Myeloma 2017 day 2 highlights: MRD, targeted therapies and imaging advances
Nov 16, 2017
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Guests Gareth Morgan, Nina Shah, and Leif Bergsagel discuss the highlights of Myeloma 2017, including MRD's impact on clinical trials, promising results of nelfinavir and proteasome inhibitor combination therapy, advancements in targeted therapies and imaging, and the consensus on primary principles of MM treatment.
The importance of minimal residual disease (MRD) in multiple myeloma was emphasized, with potential for MRD becoming a new endpoint in clinical trials.
Promising targeted therapies for multiple myeloma, such as repurposing HIV drug nelfinavir and targeting specific genetic subgroups, offer improved treatment outcomes.
Deep dives
MRD as an important prognostic factor
One of the main topics discussed in the podcast was the importance of minimal residual disease (MRD) in multiple myeloma. The speakers emphasized that MRD is a critical factor in determining prognosis, but there is still uncertainty about how to utilize this information effectively. They discussed the potential of MRD becoming a new endpoint in clinical trials and how it could lead to more targeted and cost-effective treatment strategies. However, they also acknowledged that regulatory authorities need convincing before MRD can be widely adopted as an endpoint.
Promising targeted therapies in multiple myeloma
The podcast highlighted the discussion around promising novel targeted therapies for multiple myeloma. One specific drug mentioned was nelfinavir, traditionally used as an HIV drug, which has shown potential as a protease inhibitor in combination with other agents. The speakers expressed enthusiasm for repurposing old drugs like nelfinavir to improve treatment outcomes in myeloma patients. Additionally, they discussed the importance of targeting specific genetic subgroups, such as those with chromosome translocations between 11 and 14, and the potential of drugs like venetoclax and MCL1 inhibitors to benefit a broader range of patients.
Advances in imaging and drug screening
The podcast also touched upon advances in imaging techniques and drug screening methods for myeloma. The speakers acknowledged that imaging technology has outpaced clinical trials, making it challenging to determine the best approach for utilizing imaging in disease evaluation. However, they expressed optimism about the potential of improved imaging techniques, such as F-methionine PET, to become valuable biomarkers for treatment response and possibly even endpoints. Additionally, they discussed the fascinating concept of in silico screening, where high-throughput drug screening can be performed on patients' own primary cells, leading to personalized and predictive treatment approaches.
This is a very exciting time for multiple myeloma (MM) research, with advances in a range of areas from new endpoints, to novel therapies and imaging. In this video, an overview of these updates are given by Gareth Morgan, MD, FRCP, FRCPath, PhD of UAMS Myeloma Institute, Little Rock, AR, Nina Shah, MD of UCSF Medical Center, San Francisco, CA and Leif Bergsagel, MD from the Mayo Clinic, Scottsdale, AZ following day 2 of the Myeloma 2017 meeting in Edinburgh, UK.
The coverage of MRD at the meeting, including its impact on future clinical trial design, is discussed. The panel also discusses the promising results of study using nelfinavir and proteasome inhibitor combination therapy for MM. The use of further targeted therapies for MM, as well as their combinations, is also debated. Imaging advances for MM are covered and the future of drug screening on patients’ primary cells is postulated. Lastly, the panel discusses the consensus on the primary principles of MM treatment, which will drive advances in MM research.