Selecting Patients for Maintenance or Continuous Therapy Including Regimen Selection and Duration of Treatment
Release Date: October 07, 2015
Expiration Date: October 07, 2016
Expected time to complete this activity as designed: 45 minutes
There are no fees for participating in or receiving credit for this online activity.
The use of IMiDs, such as thalidomide and lenalidomide, and the proteasome inhibitor bortezomib have significantly improved the depth of responses achieved during primary treatment in newly diagnosed multiple myeloma patients, whether they are transplant candidates or not. However, despite ongoing progress in the development of even more effective drugs, multiple myeloma (MM) remains incurable and no effective therapy is available for advanced aggressive disease. The concept of maintenance therapy in multiple myeloma is not new. Historic attempts to use chemotherapies and interferon to maintain the responses achieved through primary induction therapy provided little benefit and increased toxicity. However, with the use of IMiDs and proteasome inhibitors, increases in progression-free survival (PFS) and overall survival (OS) have been demonstrated in some trials of maintenance therapy, though others have reported improved PFS with no corresponding improvement in OS. Outstanding questions remain, including which patients may benefit most from maintenance therapy and with which type of agent, IMiD or proteasome inhibitor, with or without a steroid, and at what dose schedule and for how long? Does a patient’s risk factors influence the choice of maintenance therapy and, importantly, when do the benefits outweigh the risks? Even with answers to some of these questions still remaining, newer agents, including some not yet approved for multiple myeloma, are already being explored in clinical trials as maintenance strategies. Many of these new agents and regimens have promise to provide increased rates of achieving minimal residual disease negativity early in treatment, even in patients with high-risk cytogenetics by FISH, and thus maintenance therapy approaches that provide durability of these responses will be essential to future practice.
Join team Managing Myeloma world expert Philip McCarthy, MD, professor of oncology and the director of the Blood and Marrow Transplant Program at Roswell Park Cancer Institute in Buffalo, New York, as he reviews Managing Myeloma member responses to a recent survey regarding use of maintenance therapy in their practice. As part of Dr. McCarthy’s discussion, he provides an overview of current clinical data supporting specific maintenance strategy approaches after transplant, continuous therapy in non-transplant patients, as well as safety considerations. He also discusses some new approaches that are emerging from clinical trials.
This activity is designed for physicians, pharmacists, physician assistants, and other health care professionals who have an interest in enhancing their clinical skills in multiple myeloma.
Upon completion of this educational activity, participants should be able to:
- Relate the goals of maintenance and continuous therapy, current controversies, and who should be considered for this strategy
- Cite clinical evidence of benefits and risks of maintenance and continuous therapy, as well as outstanding questions being explored in clinical trials
- Choose maintenance therapy strategies consistent with risk-adaptive approaches for individual MM patient needs
- Recall specific maintenance therapy regimens including dose schedules and duration of therapy
Selecting Patients for Maintenance or Continuous Therapy Including Regimen Selection and Duration of Treatment – Philip McCarthy, MD
Instructions for Participation and Credit
This activity is eligible for credit through October 7, 2016. After this date, this activity will expire and no further credit will be awarded.
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Philip L. McCarthy, MD
Professor of Oncology
Director, Blood and Marrow Transplant Program
Roswell Park Cancer Institute
Buffalo, New York
Dr. Philip McCarthy received his medical degree from Tufts University School of Medicine, Boston, Massachusetts. He completed an internship and residency at Yale-New Haven Hospital, as well as two fellowships at Brigham and Women's Hospital. Dr. McCarthy is professor of oncology and director of the Blood and Marrow Transplant Program at Roswell Park Cancer Institute, Buffalo. He is also associate professor of medicine at the State University of New York at Buffalo.
Dr. McCarthy is a diplomate, American Board of Internal Medicine, with subspecialty certification in medical oncology and hematology, and holds membership in the American Society of Hematology (ASH), American Society for Blood and Marrow Transplantation (ASBMT), American Society of Clinical Oncology (ASCO), American Association of Blood Banking, and American Association for Cancer Research (AACR). He is on the editorial board of Biology of Blood and Marrow Transplantation, Bone Marrow Research, and Bone Marrow Transplantation, as well as an ad hoc reviewer for Blood, Bone Marrow Transplantation, Cancer, Journal of Clinical Oncology, Haematologica, Leukemia and Lymphoma, Oncology, and JNCCN. Dr. McCarthy has published more than 150 peer-reviewed manuscripts and abstracts, and his major research interest areas include blood and marrow transplantation, chemotherapy toxicity, cancer immunotherapy, and multiple myeloma. He has been voted Best Doctors in America 2005-2011.
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As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE) and California State Board of Registered Nursing, MediCom Worldwide, Inc. requires everyone who is a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest. Accordingly, the following disclosures were made.
Dr. Philip McCarthy has received honoraria related to formal advisory activities and as a consultant from Binding Site Group Ltd, Bristol-Myers Squibb Company, Celgene Corporation, Karyopharm Therapeutics, and Sanofi.
Planning Committee Disclosures
The individuals listed below from MediCom Worldwide, Inc. reported the following for this activity: Joan Meyer, RN, MHA, executive director, and Eugene R. Tombler, PhD, FACME, medical director, oncology, have no relevant financial relationships.
Peer Reviewer Disclosure
In accordance with MediCom Worldwide, Inc. policy, all content is reviewed by external independent peer reviewers for balance, objectivity and commercial bias. The peer reviewers have no relevant financial relationships to disclose.
Off-Label Disclosures/Investigational Disclosures
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/ participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.
Dr. McCarthy has indicated that he does not intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.
Dr. McCarthy has indicated that he does not intend to discuss investigational drugs, mechanical devices, biologics or diagnostics not approved by the FDA for use in the US.
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This activity is supported by educational grants from Takeda Oncology and Celgene Corporation.
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