NEWLY DIAGNOSED MULTIPLE MYELOMA YOUNG PATIENTS
Chairmen: Michele Cavo, Angelo Maiolino
1. Triplet induction: standard of care VTD, VRD (KRD?)
2. VGPR rates: 55-68% after induction
3. Current quadruplet regimen are more toxic, but in the future with MOAB?
1. Do we still need high dose CT and stem cell transplantation in the era of the novel agents?
Specific situations: - CR after induction – ASCT?
- primary refractory patient – ASCT?
2. Tandem vs. single ASCT?
3. AlloSCT in first line treatment for high risk myeloma patients?
4. Age limit of HD-therapy and ASCT?
Optimal Consolidation Therapy
The present and the future
Incorporation of ”newer” highly active novel agents with lack of off-target toxicities/low toxicity profile into consolidation therapies is expected to maximize the benefits through:
- more prolonged treatment exposure (e.g. increased number of cycles)
- different combinations of drugs with different, and possibly complementary mechanisms of action
Although not yet a standard, post-ASCT consolidation therapy is likely to be an important phase of the modern treatment paradigm for MM patients.
Transplant Eligible Maintenance
Philip L. McCarthy
1. Transplant eligible maintenance
- Bortezomib for 2 years following ASCT is a standard primarily for those presenting renal failure and those patients with chromosome del(17p).
- Lenalidomide until PD is a standard of care following ASCT.
- We need to understand which patients are at risk for SPMs.
- Role of maintenance after 2nd ASCT?
- Combination therapy for high risk (RVD light, Nooka et al. Leukemia 2014)
2. Risk stratification for maintenance following ASCT
3. Test new agents and identify new target pathways for induction and maintenance for transplant ineligible and transplant eligible MM patients