

    Nikhil C Munshi, MD
    Professor of Medicine
    Harvard Medical School
    Director of Basic and Correlative Science
    Associate Director
    Jerome Lipper Multiple Myeloma Center
    Department of Medical Oncology
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    Advisory Committee: Celgene Corporation; Consulting Agreements: Celgene Corporation, Merck, Pfizer Inc, Takeda Oncology; Ownership Interest: OncoPep.

    Jeffrey L Wolf, MD
    Professor of Medicine
    Director, Myeloma Program
    Division of Hematology/Oncology
    Blood and Marrow Transplantation
    University of California, San Francisco
    San Francisco, California

    Consulting Agreements: Amgen Inc, Celgene Corporation, Janssen Biotech Inc, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals, an Amgen subsidiary, Takeda Oncology.

    Jeffrey A Zonder, MD
    Professor of Oncology
    Karmanos Cancer Institute
    Wayne State University
    Detroit, Michigan

    Advisory Committee: Celgene Corporation; Consulting Agreements: Array BioPharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Janssen Biotech Inc, Prothena Corporation PLC, Seattle Genetics, Takeda Oncology; Contracted Research: Celgene Corporation.

    PROJECT CHAIR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Agendia Inc, Amgen Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology, Tokai Pharmaceuticals Inc and VisionGate Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from Celgene Corporation, Novartis Pharmaceuticals Corporation and Takeda Oncology.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: November 2016
    Expiration date: November 2017

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

Acknowledge and close

Watch video
(WIFI is recommended for best performance):
Chapters:
00:00:00 - Introduction
00:01:20 - Newly diagnosed MM
00:15:50 - Relapsed/refractory disease
00:21:30 - Integrating newly approved agents into practice
00:33:55 - Investigational immunotherapy strategies