Multiple myeloma can present very differently from patient to patient, which is why access to innovations in both diagnostics and treatments is important when determining the best possible care. Experts from Mayo Clinic Cancer Center discuss distinctions between myelomas, the process to an accurate diagnosis, the approach to risk adaptive therapies and their vision for multiple myeloma treatment in the future.
Mhm. Yeah. Yeah. Mhm. Myeloma is not one disease. Myeloma is several different diseases. You can have a specter of my llamas from people that survive with the disease for decades. Some of them even get cured and you have some people with very very aggressive disease. And individualist approaches are not only this is related and also patient related. How aggressive is my myeloma? Do I have high risk or do I have known high risk myeloma? Or what stage is my myeloma? And calculate these things using either a combination of blood tests as well as molecular studies. M. R. D. Or minimal residual disease is a laboratory methodology used to identify even tiny amounts of residual myeloma cells left in your bone marrow after therapy. It's important because several studies are now showing that patients that achieve that Mardi negativity have better outcomes. The more we know about the disease, I think the more we're going to change management based on M. R. D. As an endpoint myeloma is unique because it is a clinical pathologic diagnosis. You need both. The pathologist's opinion as well as a clinician's opinion to make the diagnosis, we see errors in diagnosis made all the time because there are asymptomatic conditions which are pre malignant, that can be very difficult to distinguish from multiple myeloma by just looking at the bone marrow or lab lab tests. Currently we consider patients with tress, armies 1114 translocation and 6 14 translocation to have standard risk multiple myeloma. And we consider patients with television 17 p. one Q. Gain 14 2014, 16 and 4 14 transportations to have high risk myeloma. And then we outline approaches to treatment which are different for each subgroup novel treatments such as protease inhibitors, imminent modulators and other small molecules and then immunotherapy is harnessing the power of your body's own immune system trying to stimulate it so that it can see the myeloma and actually act on it. These T cells are trained to fight the myeloma. Car T cell therapy is the way of the future. We have clinical trials available for every stage of myeloma. The value of a second opinion for a multiple myeloma patient. Even though they have been started on appropriate standard of chemotherapy, it's really important to understand the lay of the land of. What is that next generation? What is the therapy going to look like in the future? Our goal at the end of the day is how can we cure this disease or how can we make sure that people lead a normal lifespan with this disease? And as long as that's still the goal, we always need to keep improving on our treatments. And clinical trials really allow us to do that in a scientific fashion as well as you know provide patients with access to some of these novel treatments early on. Mhm. Mhm.