The Latest Myeloma News from the American Society of Hematology Meeting

Andrew Schorr:

Okay. My friends in the audience are calling, so we're going to start with some calls, gentlemen, and aim them at you, and whoever wants to take them. I'll aim it at somebody, but if someone else wants to chime in that's fine too.

I want to give the number for the International Myeloma Foundation, the hot line, because obviously you say what does this mean to me? Now, you're going to discuss that with your doctor, maybe you're going to get a second opinion, but use them as a resource too. Here's the number if you don't already know it: 1-800-452-CURE (1-800-452-2873). They're in the Los Angeles area, so think Pacific time when they're at work. Give them a call as well.

Here is a question from Carol. Carol, you're joining us from somewhere in New Jersey, and you're on the air. Where are you exactly, Carol?

Caller:

I'm in Cape May.

Andrew Schorr:

That sounds nice. I hope the weather isn't too bad there down on the water. You're living with multiple myeloma yourself?

Caller:

I'm a smoldering myeloma patient.

Andrew Schorr:

Smoldering is good. What's your question?

Caller:

My question is, just a few minutes ago, if I heard correctly, a completely sort of opposite view given by Dr. Berenson and Dr. Durie as far as you're approaching age 65 and how these treatment decisions should be made for patients approaching that cutoff age. Since I'm almost approaching 65, I'm very active, you know that's going to have a bearing on how I approach things and how I approach talking with my doctor.

Dr. Berenson:

I would comment that is that, and Brian and I certainly agree on, is that the data from VISTA was robust and that the melphalan/Velcade combination looks like one that can be given to older folks. The average age in that trial is 71, and I am certainly a big advocate of that combination up front, so I heartily agree with Brian that the thalidomide combinations in the older population are not well tolerated, and I'm certainly not using those up front except rarely, for example, in patients who require radiation in which there can be devastating consequences from Velcade in the setting of central radiation, so I think Brian and I actually agree on this. I don't know Brian, if you want to comment further.

Dr. Durie:

Right, well I think that the 65 cutoff is obviously arbitrary, and I think that for example a case could be made if for example the prognostic factors were good, normal chromosomes, and you're in excellent shape, and upfront induction of what we call front-line therapy with perhaps a Velcade combination followed by an autologous transplant might be excellent, even although you've crossed that magic number of 65. So, this is one of the things that you need to discuss on an individual basis with your physician, but on average, we do all get older and over the age of 65 you're more likely to have some heart problems or lung problems or kidney problems where on average it might not be quite as easy for you to go through the transplant, and the beauty of the available options right now is that we have excellent treatments. Jim mentioned that perhaps reducing the dosage slightly on the VMP regimen could make it a little more tolerable and a very excellent synergistic regimen. I hope that helps.

Andrew Schorr:

Thank you. Carol, my dad was 92 and still practicing law, and I think he looked about 75, so there are other factors that come into play and the other conditions some people may tend to have 65 or older, but it sounds like you're doing well, so that's the discussion. You can call the hotline at the International Myeloma Foundation 1-800-452-CURE or also obviously discuss it with your doctor or even seek a second opinion too in that you're smoldering now.

Advertisement
Join Our Community Register for Events Read Our Latest Blog
Advertisement

Page last updated on November 22, 2013