I like these IMF yearly symposiums because they allow doctors to have a civilized sparring of ideas

The highlight of today's ASH meetings (day one or zero depending on whose side you are on) was the IMF Satellite Symposium on "Controversies in Multiple Myeloma: Current Debates in Optimal Care". The topics covered ranged from an overview of Myeloma treatment landscape to defining and treating high-risk myeloma to what the treatment decision tree should be for Smoldering Myeloma to how to treat transplant ineligible patents and finally to what the role of Minimal Residual Disease (MRD) is in the treatment and prognosis of Myeloma.

I like these IMF yearly symposiums because they allow Doctors to have a civilized sparring of ideas which at the end hopefully will lead to clinical trials and better treatment consideration to patients.

Some of the takeaways from my perspective were:

• You need to decide what the goal of treatment should be. While no breakthrough announcement was made at this session, I was impressed by the progress that was made at looking at treatment goal holistically from both the Myeloma and the patient perspective.
  
  
• While the Myeloma diagnosis, treatment and care has exponentially increased in the last decade, it lags significantly behind other blood cancers. It really was refreshing and gratifying to see Drs. challenging each other and their colleagues to elevate the quality of care and pace of research for Myeloma.
  
  
•  It was clear that the research for treatment of Myeloma is further going to the molecular level and laboratory research is as critical as what I call bedside research.
  
  
• For the three case studies presented (a 70 year old male with CRAB based symptoms and increasing cytogenetic and FISH (standard, intermediate and high) risk abnormalities, the majority of the instant feedback survey respondents indicated they will choose a 3 drug combination of CyBorD (Cytoxan, Velcade and Dex) combination.

The final session of the Symposium was a debate between Drs. Jesús San-Miguel and Philippe Moreau about whether Minimal Residual Disease (MRD) is a treatment goal or a prognostic marker. Dr. San-Miguel said Minimally Residual Disease will contribute both to a better definition of response and enable better monitoring of the efficacy of intensification and maintenance therapies... to avoid both under and over treatment. Dr. Moreau had a different opinion and indicated MRD evaluation is important but has no impact on current treatment and the goal of which should be risk-adopted treatment strategy.

Tomorrow starts at 6:30 a.m. with the IMWG breakfast and ends at 9 p.m. with the IMF Senior and Junior Grant Awards

Sharing the Hope!
Yelak from North Texas Myeloma Support Group