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Are Myeloma Treatment Plans Changing During Coronavirus?

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Published on April 3, 2020

Key Takeaways

Dr. Robert Orlowski, from The University of Texas MD Anderson Cancer Center, discusses the particular impact of the coronavirus pandemic on multiple myeloma patients. Watch as he shares modified guidelines for myeloma care in response to the outbreak, including reasons to consider delaying a visit, adjusting dosage or changing treatments. 

Dr. Orlowski also describes myeloma patients’ susceptibility to infection, how to assess immunity and safety precautions to prevent exposure. 

This educational program is sponsored by Karyopharm. This organization has no editorial control. It is produced by Patient Power. Patient Power is solely responsible for program content.

[Due to extreme load on our website and Zoom platform, viewers may experience a time delay between the audio and video of the interview - please note the transcript can be read below.] 

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Transcript | Are Myeloma Treatment Plans Changing During Coronavirus?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Recorded on April 2, 2020

Andrew Schorr:
Welcome, it's Andrew Schorr here with Patient Power. Thank you so much for being with us. I'm in Carlsbad, California near San Diego. And joining us today is Dr. Robert Orlowski, who's Head of the Myeloma program at MD Anderson Cancer Center in Houston. And, Bob, just pop your video on, and we'll see you there, and he's joining us now. So, there you go. Hi, Bob. Thank you so much for being with us once again.

Dr. Orlowski:
Well, good morning to you, Andrew. And I wanted to thank you and your whole team at Patient Power for putting this program together, because really everybody has lots of questions about this coronavirus situation, and you're helping to, I think, make people feel more secure.

Andrew Schorr:
Thank you. Well, that's our goal, and there's so much in the media about the general situation, which is concerning to say the least, in instructions, but also for people with multiple myeloma. When you say, “Well, what about my immune system? What about now with the medicines I'm on? If I'm getting infused therapy, if I'm getting oral therapy, what about my schedule? What should I take?” A million things, and even family relations. So we're going to go through all that, folks. If you have a question, many have been sent to me and Dr. Orlowski at comments@patientpower.info, but during this live program there's a little Q&A button down at the bottom of the screen. Click on that. That'll go to our producers, and then there'll be sending me messages as well. So, Dr. Orlowski, let's get started. So, the first thing is the risk of getting coronavirus, COVID-19, for myeloma patients. Does it vary either within myeloma or from other people?

Dr. Orlowski:
I think first of all, we should acknowledge that there is not enough literature and there have not been enough publications or data for us to be 100 percent sure. And actually, before this program I did a search on PubMed, and I put in coronavirus and myeloma, and there were all of zero publications that came out, because this whole thing is so new. We do worry, of course, that myeloma patients who have tended in the past to be more susceptible to viral illnesses, we all, for example, know that in the wintertime our inpatient census tends to go up with patients that have influenza, respiratory syncytial virus, other types of coronaviruses.
 
So, we know that myeloma folks are probably at higher risk of viral infections, and I do think that there's no reason to suspect, unfortunately, that it would be any different with the SARS coronavirus that we're dealing with right now. And there are data from China in a general cancer population that suggests that if patients who have cancer or on therapy get infected, there is a higher risk of complications. Although, that was not a myeloma-specific population, and the sample size was relatively small.

Andrew Schorr:
Okay. So, Dr. Orlowski, would it vary though, let's say if somebody is MGUS, right, or let's take it a little further, smoldering myeloma, and then you go up through the continuum to more high-risk advanced disease, would it vary? I mean I know you don't have the data. Do you have any thought about it?

Dr. Orlowski:
I think you're asking an important question, which is if you have less disease or more disease, does that change your susceptibility? I would certainly think that if you have a healthier immune system, that that's going to be helpful in terms of reducing your risk and potentially reducing the severity of the illness if you do contract it. But that's really just a speculation, and we don't know for sure, which is why I think all patients with diseases in this category need to take the same high level of precautions.

