Treat so-called “ high-risk ” smoldering myeloma … Yes or No?

My (predictable) answer is “NO, absolutely NOT.” Not until you begin having CRAB symptoms. But first things first… I began writing this post last week, then I just had too many things to do so I didn’t finish my draft. Then, yesterday morning, before going to work, I came across an article by Dr. Brian Durie (I don’t think I need to explain who he is!) making some of the points I had already made in my draft, BUT from the point of view of a world-famous hematologist. So I decided to cut my draft in half and give you the link to Dr. Durie’s piece: http://bit.ly/2WWwsX9 But, of course, I still have some comments to make…   First, though, a bit of background. In a recent trial, the ECOG trial that Dr. Durie refers to in his article, lenalidomide was administered to so-called “high risk” smoldering myeloma patients. Based on the trial results, the authors state that lenalidomide “may” delay progression to active myeloma. Yes, this was a “big” SMM trial, the biggest to date, anyway, with 182 participants…but, according to Dr. Durie, “Of the 180 patients in the ECOG trial, only 13 with HR-SMM received treatment with lenalidomide. Though their outcomes were improved versus observation alone, this is an extremely small number of patients as a basis for a “standard of care.” In addition, the remaining patients (the vast majority of them) were those with lower-risk SMM, an...
Source: Margaret's Corner - Category: Cancer & Oncology Authors: Tags: Blogroll HR SMM lenalidomide Source Type: blogs

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rancesca Gay Multiple myeloma (MM) is still considered an incurable hematologic cancer and, in the last decades, the treatment goal has been to obtain a long-lasting disease control. However, the recent availability of new effective drugs has led to unprecedented high-quality responses and prolonged progression-free survival and overall survival. The improvement of response rates has prompted the development of new, very sensitive methods to measure residual disease, even when monoclonal components become undetectable in patients’ serum and urine. Several scientific efforts have been made to develop reliable ...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Inokuchi Despite therapeutic advances over the past decades, multiple myeloma (MM) remains a largely incurable disease with poor prognosis in high-risk patients, and thus new treatment strategies are needed to achieve treatment breakthroughs. MM represents various forms of impaired immune surveillance characterized by not only disrupted antibody production but also immune dysfunction of T, natural killer cells, and dendritic cells, although immunotherapeutic interventions such as allogeneic stem-cell transplantation and dendritic cell-based tumor vaccines were reported to prolong survival in limited populations of MM p...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
This article provides a comprehensive overview about the progress to date in the preclinical and clinical development of filanesib for the treatment of cancer, and particularly, MM.Expert opinion: Responses observed with filanesib alone or in combination with dexamethasone were encouraging in MM. However, the subsequent appearance of highly effective novel agents such as monoclonal antibodies, has hindered the development of agents such as filanesib that exhibit a more limited activity. Nevertheless, filanesib has shown interesting results for some patients when combined with carfilzomib and pomalidomide. Most importantly,...
Source: Expert Opinion on Investigational Drugs - Category: Drugs & Pharmacology Tags: Expert Opin Investig Drugs Source Type: research
Conditions:   Stem Cell Transplant Complications;   Myeloma;   Lymphoma;   Allogeneic and Autologous Stem Cell Transplant Interventions:   Other: physical therapy consult;   Other: Cognitive Assessment;   Other: Cancer Aging Research Group (CARG) assessment;   Other: Medication Review;   Other: Nutrition assessment;   Other: Laboratory studies;   Other: Patient satisfaction questionnaire;   Other: Physician Q uestionnaire;   Other: Pati...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractMultiple myeloma (MM), an incurable hematologic malignancy of plasma cells increasing in the bone marrow (BM), has a complex microenvironment made to support proliferation, survival, and drug resistance of tumor cells. MicroRNAs (miRNAs), short non ‐coding RNAs regulating genes expression at posttranscriptional level, have been indicated to be functionally deregulated or abnormally expressed in MM cells. Moreover, by means of miRNAs, tumor microenvironment also modulates the function of MM cells. Consistently, it has been demonstrated that m iRNA levels regulation impairs their interaction with the microenvironme...
Source: IUBMB Life - Category: Research Authors: Tags: CRITICAL REVIEW Source Type: research
Blood Cancer Journal, Published online: 11 December 2019; doi:10.1038/s41408-019-0264-yComprehensive detection of recurring genomic abnormalities: a targeted sequencing approach for multiple myeloma
Source: Blood Cancer Journal - Category: Hematology Authors: Source Type: research
(Dana-Farber Cancer Institute) Results of studies on a novel agent to treat multiple myeloma and a combination therapy aimed at slowing the progression of a precursor myeloma condition are among reports being presented by Dana-Farber Cancer Institute investigators at the ASH Annual Meeting.
Source: EurekAlert! - Cancer - Category: Cancer & Oncology Source Type: news
Authors: Jiang Y, Chen J, Chen G Abstract Long noncoding RNAs (lncRNAs) are aberrantly expressed in a variety of cancer types. The lncRNA IGF1R antisense imprinted non-protein coding RNA (IRAIN) is associated with various cancer types, yet the role of IRAIN in multiple myeloma (MM) progression remains unclear. In the present study it was identified that IRAIN may act as a tumor suppressor in MM, whilst microRNA (miR)-125b may promote tumorigenesis. Downregulation of IRAIN significantly increased the expression of miR-125b. Furthermore, by using dual-luciferase reporter assays, IRAIN was identified as a target of mi...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
Cancer Gene Therapy, Published online: 05 December 2019; doi:10.1038/s41417-019-0154-2BAG3 regulates multiple myeloma cell proliferation through FOXM1/Rb/E2F axis
Source: Cancer Gene Therapy - Category: Cancer & Oncology Authors: Source Type: research
Abstract Heparanase is known to enhance the progression of many cancer types and is associated with poor patient prognosis. We recently reported that after patients with multiple myeloma were treated with high dose chemotherapy, the tumor cells that emerged upon relapse expressed a much higher level of heparanase than was present prior to therapy. Because tumor cells having stemness properties are thought to seed tumor relapse, we investigated whether heparanase had a role in promoting myeloma stemness. When plated at low density and grown in serum-free conditions that support survival and expansion of stem-like c...
Source: Matrix Biology - Category: Molecular Biology Authors: Tags: Matrix Biol Source Type: research
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