Dr. Robert Z. Orlowski, MD, PhD MD Anderson Cancer Center Interview Date: January 9, 2015

Dr. Orlowski begins the new year by highlighting some of the most important myeloma therapies that will take us into 2015. He reminds us of the new International Myeloma Working Group guidelines that allow for earlier treatment in smoldering myeloma without waiting for CRAB features. He notes that MRIs will be a critical tool for smoldering myeloma patients to make this determination. He notes the important results of the ASPIRE study of carfilzomib/lenalidomide/dex, telling us that it gave progression-free survival for two years, even in the relapsed/refractory setting. To put that in perspective, this used to be only accomplished with transplant in the newly diagnosed setting. He describes how treatment is becoming more tailored and uses the example of how immunophenotyping can tell if the plasma cells in the bone marrow are normal or not post-treatment. He predicts that two new immunotherpaies (elotuzumab and daratumumab) may be approved in 2015. The appeal of these immunotherapies are that they target myeloma cells that are in virtually all patients, for maximum effect. He also shares the excitement around CAR T and CAR NK cell therapies in myeloma. He shares the development of new oral proteasome inhibitors to make treatment more convenient for patients and highlights two new inhibitors that are showing impact on their own that will be therapies to watch in the new year. The Myeloma Crowd Radio Show with Dr. Robert Z. Orlowski