Professor Gareth Morgan from London, UK, leads an expert panel discussing key topics from the Multiple Myeloma Debate 2012 in Berlin for ecancer.TV, as well as the changing treatment landscape in multiple myeloma (MM).

The experts - Roman Hajek from Brno, Czech Republic, María-Victoria Mateos from Salamanca, Spain and Hartmut Goldschmidt from Heidelberg, Germany – summarise the main points made at the 2012 Debate, and look to the future of MM management.

Dr Mateos summarises her main findings on smoldering multiple myeloma (SMM) in terms of defining and identifying high-risk SMM and how/if symptomatic disease should be treated.  The experts note that SMM is now a research priority, and comment on how they would currently treat these patients in clinical practice.

Professor Goldschmidt discusses recent advances in MM risk stratification, with interphase fluorescence in situ hybridisation (FISH) being a strong predictor of progression-free survival, and promise also from other cytogenetic markers.  The future will involve analysing the different sub-clones of MM at different stages of the disease, and identifying how they can be treated.  All experts share their views on risk stratification and how/whether patients of different risk should currently be managed.  Professor Hajek outlines current views on how patients should be managed when cytogenetics are not available, and the experts discuss the importance of actively managing low- as well as high-risk patients.

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

The expert panel then comment on novel agents in MM.  ProfessorHajek outlines the role of the single agent monoclonal antibody - the first being the anti CD38, daratumumab.  Other novel agents with potential promise that are outlined include ARRY-520, ibrutinib, elotuzumab and BTK inhibition. They also comment on combinations of novel with existing agents, and the need for a clear rationale for drugs entering phase III research.