Andrew Schorr:
I've got a question for you. So we have people on oral medicines, and we have people on infused medicines if they're in treatment or sometimes a combination of both. And the worry is about going to the hospital where you feel maybe there's higher risk. So what about people who—should people be switching, or should their doctors be discussing, well we have powerful oral combinations even with some new classes of medicines. Should we be thinking about that?

Dr. Orlowski:
Well, that's a great question, and some of the slides that I have do cover those questions. But just to give you an overview, I think first of all, as many visits as possible should be converted either to telephone visits or to telemedicine visits with your physician or other healthcare provider—on the therapy perspective and in terms of different types of patients. You talked about MGUS and smoldering myeloma. I would think about stretching out visits for those patients, because especially if they've been stable for long periods, it probably is best to have them wait until hopefully this coronavirus dies down, especially if they're doing well.
 
On a therapy perspective, I do think it's reasonable to look at each individual case, because some people will need to continue on the therapy that they're getting right now. For example, if somebody has relapsed/refractory disease that is symptomatic and just got switched to a new therapy, you may need to consider continuing that therapy to reduce the amount of disease burden, but in cases where it's feasible, I do think it's valuable to switch to less frequent treatment as long as that doesn't compromise efficacy.
 
I think one great example would be if somebody is on a carfilzomib-based (Kyprolis) combination and is still doing the two days in a row treatment, one option would be to go to the once a week treatment, which has been shown to be at least as good and probably even more effective. In some cases, if someone is on the combination of an oral and an IV or an oral and a subcutaneous therapy, it may be reasonable to consider just staying on the oral for the next few months and holding the IV or subcutaneous. And I'll give you an example. Again, if somebody has relapsed disease and has been on lenalidomide (Revlimid), daratumumab (Darzalex) and dexamethasone (Decadron), and their disease burden is at a very low level, hopefully they're in complete remission. That would be the kind of patient where I would consider the possibility of holding the daratumumab for a few months, because that would reduce the number of visits that the patient has to make—and therefore, their risk of exposure.

Andrew Schorr:
Okay. Now, what about all oral combinations? I mean so much in myeloma now is combination therapy. What about oral, all oral combinations with different classes of medicines?

Dr. Orlowski:

I do you think that switching or using an all oral regimen for at least the next few months would be very wise, as long as the clinical scenario allows that. Again, there are people that have high disease burden and are symptomatic. For example, if somebody has a recent fracture or they're running into renal problems, those are people in whom you want to use the best and most aggressive therapy to reduce their disease burden. But if your myeloma is at a low level, then an all oral combination for the interim I think would be a wise move. Although as always, consult with your local myeloma expert, because he or she will know your disease better.

Andrew Schorr:
Okay. Dr. Orlowski, you can share your slides now, if you have some. So, let's give that a go. Thank you for preparing them, and we'll go through that. And then we'll get to your questions, folks. Just send it to the Q&A button. Okay, so whenever you want to go, Bob.

Dr. Orlowski:
So, hopefully you can see these slides, and these are guidelines that I pulled from a number of places. First, in terms of the Multiple Myeloma Research Foundation, and I'll go through these quickly, because I've provided the websites from where they came, but hopefully this will answer a lot of questions. First of all, most important is that people should stay safe and as much as possible avoid risk of exposure. So, you can see the guidelines include making sure that you have enough food and medicine on hand, that you wash your hands frequently, if you're going out, and if soap and water are not available to use sanitizers with at least 60 percent alcohol.
 
As much as possible avoid touching your nose, eyes and mouth. And if friends and family or colleagues are sick, you should definitely think about avoiding them. Social distancing is the key here for all people, but especially for myeloma patients. Try to limit social gatherings and wear masks in crowded areas. If you're going outside to take a walk, then that's not really necessary. Travel wise, most places are difficult to get to now, but you should definitely limit non-essential travel and especially by commercial airline or cruise ship.
 
