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The IMWG Conference Series "Making Sense of Treatment"
7th IMWG Summit | June 9, 2016

Drs. Brian GM Durie, Joseph Mikhael,Paul Richardson, and Maria Victoria Mateos discusses the latest news and trends in the treatment of Multiple Myeloma.


The first question of the series is “What is the impact of the new diagnostic criteria?” The criteria to which the doctors are referring is the SLiM CRAB criteria, which expands the former CRAB criteria. SLiM CRAB stages myeloma considering the following seven factors: S, which stands for 60% plasmacytosis; Li, for light changes 1/U > 100; M (More than 1 MRI focal lesion); C for Calcium elevation; R for renal insufficiency; A for anemia; and B for bone disease.

The second question of the series is “How does risk status affect treatment?” The doctors consider mSMART classification to look at high-, intermediate-, and standard-risk myeloma. They discuss, with the increasing depth of response in myeloma with the newer drugs, how doctors should evaluate the use of these drugs with the higher-risk disease groups.

The third question of the series is “Are you proactive regarding your patients’ possible comorbidities?” In particular, the doctors consider patient characteristics such as age, performance status, and other health problems. They talk about when to consider stem cell transplant with frailer patients.

The fourth question of the series is “How do you use MRD testing?” Discussed are the new IMWG Criteria in MRD testing in multiple myeloma, which is to be published in Lancet Oncology. Attention is given as to how to use the testing going forward with patient care.

The fifth question in the series is “Is maintenance a standard of care?” Discussed is the value of Revlimid (lenalidomide) maintenance post-autologous stem cell transplant (as based on a recent French study).

The sixth and final question in the series is “How do you sequence new therapies?’ Even though there is a tremendous access to new drug therapies, doctors have yet to determine the best way to use these new therapies. The doctors conclude that some of the most exciting therapies are monoclonal antibodies, vaccines, small molecules, cellular therapies, CAR- T cell therapy, and more.

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