Dr. Robert Z. Orlowski, MD, PhD MD Anderson Cancer Center Interview date: March 21, 2014 

Dr. Robert Z. Orlowski shares a three-themed approach at MD Anderson to combat myeloma: Using immonotherapy in many new and exciting ways, better therapies to make stem cell transplants more effective, and new small molecules. He describes options for both newly diagnosed and relapsed/refractory myeloma patients using monoclonal antibodies to allow a patient's own immune system to target the myeloma. For high-risk newly diagnosed patients, elotuzumab (that targets the CS1 protein) is being used. For relapsed/refractory patients, daratumumab (that targets the CD38 protein) is being used. He shares the very exciting use of vaccines and how they target myeloma and strengthen the immune system at the same time. These newer vaccine approaches are being used with and without transplant and possibly as maintenance therapy (!). He also discusses an upcoming PD-1 study that takes the brakes off the immune system. These powerful approaches may be what the future holds for myeloma therapies - less chemotherapy and a combination of immunotherapies that will strengthen, support and take the breaks off the immune system to target myeloma but boost the immune system at the same time. With 38 active open trials in myeloma (an exceptionally large number at one center), he shares the benefits of having a large myeloma team. With the complexity of myeloma and a wide variety of newer approaches, it is simply not possible for one expert to cover it all. Dr. Orlowski also describes the work to improve quality of life by using small molecules (like proteasome inhibitors) in oral versions so patients can spend less time in the clinic.  The live mPatient Myeloma Radio podcast with Dr. Robert Z. Orlowski