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Accreditation/Credit Designation

Physicians' Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians' Education Resource®, LLC, designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Sanofi Genzyme.

Advances In™ Therapies for Patients with Multiple Myeloma: More Options…More Decisions…Better Outcomes


Release Date: December 31, 2018
Expiration Date: December 31, 2019
Media: Internet - based

Activity Overview

This activity, Advances In™ Therapies for Patients with Multiple Myeloma: More Options… More Decisions… Better Outcomes, is designed to update clinicians on the latest strategies to optimize outcomes for patients with multiple myeloma (MM). As clinicians who treat patients with MM, you require a solid understanding of treatment options available for patients with newly diagnosed MM, and how to tailor therapy for individual patients based on transplant eligibility and other patient and disease characteristics. It is vital to understand the benefits and risks of maintenance therapy, both in patients who undergo transplantation and in those who do not. In addition, you need to be aware of the expanding armamentarium of agents for patients with relapsed and/or refractory (R/R) MM, and the specific settings in which their use is supported by high-level clinical evidence. Finally, you want to be up-to-date on emerging agents and clinical trial options to expand opportunities for your patients with MM.

To help you meet these goals, we have developed an educational activity that features a review of the latest data and expert guidelines regarding treatment options for newly diagnosed and R/R MM, accompanied by video commentary from a leading expert in the management of patients with MM, who will discuss current treatment paradigms and strategies for integrating the latest data in order to optimize outcomes for your patients with MM.

Benefits of Participating

  • Learn how to individualize and optimize treatments for patients with newly diagnosed and relapsed/refractory multiple myeloma (MM)
  • Understand how treatment paradigms for MM are evolving with the introduction of new targeted agents
  • Learn how evolving methodologies to measure minimal residual disease may impact the management of MM in the future
  • Explore options for clinical trials investigating novel agents and new strategies for MM

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Sanofi Genzyme.

Instructions for This Activity and Receiving Credit

  • You will need to log in to participate in the activity.
  • Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review audio files/content until you finish the presentation.
  • At the end of the activity, educational content/audio files will be available for your reference.
  • In order to receive a CME certificate, you must complete the activity.
  • Complete the Posttest and pass with a score of 70% or higher, complete the Evaluation, and then click on “Request for Credit.” You may immediately download a CME certificate upon completion of these steps.


Target Audience

This educational activity is directed toward medical oncologists, hematologists, advanced practitioners, and nurses who treat patients with MM. Pharmacists and other healthcare professionals interested in the treatment of MM are also invited to participate.

Learning Objectives

Upon successful completion of this activity, you should be better prepared to:

  • Individualize therapeutic selection in patients with newly diagnosed and relapsed/refractory multiple myeloma (MM)
  • Implement appropriate treatment sequencing strategies in patients with MM who experience multiple relapses or refractory disease
  • Explain the significance of minimal residual disease in patients with relapsed MM
  • Discuss the emerging MM treatment landscape and available clinical trial opportunities for eligible patients

Faculty, Staff, and Planners' Disclosures

Faculty

Alexander M. Lesokhin, MD
Assistant Attending Physician
Memorial Sloan Kettering Cancer Center
New York, NY
 
 

Disclosures: Consultant, Advisory Board, or Speaker Compensation: Bristol-Myers Squibb, OncoMed Pharmaceuticals, Creative Educational Concepts, Inc., Juno Therapeutics, Dava Oncology, Syndax, GenMab, Takeda Pharmaceuticals; Research Funding: Janssen (Johnson and Johnson), Bristol-Myers Squibb, Genentech, Celgene; Royalties: Serametrix, Inc.

The staff of PER® have no relevant financial relationships with commercial interests to disclose.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI.

Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.

Off-Label Disclosure and Disclaimer

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.

