Current Approaches to Initial Treatment of Newly Diagnosed Multiple Myeloma

The number of treatment options for both transplant eligible and transplant ineligible patients continues to grow year after year.  Regimens previously approved in the second-line setting are proving to be efficacious as primary therapy. In addition, there are new data on using current drugs in new combinations leading to newer and/or more effective treatment options for patients with MM. The list of agents available for supportive care such as bone-directed therapy has also expanded with the recent FDA approval of denosumab for patients with MM.  Many factors come into play during initial treatment selection and supportive care including supporting evidence, relative efficacy and toxicity of the regimen, and other factors such as pre-existing comorbidities (e.g. peripheral neuropathy, renal insufficiency etc.), nature of the disease, and in some cases consideration of availability/access to agents.  In addition, patients should be appropriately evaluated before each treatment cycle to determine how their disease is responding to therapy and to modify therapy or adjust doses based on response and toxicity.  The American Cancer Society has estimated 30,770 people will be diagnosed with MM and 12,770 will die of the disease in 2018 in the United States.16 In order to improve these statistics, it is important to help clinicians to keep up-to-date with the rapidly evolving standard–of-care and the newer options available for management of patients with multiple myeloma and apply these in selecting the most efficient treatment strategy for patients.  Discussion of patient cases and review of the rationale for the various treatment choices based on expert experience and recent data from trials will aid the decision-making process for physicians treating patients with myeloma.

This information was originally presented at the NCCN 13th Annual Congress: Hematologic Malignancies™ held in New York, New York, from September 21-22, 2018.

Target Audience

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

Learning Objectives

Following this activity, participants should be able to:

  • Identify key patient and clinical factors that influence first-line treatment selection for patients with multiple myeloma.
  • Analyze efficacy and tolerability of available therapies and effectively counsel patients with multiple myeloma.
  • Integrate evidence-based data into the management of bone disease in patients with multiple myeloma.
Additional information

This activity is supported by educational grants from:

  • Astellas
  • AstraZeneca
  • Celgene Corporation
  • Genentech
  • Jazz Pharmaceuticals, Inc.
  • MEI Pharma
  • Novartis
  • Pharmacyclics LLC, an AbbVie Company and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC
  • Pfizer
  • Sanofi Genzyme
  • Takeda Oncology

This activity is supported by independent educational grants from AbbVie and Incyte.

This activity is supported by educational funding provided by Amgen.

This activity is supported by an unrestricted educational grant from Gilead Sciences, Medical Affairs.

Course summary
Available credit: 
  • 0.50 ACPE contact hours
  • 0.50 AMA PRA Category 1 Credit™
  • 0.52 ANCC contact hours
  • 0.50 Participation
Course opens: 
Course expires: 

Natalie S. Callander, MD
University of Wisconsin Carbone Cancer Center


Disclosure of Relevant Financial Relationships
All faculty and activity planners participating in NCCN continuing education (CE) activities are expected to disclose any relevant financial relationships with a commercial interest as defined by ACCME’s, ACPE’s, and ANCC’s Standards for Commercial Support. All faculty presentations have been reviewed for adherence to ACCME’s Criterion 7: The provider develops activities/educational interventions independent of commercial interests (SCS 1, 2, and 6) by experts on the topics. Full disclosure of faculty relationships will be made prior to the activity.


NCCN continuing education considers financial relationships to create a “conflict of interest” when an individual has both a financial relationship with a commercial interest and the opportunity to affect CE content about the products or services of a commercial interest with which he/she and/or a spouse or partner has a financial relationship.

NCCN continuing education considers “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. NCCN does not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship.

Faculty Disclaimers

All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.

Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling.

Faculty Disclosures

The faculty listed below discloses no relevant financial relationships:

Natalie S. Callander, MD

NCCN Staff Disclosures

The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Robert W. Carlson, MD; Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Lisa G. Kimbro, MBA, CPA (employed by NCCN until 8/10/2018); Joan S. McClure, MS (employed by NCCN until 8/1/2018); Lisa Perfidio, MS; Shannon Ryan; Kathy Ann Smith, CMP, CHCP; Gary J. Weyhmuller, MBA, SPHR

The NCCN Activity Planning staff listed below discloses the following relevant financial relationships:

Donald Harting, ELS, CHCP
Laboratory Corporation of America (LabCorp): Equity interest/Stock Options

Katherine Pierce
Pfizer Inc.: Equity Interest/Stock Options
Boston Scientific Corporation: Equity Interest/Stock Options

The NCCN Clinical staff listed below discloses no relevant financial relationships:

Alyse Johnson-Chilla; Rashmi Kumar, PhD

National Comprehensive Cancer Network is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

NCCN designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 0.50 hour of Category 1 credit for completing this activity.

National Comprehensive Cancer Network (NCCN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

NCCN designates this educational activity for a maximum of 0.52 contact hour.


National Comprehensive Cancer Network is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

NCCN designates this knowledge-based continuing education activity for 0.50 contact hour (0.05 CEUs) of continuing education credit. UAN: 0836-0000-18-115-H01-P

Available Credit

  • 0.50 ACPE contact hours
  • 0.50 AMA PRA Category 1 Credit™
  • 0.52 ANCC contact hours
  • 0.50 Participation


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Required Hardware/software

To complete this activity, users will need: