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RTP On Demand — Multiple Myeloma
Released May 2014

Proceedings from a video interview with Drs Irene M Ghobrial and Ola Landgren on multiple myeloma, including data review, case-based discussions and downloadable slides. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical oncologists, hematology-oncology fellows 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. It is estimated that 24,050 new cases will be diagnosed and 11,090 deaths will occur in the United States in 2014. Patients with smoldering (asymptomatic) or Stage I active myeloma may be observed, as they often have an indolent disease course for many years without therapy, although this paradigm may be changing for those considered to be at high risk. On the other hand, the disease course for advanced myeloma is uniformly aggressive. 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 (IMiD) agents have effectively transformed the standard treatment for patients with newly diagnosed and relapsed/refractory MM. Thus, the current challenge facing the oncology community is identifying those patients who will obtain the greatest benefit from a specific regimen while incurring the least toxicity.

    For this reason, hematologic oncologists must be apprised of the unique risks and benefits accompanying each evidence-based treatment strategy and of the acceptable monitoring and supportive management techniques that enable early recognition of safety concerns and effective interventions to address side effects. Despite the existence of a number of tools to assist clinicians in this regard, many areas of controversy persist within academic and community settings. This program uses a review of recent publications and presentations, faculty cases and Q&A sessions to assist medical oncologists, hematology-oncology fellows and other healthcare providers with the formulation of up-to-date clinical management strategies for MM.

    LEARNING OBJECTIVES

    • Recall existing and emerging clinical research data to effectively implement evidence-based therapeutic approaches for patients with newly diagnosed and relapsed/refractory MM.
    • Recognize essential patient care considerations with the use of proteasome inhibitor- and/or IMiD-containing systemic therapies in newly diagnosed MM.
    • Examine optimal duration and benefits/risks of lenalidomide maintenance therapy after stem cell transplantation for patients with active MM.
    • Assess the use of bone-targeted therapy in patients with newly diagnosed MM regardless of the presence of disease in the bone.
    • Recall new data with novel treatment approaches with histone deacetylase inhibitors or monoclonal antibodies for relapsed and/or refractory MM.
    • Appraise emerging clinical trial data with proteasome inhibitors and tyrosine kinase inhibitors as treatment for Waldenström macroglobulinemia.
    • Develop a risk-adapted treatment plan for patients with smoldering MM.
    • Assess the ongoing clinical trials evaluating therapeutic approaches for MM, and counsel appropriately selected patients for study participation.

    ACCREDITATION STATEMENT

    CME credit is no longer available for this issue

    CREDIT DESIGNATION STATEMENT

    CME credit is no longer available for this issue

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. The participant should watch the video.

    CME credit is no longer available for this issue

    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 potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent 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 real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Irene M Ghobrial, MD
    Assistant Professor in Medicine
    Dana-Farber Cancer Institute
    Harvard Medical School
    Boston, Massachusetts

    Advisory Committee: Bristol-Myers Squibb Company, Celgene Corporation, Genzyme Corporation, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc.

    Ola Landgren, MD, PhD
    Chief, Myeloma Service
    Memorial Sloan-Kettering Cancer Center
    New York, New York

    Contracted Research: Celgene Corporation, Onyx Pharmaceuticals Inc.

    MODERATORDr 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, Algeta US, Amgen Inc, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, Exelixis Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc, Teva Oncology and VisionGate Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent 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 Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation and Onyx Pharmaceuticals Inc.

    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: May 2014
    Expiration date: May 2015

    CME credit is no longer available for this issue

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Watch video
(WIFI is recommended for best performance):

Two- versus 3-drug pretransplant induction in younger patients with lower-risk disease
Two- versus 3-drug pretransplant induction
Role of transplant in the era of new agents
NCI Phase II study of up-front CRd
Toxicity of carfilzomib


Post-transplant maintenance/oral proteasome inhibitors
Post-transplant maintenance


Up-front treatment for elderly patients
Up-front treatment for elderly patients: Case presentation


Management of relapsed/refractory disease
Management of relapsed/refractory disease: Case presentation 1
Management of relapsed/refractory disease: Case presentation 2
Combination therapy in relapsed disease


Bone-targeted treatment
Bone-targeted treatment


New agents: HDAC inhibitors (panobinostat)
New agents: HDAC inhibitors (panobinostat)


Monoclonal antibodies (anti-CS1 or SLAMF7 and anti-CD38)
New agents: Monoclonal antibodies


Smoldering myeloma
Smoldering myeloma


Waldenström's macroglobulinemia
Waldenström's macroglobulinemia