PER Pulse™ Recaps

1 of 3
Advances In™ Therapies for Patients With Multiple Myeloma: More Options…More Decisions…Better Outcomes

Treatments for Newly Diagnosed Multiple Myeloma

Advances In™ Therapies for Patients With Multiple Myeloma: More Options…More Decisions…Better Outcomes is designed to update you on the latest strategies to optimize outcomes for patients with multiple myeloma (MM). This activity will increase your knowledge of treatment options for patients with newly diagnosed MM and your ability to tailor therapy for individual patients based on transplant eligibility and other patient and disease characteristics. In addition, it will address the benefits and risks of maintenance therapy, the expanding armamentarium of agents for patients with relapsed and/or refractory (R/R) MM, and emerging agents, along with clinical trial options to expand opportunities for your patients. This activity features a review of the latest data and expert guidelines regarding treatment options for newly diagnosed and R/R MM, accompanied by video commentary from Alexander M. Lesokhin, MD, a leading expert in the field of MM, who will discuss current treatment paradigms and strategies for integrating the latest data to optimize outcomes for your patients with MM.

This first of 3 PER Pulse® Recaps focuses on the management of patients with newly diagnosed MM, in both the transplant-eligible and transplant-ineligible settings. Highlights include:

  • A recent study showing similar survival outcomes following transplant for patients age ≥75 years compared with those aged <75 years suggests that age should no longer be the primary consideration when selecting patients for autologous stem cell transplantation.
  • For transplant-eligible patients, a 3-drug induction regimen incorporating a proteasome inhibitor remains the standard of care. National Comprehensive Cancer Network (NCCN) guidelines have expanded the list of options to include carfilzomib- and ixazomib-based regimens, as well as conventional regimens containing bortezomib, based on phase I/II data with these agents in the up-front setting. Comparative phase III trials are ongoing.
  • NCCN guidelines recommend many of the same 3-drug regimens as frontline therapy for transplant-eligible patients. However, recent practice-changing data with the novel anti-CD38 antibody daratumumab is changing this paradigm.
    • In 2018, the FDA approved a 4-drug regimen that incorporates daratumumab with a bortezomib/melphalan/prednisone backbone for the treatment of transplant-ineligible patients with MM. Approval was based on the results of the phase III ALCYONE trial, which showed that the addition of daratumumab significantly improved 18-month progression-free survival (PFS) from 50% to 72% (HR, 0.50; P <.001).
    • More recently, results from the phase III MAIA trial demonstrated that the addition of daratumumab to a lenalidomide/dexamethasone (Rd) backbone significantly improved PFS (median not reached with daratumumab vs 31.9 months with Rd alone; HR, 0.56; P <.0001) in transplant-ineligible patients with newly diagnosed MM.

2 of 3
Advances In™ Therapies for Patients With Multiple Myeloma: More Options…More Decisions…Better Outcomes

Maintenance Therapy in Multiple Myeloma

Advances In™ Therapies for Patients With Multiple Myeloma: More Options…More Decisions…Better Outcomes is designed to update you on the latest strategies to optimize outcomes for patients with multiple myeloma (MM). This activity will increase your knowledge of treatment options for patients with newly diagnosed MM and your ability to tailor therapy for individual patients based on transplant eligibility and other patient and disease characteristics. In addition, it will address the benefits and risks of maintenance therapy, the expanding armamentarium of agents for patients with relapsed and/or refractory (R/R) MM, and emerging agents, along with clinical trial options to expand opportunities for your patients. This activity features a review of the latest data and expert guidelines regarding treatment options for newly diagnosed and R/R MM, accompanied by video commentary from Alexander M. Lesokhin, MD, a leading expert in the field of MM, who will discuss current treatment paradigms and strategies for integrating the latest data to optimize outcomes for your patients with MM.

This second of 3 PER Pulse® Recaps focuses on the use of maintenance therapy for patients with MM and recent data exploring the role of newer targeted agents in the maintenance setting. Highlights include:

  • Evidence from 2 phase III studies (IFM 2005-02, CALGB 100104) demonstrated a progression-free survival (PFS) benefit in the posttransplant setting and supports maintenance therapy with lenalidomide. A recent meta-analysis also revealed a significant overall survival advantage. However, maintenance lenalidomide has been associated with an increased rate of second primary malignancies, which should be discussed with patients.
  • Results from studies evaluating bortezomib in maintenance or consolidation settings have shown that its use can improve response rates over those achieved with primary therapy with or without autologous stem cell transplant (ASCT).
  • Recently reported results from the phase III TOURMALINE-MM3 trial comparing 2 years of maintenance therapy with ixazomib versus placebo in patients with newly diagnosed MM who achieved a partial response to induction therapy followed by ASCT showed a significant improvement in median PFS with ixazomib (26.5 months vs 21.3 months; HR, 0.72; P = .002).
  • A phase II study of lenalidomide plus the anti-SLAMF7 monoclonal antibody elotuzumab as maintenance therapy following ASCT showed that the combination increased the complete response rate from 32% at study entry to 52%, with an estimated 3-year PFS of 81%.

3 of 3
Advances In™ Therapies for Patients With Multiple Myeloma: More Options…More Decisions…Better Outcomes

Treatments for Relapsed/Refractory Multiple Myeloma

Advances In™ Therapies for Patients With Multiple Myeloma: More Options…More Decisions…Better Outcomes is designed to update you on the latest strategies to optimize outcomes for patients with multiple myeloma (MM). This activity will increase your knowledge of treatment options for patients with newly diagnosed MM and your ability to tailor therapy for individual patients based on transplant eligibility and other patient and disease characteristics. In addition, it will address the benefits and risks of maintenance therapy, the expanding armamentarium of agents for patients with relapsed and/or refractory (R/R) MM, and emerging agents along with clinical trial options to expand opportunities for your patients. This activity features a review of the latest data and expert guidelines regarding treatment options for newly diagnosed and R/R MM, accompanied by video commentary from Alexander M. Lesokhin, MD, a leading expert in the field of MM, who will discuss current treatment paradigms and strategies for integrating the latest data to optimize outcomes for your patients with MM.

This third of 3 PER Pulse® Recaps focuses the expanding armamentarium of active agents for patients with R/R MM, particularly agents that have recently received regulatory approval. Highlights include:

  • Since 2012, 6 new agents have been approved for the treatment of R/R MM: pomalidomide, carfilzomib, panobinostat, ixazomib, elotuzumab, and daratumumab.
  • The final analysis of the phase III ASPIRE trial comparing lenalidomide/dexamethasone (Rd) with or without carfilzomib in patients with R/R MM showed a statistically significant 7.9-month improvement in overall survival (OS) with carfilzomib (HR, 0.79; P =.0045). Likewise, an updated analysis of the ENDEAVOR trial demonstrated a significant improvement in OS for carfilzomib/dexamethasone compared with bortezomib/dexamethasone (Vd) in patients with R/R MM with 1 to 3 prior therapies (47.6 months vs 40.0 months; HR, 0.791; P = .010).
  • The phase III PANORAMA 1 trial demonstrated a statistically significant improvement in progression-free survival (PFS) when panobinostat was added to Vd (HR, 0.63; P <.0001). Although there was a trend toward improved OS, it has not reached statistical significance.
  • The phase III TOURMALINE-MM1 trial in patients with R/R MM demonstrated that adding ixazomib to Rd significantly improved median PFS (20.6 months vs 14.7 months in the control arm; HR, 0.74; P =.01).
  • In the phase III ELOQUENT-2 study, the addition of the SLAMF7-directed monoclonal antibody elotuzumab to Rd resulted in prolonged PFS compared with Rd alone (19.4 months vs 14.9 months; HR, 0.70; P <.001). OS data are not yet mature.
  • In the phase III POLLUX study in patients with MM who had received ≥1 prior therapy, daratumumab significantly improved PFS when added to Rd (median not reached vs 17.5 months; HR, 0.41; P <.0001). A similar increase in PFS was observed in the CASTOR trial when daratumumab was added to Vd (median, 16.7 months vs 7.1 months; HR, 0.31; P <.0001).

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