Preventing Multiple Myeloma | Claudio Cerchione, MD | IMS 2024

Claudio Cercione, Instituto Romagnolo per lo Studi della Cura dei Tumori di Namadori, Meldola, Italy. I think it's really important to think about the idea of preventing multiple meloma. And I think that this is an hematological disease in which the prevention program should be really effective, particularly starting from a correct differential diagnosis between hemgaz and smoldering meloma, particularly going to discriminate who are the high-risk patients in order to solve to the eternal question, who is the patient who should be treated in the pre-meloma status. And particularly we are going to perform in my institution a correct evaluation of all the monoclonal gamopathies that came in our referral point. And I think that it's really important to focus about how is concretely today defined the high-risk smoldering meloma. 2020, according to Pertema studies, according to Marimi Matteo's databases, 20 are the plasma cells in Mulmarov, 20 are the Freelance Chain Ratio and 20 is the M-spike, the monoclonal component that we have to evaluate. If the patient has at least two of these 20, maybe should undergo, in my perspective, absolutely should undergo two treatment programs. And we have many ongoing clinical trials going to evaluate all the new immunotherapies, monoclonal and specific antibodies in order to say also a long-term approach that considering the potential evolution of 60% in two years of high-risk smoldering meloma, the answer to should we treat this patient, in my opinion, is absolutely yes and we should make this therapeutic program, this clinical trials, democratic for every patient because in Europe in this moment, unfortunately, we don't have any drug reimbursant and approved even if lenalidomide has changed the history of these patients. Preventing is better than treat the patient and if we are able to prevent as many patients as possible, we can start to treat the patient and eradicate the clone before then they get teal and treating before they get teal means to avoid the bone disease, to avoid renal failure, to avoid anemia and to avoid all myoma related events and this is what I'm trying to do with my institution every day in order to also aware the population about the importance of deeply understand which is the status of the monoclonal ganmopathy or no significance. In this way, we can optimize the treatment and we can optimize also their long-term outcomes. Thank you for your attention.