Ask the Expert: Stem Cell Transplant, New Drugs and High-Risk Disease

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Topics include: Treatments

How does the continued emergence of new drugs impact the use of stem cell transplant for myeloma patients? Dr. Gareth Morgan, a leading researcher at The Royal Marsden in the United Kingdom, suggests that the standard therapies available today will continue to offer good results for standard-risk patients. Dr. Morgan also argues that research should focus instead on the “20 to 30 percent” of multiple myeloma patients living with high-risk disease.

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Dr. Morgan:

Transplants seem to have a bad press. So autologous stem cell transplants are a significant chemo, but they are highly effective, and people remain stable and off treatment for a long time. So I don’t see it being a competition between drugs and transplants. What we have are highly effective tools: protezome inhibitors, the IMiD drugs, stem cell transplantations, soon-to-be antibodies. And if we use those combinations correctly, we will get people into deep responses, where, even with sensitive tests we can’t find any evidence of the cancer.

It’s those people that are going to be cured, being long survivors, whichever your view is. We’re doing well. We’re in a moment where we’re making good process. That issue, that we shouldn’t forget, is 20 to 30 percent of all myelomas have what you might think of as high-risk disease. Those patients have one a half years free of disease, and most of them are dead within two to three years. So if you took those out of the whole group, you see we’ve been really successfully in standard risk patients. There’s a subgroup that we really need to concentrate on. So part of the Oracle project, we were talking about, is to try to identify that high-risk group and to start doing trials and investigations into them because they allow us to develop new drugs, change the outcome of currently a really very poor condition to have. But people don’t know they have it without tests. So that’s a big and important strategy, I think.

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Page last updated on April 15, 2014