Cindy Chmielewski was diagnosed with IgG Kappa stage 3 multiple myeloma (MM) 15 years ago. Today, she is a patient advocate. Recently, on behalf of The Patient Story, she spoke with 2 doctors about some developments in MM research presented at the 2022 Annual Meeting of the American Society of Hematology (ASH).
Chmielewski and Drs. Caitlin Costello, University of California, San Diego, and Sagar Lonial, Winship Cancer Institute, Emory University, discussed updated results from the MAIA trial, which looked at the addition of daratumumab. This monoclonal antibody is used to treat MM instead of standard multi-drug regimens.
“One of the things that patients with newly diagnosed myeloma, who are not planning or not eligible or too frail to go to transplant, have enjoyed is the addition of daratumumab to the first treatment you receive when you’re diagnosed,” Dr. Costello told Chmielewski.
Dr. Costello explained that typical MM treatment involves different combinations of pharmaceuticals, telling Chmielewski, “We like to use multiple drugs. I think of it as like the old game of Clue. Instead of just using a candlestick, a revolver, or a lead pipe, we want to use all the tools we have together as a cocktail so that we can approach the myeloma, sneak up on it, and kill it [in] different ways.”
After discussing the MAIA Trial results, Chmielewski wondered about transplant necessity, saying to Dr. Costello, “We have all these wonderful drugs that you’ve been talking about now. In the era of these novel therapies, is stem cell transplant still needed initially?”
In the DETERMINATION Trial, 2 groups of patients were given the same treatment with RVd (Revlimid, Velcade, dexamethasone), and then 1 group had stem cell transplant and the other did not.
“The transplant group stayed in remission longer,” Dr. Costello said. She clarified, “The survival was no different, but there did seem to be improved time to staying in remission because, we think, of the longer-lasting use of the maintenance Revlimid.” A trial in France showed similar results.
Dr. Lonial added, “I think that with the results of the DETERMINATION study, it’s pretty clear to me that even with good drugs, transplant continues to offer [a] benefit.”
To watch the entire discussion, view the video here.