In this online, self-learning activity:
Multiple myeloma (MM) is a hematologic malignancy of the lymphocytes, and while the true cause is unknown, associated factors are thought to include: radiation, genetics, viral infections, and the human immunodeficiency virus. Myeloma is most common of the hematologic malignancies after non-Hodgkin lymphoma, with an incidence of over 34,000 and an annual mortality rate of over 12,000. The peak incidence age of MM is at about 70 years of age, and the disease occurs twice as commonly in African Americans as it does in whites.
Goals of care in MM are prolonging survival rates and improving quality of life, and treatment begins with induction and post-induction therapy, followed by hematopoietic stem cell transplant or maintenance therapy in patients ineligible for transplant. Relapse is indicated by any of several clinical signs, including new soft tissue plasmacytomas, hypercalcemia, renal insufficiency, anemia, new bone lesions, or hyperviscosity related to serum paraprotein.
Hematologists and oncologists; physician assistants, nurse practitioners, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with RRMM.
Commercial Support Disclosure: This program is supported by an educational grant from Takeda.
This activity is free of charge.
Release Date: October 08, 2022 -- Expiration Date: October 08, 2023
Faculty: Scott Goldsmith, MD
Faculty introduction, disclosures |
Introduction content
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Updates in treatment and monitoring of patients with RRMM
· Present pharmacotherapy, clinical trial findings, and guideline updates o Treatment of first relapses § Lenalidomide sensitive § Treatment options when refractory to: · Lenalidomide alone · Lenalidomide and bortezomib · Lenalidomide and daratumumab o Treatment of later relapses § Regimens including agents to which the patient’s disease is not already refractory: pomalidomide, carfilzomib, isatuximab, elotuzumab, ixazomib, selinexor § Penta-refractory disease · Therapy aimed at B cell maturation antigen (BCMA) via chimeric antigen receptor T cell (e.g., idecabtagene vicleucel or ciltacabtagene autoleucel) or antibody conjugate (e.g., belantamab mafodotin) therapy · Nuclear export inhibition · Alkylator-containing regimens · Investigational therapies targeting: Bcl-2; Bruton tyrosine kinase; BCMA · Disease response and relapse monitoring o Timing o Assessment: serum protein electrophoresis, 24-hour urine protein electrophoresis, free light chain assay, and minimum residual disease · Additional considerations and challenges o Treatment-emergent adverse effects and their management o Other patient-related factors: age-related frailty, acute renal failure, extramedullary disease o Pandemic-related considerations o Patient education, shared decision-making, and patient-reported outcomes o Disparities in care
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Summary, conclusions, and best practice recap |
By the end of the session the participant will be able to:
ACCME Activity #202340979
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.
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ABIM MOC Credit Type: Medical Knowledge
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Pharmacists
ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-22-056-H01-P. This is an Application (A)-type activity.
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Faculty Disclosure: Scott Goldsmith, MD, Assistant Professor, Division of Myeloma, City of Hope National Medical Center, has received financial compensation from Janssen, Sanofi-Genzyme, Wugen, Adaptive Biosciences, and Oncovalent for consulting and/or advisory board work.
Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.
Faculty will discuss off-label uses.
All relevant financial relationships have been mitigated.
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Commercial Support Disclosure: This program is supported by an educational grant from Takeda.
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Mesothelioma management: Therapeutic updates and best practices