Hematologist Dr. San Miguel Envisions Big Changes In Myeloma Treatment Paradigms

BY LIZZY SMITH An excellent recap was just published at OncLive (Multiple Myeloma Advances: Noted Hematologist Envisions Big Changes in Treatment Paradigms) of a lecture given at the ASH conference in December 2014. The presenter was myeloma specialist, Dr. Jesus San Miguel. I was at that lecture, which was packed to the brim with attendees. Both Jenny Ahlstrom and I wrote highlights about it but I can resist posting one more recap. It is true (and I am incredibly grateful, as I know every other myeloma survivor and her supporter) that myeloma is experiencing incredible advancements, though more can and must be done. Several clinical trials show great promise, and I am hoping and praying that they make it through the approval process quickly so that maximum number of patients can benefit. And until then, clinical participation is essential if one is eligible. Anyway, without further ado, here is the article: Multiple Myeloma Advances: Noted Hematologist Envisions Big Changes in Treatment Paradigms by Mary K. Caffrey Published Online: Tuesday, January 20, 2015 Clinicians who treat patients with multiple myeloma have witnessed a sea change in the past 15 years. Yet another revolution appears right around the corner, with emerging monoclonal antibodies generating promising results in clinical trials and research on risk stratification revealing how to identify which patients should be treated early, according to Jesús F. San Miguel, MD, PhD. San Miguel delivered the Ham-Wasserman Lecture, entitled “Multiple Myeloma: A Modern Model for Scientific and Clinical Progress,” during the 56th Annual Meeting of the American Society of Hematology (ASH), which convened December 6-9, 2014, at the Moscone Center in San Francisco. He is a professor and administrator at the Clinica Universidad De Navarra, Pamplona, Spain. During his lecture, San Miguel noted the encouraging clinical trial findings about two new agents in development, daratumumab and elotuzumab, presented during the conference. Clinicians who treat individuals with multiple myeloma and patient advocates have been anticipating research data about these agents for some time now, particularly since the FDA has granted breakthrough therapy status to both agents in multiple myeloma settings. San Miguel said it has become clear that the disease “should not be considered a single entity, but different entities,” and thus, multiple treatment options will exist. For example, he said, many thought there would be no role for melphalan after last year’s ASH meeting in New Orleans, which saw the paradigm-shifting results from Thierry Facon, MD, on lenalidomide and low-dose dexamethasone.1 But San Miguel said that has turned out not to be the case. An increased understanding of the genetics behind myeloma is building awareness that treatments must be tailored to the individual, said San Miguel. Identifying and measuring key drivers of the disease holds great promise, he noted, since this will give clinicians information to create combination therapies for more patients. While survival has increased from the abysmal rates of 1 to 3 years from previous eras to 5 to 7 years today, more can be done, he said. San Miguel also reviewed an area where his research team, the Spanish Myeloma Group, made a major contribution in 2013: risk stratification of those patients with precancerous disease who show signs of smoldering myeloma, and methods of identifying those at highest risk of progression so that they can receive early treatment. Keep reading...