Impact of extramedullary plasmacytoma on outcomes in patients with relapsed refractory multiple myeloma treated with talquetamab: U.S. Myeloma Immunotherapy Consortium #mmsm@BloodCancerJnl@utswcancer@AimazAfrough@ldandersonjr
➡️ https://t.co/ZnDqCuvdBR
3. The ECOG trial that showed that lowering the dose of dexamethasone in myeloma saves lives. @TheLancetOncol 2010
Randomized trial that helped my career the most. Design proposed by a patient advocate! We didn’t realize the 10% mortality in the first year following diagnosis that occurred in newly diagnosed myeloma due to Dex related toxicity until this trial. The trial was done in a narrow population with doublet regimen. But the results were compelling and welcomed by patients and physicians alike that it became standard across the board with all regimens and all settings. @Rfonsi1
These type of randomized trials are only possible through @theNCI funded cooperative groups: @eaonc@SWOG@ALLIANCE_org
Leadership of these trials requires investment of years participating in the group activities and perseverance. Also skill and effort because every word of the protocol and paper you have to write.
Final one is a bonus. Not authored by me. It’s a gift from @TheLancet 2011
Totally mind boggling that most of us will be happy to have a small paper in @TheLancet — but to have The Lancet do a paper on you is still unbelievable for me even after all these 15 years!
Just when medicine has become incredibly complex due to dramatic scientific advances, the need for more expertise and individualization for best outcomes, and when patients want physicians who are competent, empathetic, and accessible…
We are in the midst of continued physician burnout, loss of autonomy, and micromanagement. Physicians are leaving the profession early or cutting down work hours (FTE) to cope. Patients with complex problems want the best expert for their care but experts are leaving clinical jobs for non clinical ones.
The solution will only come from visionary leaders who put the welfare of patients first. From physician Leaders who connect with their colleagues and find out what the problems are and genuinely try to help solve it. From realizing that a broken healthcare delivery system with big physician shortages particularly in fields like oncology where the choice of a wrong therapeutic strategy can have massive consequences affects everyone eventually.
I’m not seeing much of the kind of leadership that’s needed, only a lot of fancy words and sentences that I really don’t know the meaning of.
4. Daratumumab is effective in high risk smoldering multiple myeloma. (AQUILA). @NEJM 2024
Randomized trial that showed early intervention works. International effort that to the first approved therapy for high risk smoldering myeloma. Changed paradigm. 10 years from trial concept to publication. But over 20 years from the time of my first trial in SMM. It takes time and there are no shortcuts.
This type of trial requires a track record in the field on the particular topic. Leading many natural history studies, phase IIs and a phase III in SMM before helped. Patience and time. It also needs a conviction in the hypothesis: in this case that early intervention works.
Based off #ENDURANCE trial, Lenalidomide is now for 2yrs maintenance (instead of indefinite) for standard risk #MultipleMyeloma (75-80% of myeloma can fall in this category). Indefinite maintenance did NOT improve OS when compared to 2yrs therapy!
#HemeTwitter#OncTwitter
Tonight’s the night! Join leading experts Rahul Banerjee, MD, Beth Faiman, PhD, and Ashley Chen, PharmD, at 7:00 PM EST to elevate your case-based NDMM strategies and claim credit. Register HERE: https://t.co/QrsdNM3nGU
@RahulBanerjeeMD | @UW@BethFaiman | @ClevelandClinic
Bortezomib (Velcade) was first approved by the FDA in 2003. Finally 23 yrs later generic bortezomib available from at least 10 generic companies. The market price has dropped from $1600/vial to under $20/vial. A big fan of A/P rated generic injectables.
#Myeloma Paper of the Day: International Myeloma Working Group recommendations for diagnosis & management of solitary #plasmacytomas: https://t.co/lDJ4laJ5iR. #mmsm Note the 50% risk of progression to symptomatic myeloma within 5 years after initial definitive local radiotherapy.