Hi, my name is Jean-Sebastien Claveau.
I am a hematologist at Maisonneuve-Rosemont in Montreal, Canada.
I did my fellowship at Mayo Clinic in Minnesota.
So today I will talk about progressions in multiple myeloma.
Currently, with the criteria that we use, when patients relapse from myeloma, we need to do two blood or urinary assessments at two different times to confirm that the patient is really progressing with the disease.
If it's the case, we need to change the treatment.
Usually, we do the first assessment, and if it meets the progression criteria, we will do a second assessment a few days or weeks later, and then we will change the treatment.
In our study, we looked at close to 600 patients at Mayo Clinic that were enrolled in research protocols.
And we looked at the time after the progression.
What we saw is that in some patients—close to 70% of patients—we could see that one test tells us they are progressing at one moment in time.
But if we look at the second test, we are also able to confirm at that time point that the patient is progressing with two tests at the same time.
This is useful for us because we don't need to do a second test to confirm progression.
Especially useful, for example, is when a patient is rapidly progressing, and we need to change the treatment.
In that case, we don’t need to wait. We can go faster and change the treatment.
This was also an issue in some clinical trials, our research protocol, where patients did not have the second assessment before changing the treatment.
So now, when it's possible, we can use these simultaneous criteria, which will avoid needing a second blood test or a second urinary test.
This also helps avoid having the patient come back to the hospital just to confirm that the disease is already progressing.
It’s not perfect—there are some limitations.
It doesn't work for every patient, but in some cases, it could be interesting.
We hope that this will be added to the revisions of the response criteria that the International Myeloma Working Group will update in the next few months or years.
The goal is to eliminate time-related toxicities, both those related to the disease and also to treatments that take time before we are able to change the treatment.
It could also help enroll patients in clinical research because, in research, we often have a hard time screening or confirming that everything is good before changing the treatment or starting a new research treatment.
So if we can shorten the timeline between the time when we say that the patient is relapsing and the start of the new treatment, it can be better for the patients, especially to avoid complications like bone complications, anemia, and other issues.
It can be really good for patients.
It's always difficult for both patients and physicians to know when is the best timing to change the treatment.
I think that this new criteria or new way to work with patients who are relapsing could be something interesting for some patients.
And we hope that it will be used by clinicians in the next few years.
HealthTree • December 23, 2024