Sergio Giralt, MD Memorial Sloan Kettering Cancer Center Interview Date: November 11, 2016 

 Stem cell transplant is still the single most effective treatment for multiple myeloma. But only 40% of whites have one while only 25% of blacks do. What? Dr. Giralt says that it is an issue of access to care, patient preferences and untrained local oncologists. Dr. Giralt shares his goals to make stem cell transplant even better and to make them easier by “flattening the symptom burden curve.”  He stresses the importance of "giving your best drug up front."  Today's pre-transplant options are typically three drug combinations which he tells us are far better than two drugs together. He notes that research is now being done to see if other combination therapies could be added for certain patients. For example, patients with the 11;14 translocations seem to do better on venetoclax so it could be added to the induction treatment for these patients. He says that the data supports maintenance therapy post-transplant because it extends progression free survival. He mentions the inclusions of checkpoint blockades, vaccines and other immunotherapies in the treatment mix. His two main goals are to increase access and improve outcomes.

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