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, and they did not achi...
Source: Margaret's Corner - Category: Cancer & Oncology Authors: Tags: Blogroll HR SMM lenalidomide Source Type: blogs