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Role of immunotherapy and precision medicines in multiple myeloma and key new guidelines

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Published: 03.03.17
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Prof Sagar Lonial - Emory University, Atlanta, USA

Professor Sagar Lonial (Emory University School of Medicine, Atlanta, USA) discusses key advances from IMW 2017, such as the emerging role of new immunotherapies where standard cytotoxic therapies have not been successful. 

Looking at genetics and genomics, Prof Lonial notes how precision medicine has been very successful in solid tumours but has not previously shown a similar impact for the haem malignancies.

He suggests that if we are to cure myeloma it won’t come through one approach but will instead be by utilising all three of immunotherapy, precision medicines and “biology-based” approaches. 

Touching on MRD, Prof Lonial notes how there is controversy around whether to use flow or next-generation sequencing to measure MRD, suggesting that the latter will be the modality of the future.

Whilst MRD is useful as an investigational tool, Prof Lonial suggests that it is not ready for “prime time”.

Finally, Prof Lonial discusses the three new treatment guidelines coming from the chairs of IMW 2017.

This includes definitions of smoldering myeloma and risk stratification, guidelines for how clinicians could assess risk and suggested treatment approaches, and a consensus statement around vaccination and infection prophylaxis in patients with myeloma.

Summarising the recent advances and what this means for patients, Prof Lonial said the overriding message is one of hope for the treatment of myeloma, as well as strong global alignment in the myeloma community due to meetings such as IMW. 

The role of MRD negativity is discussed further by Prof San Miguel, here.

Smoldering myeloma is discussed by Prof Mateos and Prof Richardson here.

This programme has been supported by an unrestricted educational grant from Janssen Pharmaceuticals (A Johnson & Johnson Company).

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