Dr. Sergio Giralt, MD Memorial Sloan-Kettering Cancer Center

Interview date: September 20, 2013

Dr. Sergio Giralt discusses the role of transplant as consolidation therapy and his current study of how the various approaches relate to a patient's cytogenetics.  He shares his experience showing high-dose melphalan with an autologous transplant is still the best way of achieving long-term disease control and how the road to cure goes through complete remission. He discusses the 5 stages of transplantation and describes how he is working to use newer combinations to both improve the effectiveness of transplants but also to reduce the time to recovery and side effects for patients, with the goal to make transplantation as tolerable as regular chemotherapy. He shares studies at Memorial Sloan-Kettering that are working to eliminate host vs. graft disease for allogeneic transplant and why young, high-risk myeloma patients may want to consider that option. He describes new approaches at Memorial targeting gene mutations (like BRAF and MET gene mutations) and how a vaccine approach is just beginning. He describes the near future of genetic-specific trials that are just beginning in high-risk myeloma, but that they require national support so that one particular study can target a sufficient number of patients.  He stresses the importance of patient participation in clinical trials to push forward new and better therapies in myeloma.