[Multibilly]

New IMWG consensus - treatment of high-risk myeloma

by Multibilly on Wed Mar 23, 2016 11:11 am

Abstract:

The International Myeloma Working Group consensus updates the definition for high-risk multiple myeloma based on cytogenetics. Several cytogenetic abnormalities such as t(4;14), del(17/17p), t(14;16), t(14;20), non-hyperdiploidy and gain(1q) were identified that confer poor prognosis. The prognosis of patients showing these abnormalities may vary with the choice of therapy. Treatment strategies that have shown promise for high risk cytogenetic diseases, such as proteasome inhibitor in combination with lenalidomide/pomalidomide, double autologous stem cell transplant plus bortezomib, or combination of immunotherapy with lenalidomide or pomalidomide. Careful analysis of cytogenetic subgroups in trials comparing different treatments remains an important goal. Cross trial comparisons may provide insight in the effect of new drugs in patients with cytogenetic abnormalities. However, in order to achieve this, consensus on definitions of analytical techniques, proportion of abnormal cells and treatment regimens is needed. Based on data available today, bortezomib and carfilzomib treatment appear to improve complete response, progression-free survival and overall survival in t(4;14) and del(17/17p), while lenalidomide may be associated with improved progression-free survival in t(4;14) and del(17/17p). Patients with multiple adverse cytogenetic abnormalities do not benefit from these agents. FISH data are implemented in the revised International Staging System for risk stratification.

Reference:

P Sonneveld et al, "Treatment of Multiple Myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group," Blood, March 2016 (abstract)

[Cheryl G]

Re: New IMWG consensus - treatment of high-risk myeloma

by Cheryl G on Wed Mar 23, 2016 3:36 pm

Thank you for letting us know about this, Multibilly.

[Ted Kan]

Re: New IMWG consensus - treatment of high-risk myeloma

by Ted Kan on Wed Mar 23, 2016 6:03 pm

Thanks for posting this Multibilly.

[Mark Pouley]

Re: New IMWG consensus - treatment of high-risk myeloma

by Mark Pouley on Wed Mar 23, 2016 7:29 pm

Thank you for posting!

As a high risk patient (del17), currently being treated with Kyprolis (carfilzomib), and facing serious questions about what future treatment course to take, I found the abstract very interesting.

I'm currently responding well to induction previously read that carfilzomib may be beneficial for del17 patients. This may repeat that science (I didn't pay to read the full report), but it is helpful to see this again.