Archived Monthly Oncology Tumor Boards: A Multidisciplinary Approach to Individualized Patient Care - Multiple Myeloma

Join Carol Ann Huff, MD, and Ivan Borrello, MD, as they present their multidisciplinary expertise on a range of cases pertaining to multiple myeloma.

The understanding of key pathways responsible for multiple myeloma (MM) has led to the development of novel agents and resulted in availability of many evidence-based options for treatment of MM with significant improvements in response and survival. The challenge lies in deciding the best treatment to provide maximum benefit to the patient.

Newly-diagnosed MM is responsive to treatment with regimens containing immunomodulatory drugs (IMiDs) such as thalidomide and lenalidomide; proteasome inhibitors such as bortezomib; high-dose chemotherapy and autologous stem cell transplant in appropriate patients; or combinations containing melphalan and prednisone with novel agents.

However, most patients eventually relapse or become refractory to treatment, owing in part to the changing biology of the tumor. Although most agents and regimens used as initial therapy have also shown significant activity and improved outcomes in patients with relapsed or refractory MM, these responses are often of limited duration. In patients who have become resistant to bortezomib, the use of a new proteosome inhibitor, such as carfilzomib, with a different chemical backbone has shown to overcome this resistance. The FDA recently approved carfilzomib for treatment of patients with relapsed/refractory MM who have received at least two prior therapies, including treatment with bortezomib and an IMiD. Another agent that has a role in relapsed/refractory MM is vorinostat, an oral histone deacetylase (HDAC) inhibitor, FDA-approved for the treatment of patients with cutaneous T-cell lymphoma. For patients with MM, the synergistic effect of vorinostat and bortezomib has been proven to significantly improve response rates and prolong disease free survival. Vorinostat is being investigated in combination with lenalidomide and dexamethasone and in combination with PLD and bortezomib.

Several new agents from a range of therapeutic classes are being examined in the relapsed/refractory setting. Specific agents in development include new IMiDs (e.g., pomalidomide), the signal transduction modulators (e.g., perifosine), monoclonal antibodies (e.g., elotuzumab), and HDAC inhibitors (e.g., panobinostat).

In patients with multiple myeloma, clinicians need to be aware of the previous treatment history of the patients. Also, it is important for clinicians to know the extent of the disease, including the transition to systemic disease. The challenge lies in deciding the best treatment to provide maximum benefit to the patient.

Target Audience

This educational program is designed to meet the educational needs of oncologists, pathologists, nurses, pharmacists, and other health care professionals who manage patients with cancer.

Learning Objectives

Following this activity, participants should be able to:

  • Apply NCCN Guideline-based therapeutic strategies for multiple myeloma in the treatment of patients
  • Describe the multidisciplinary aspects of patient management for multiple myeloma
  • Identify the key characteristics for multiple myeloma that trigger decision points
  • Recognize situations where optimal care may require adapting the Guideline recommendations to individual circumstances
Additional information
Supporters: 

This activity is supported by educational grants from:

  • Daiichi Sankyo, Inc.
  • Genentech
  • Novartis Pharmaceuticals Corporation
  • Takeda Oncology
  • Teva Pharmaceuticals

This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.

This activity is supported by a grant from Onyx Pharmaceuticals.

Course summary
Available credit: 
  • 0.50 Participation
  • 0.54 Nurse
  • 0.50 Pharmacist
  • 0.50 Physician
Course opens: 
05/27/2014
Course expires: 
05/27/2015
Cost:
$0.00

Carol Ann Huff, MD
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Ivan Borrello, MD
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Available Credit

  • 0.50 Participation
  • 0.54 Nurse
  • 0.50 Pharmacist
  • 0.50 Physician

Accreditation Period

Course opens: 
05/27/2014
Course expires: 
05/27/2015

Price

Cost:
$0.00
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