Dr. Philip McCarthy, MD
Roswell Park Cancer Institute

Interview date: February 21, 2014

Dr. Philip McCarthy shares his deep experience with transplantation in myeloma. He tells us that transplant eligibility depends on fitness, not age, and that older patients can successfully complete transplants. He notes that research is showing that the most effective induction therapies before transplants are triple combinations that include a proteasome inhibitor, an iMiD, and a steroid and tells us why this is better than either a two-combination or even four-combination approach. He shares a study recently closed with 750 patients that aims determine which approach is best for transplant - a single transplant, a tandem transplant, or a single transplant with maintenance therapy (we look forward to seeing this data). He describes a study that is looking at the timing for transplant, whether it's better to have it up-front or later and tells us that the up-front transplant may be better in younger patients. He tells us that the right approach for the right patient is based on a full set of diagnostic tests including testing for minimal residual disease which is tested through both flow cytometry and a new test called PCR. He also describes a new test to study the heavy chain from a company called Binding Site. He describes efforts to make these test more standardized so that when research is done for myeloma patients, they are comparing apples to apples. He shares studies that show best approaches for patients with del 17, del 13 and renal failure. He describes his research efforts to help minimize side effects like mucositis and assist patients' immune systems to recover at a faster pace after transplant.  In the caller questions, he also answers an important question about lenalidomide and secondary cancers and how the benefits and risks are reviewed.