The Evolving Landscape of Multiple Myeloma | Claudio Cerchione, MD, PhD | ASH 2023

Hi, I am Claudio Cercione. I work in Instituto Romagnolo per lo Stoio dei Tumori di Namadori in Meldola, not far from Bologna, northern part of Italy. And I'm really glad to speak about the new opportunities for multiple meloma patients. In my institution, considering the evolving landscape in terms of therapy for multiple we are going to evaluate the new molecular profiling of our patients, particularly aiming to develop new biomarkers. Because I think that today, considering the emerging drug, many new target-directed drugs that we have available, we have to go to a target-driven approach. And that's why we are starting with the Sky 92 panel, the molecular expression for every our patients, integrating that with the new generation imaging, because it's really important to study the patient not only from the PET CT point of view, but also integrating with the whole body MRI. And I think that this is the best way to study the bone, but also eventual extramedullary evaluation that could be particularly present in the relapsed refractory setting. We dream to integrate this data together with the clinical data in order to produce a new prognostic index. And this is what we are going to do in the next future when we will integrate our monocentered data with other multi-institutional trial that we are going to collect in our network. Moreover, I think it's going to become really important to study not only the multiple meloma, but the pre-meloma status. And I think that focusing the attention on M. gas, smoldering meloma is particularly important. We are starting an awareness campaign about the idea of performing a correct differential diagnosis between M. gas, smoldering meloma, and different stadiums of smoldering meloma going from low intermediate and high risk. And particularly to understand which are the patients in which we need to intervene with the therapeutic action. I think that curing this smoldering meloma could be something that permits the patient to not develop multiple melomas, so never becoming ill. And I think that this should be really our end point in the next future, that we have to identify in the population patients who have a bomb that is going to attack them and to cure before the bomb can explode. I think this should be the aim of all researchers. We had also an experience with some clinical trials about smoldering meloma and the idea that in this patient the current end point should be MRD negativity, so the presence of no sign of disease. This is what they have to reach and I think that this is the achievement that we should promise to our patients. However, I think that we should focus our attention not only on the wonderful therapies but also on improving the diagnostic tools because I think that the fight against multiple melomas is being played also in correct diagnosis and correct monitoring. So performing a molecular evaluation but also introducing MRD monitoring in our daily practice. Thanks to these tools I'm sure that we will run towards the cure of multiple meloma and this is the best wish that we give to our patients, to their caregivers and to all the researchers that every day fight against multiple meloma. Thank you for your attention.