Other considerations, you should of course maintain hydration and exercise, monitor your temperature. Remember that sometimes myeloma patients may not develop as high a fever, because they either have some level of immune suppression or if, for example, you may be on a steroid-containing regimen, you may even be on an aspirin to reduce the risk of blood clots. So all of those can be considerations and certainly if you're coughing or sneezing, be careful in those situations and do remember that in some parts of the country it's still flu season, so it's very possible that you could catch that even if you have symptoms that make it sound like it's a coronavirus. And, of course, consult with your local physician about any more serious situations.
 
And then just briefly, these are International Myeloma Society guidelines, which are also available on the web. And these are guidelines for physicians, but I thought it would be helpful to review them. The recommendation is to make patients aware of their vulnerability and stress the need to help in terms of preventing infection, which is the best that we can do right now. Again, therapeutic decisions should be made on an individual basis and consider things like newly diagnosed, relapsed/refractory and high-risk versus standard risk.
 
Again, limit patient contacts, do telemedicine, try to use oral drugs, if possible. And there also as a recommendation to consider either reducing the dose of dexamethasone (Decadron) or potentially consider stopping it altogether. In the newly diagnosed patients, most centers now are limiting stem cell transplant, so delay transplant if at all possible and continue induction therapy. And for older patients who maybe are not transplant candidates, again, oral therapies would be important.
 
In the relapsed or refractory disease setting try to do weekly therapy instead of bi-weekly as we mentioned earlier, and oral regimens are certainly reasonable. If you're on daratumumab, try to switch to less frequent dosing as quickly as possible. And in terms of clinical trials, do be in touch with your local providers, because there are some differences in different locations. Some of them have continued to enroll onto trials, others have not. You may need to look at what your local myeloma expert is doing.
 
So just as a summary, delay visits definitely for MGUS or smoldering patients, reduce visits for patients who've been stable on their therapy with a low level of disease burden, convert visits to telemedicine, look at using less frequent dosing and consider avoiding myelosuppressive therapies, for example, alkylating agents. And look at delaying transplant or CAR-T cells. And these are some of the resources that I mentioned, including the CDC, the Multiple Myeloma Research Foundation, the International Myeloma Society as well as The Leukemia & Lymphoma Society.

Andrew Schorr:
This is great, Dr. Orlowski. Thank you so much. And for folks who don't know Dr. Orlowski, he is the Director of the Myeloma Program at MD Anderson in Houston, and he's also one of the leaders of the SWOG Research Group, right? Am I right? The group of all the myeloma specialists? Bob, you can stop sharing your screen, and we'll go on. We have lots of questions. I have a few questions for you. So, in the news today as we do this live program, they're talking about whether or not beyond the droplets from somebody coughing or sneezing, that there could be an aerosol that stays in the air.
 
Like if a sick person or a person who didn't even know they were sick with coronavirus was in the elevator, they get out, I get in, is there something from just them breathing where I should be wearing a mask at least? And so now they're here in California, Bob, they're saying, the mayor of Los Angeles is saying to Los Angelenos, if you go out, wear a mask.

Dr. Orlowski:
As far as we know the droplets, the larger droplets are definitely the greater risk for transmission. But, I would worry in terms of the smaller aerosols that you're mentioning. And if you have availability to be able to use a mask, I do think that I would recommend that for patients with myeloma who are going outside of the home.

Andrew Schorr:
Okay. And let me just mention I'm a leukemia patient and also at high risk, so I maybe take a walk or walk the dog in not a very densely populated area and do some exercise. My wife is the one who takes all sorts of precautions and does grocery shopping or goes to the pharmacy, which are essential visits. I would say with a lot of myeloma patients who may be older, there are people who are volunteering to get your groceries, or you may have a family member, something like that. So, you don't go out at all, and I think that's something to be considered.
 
I do want to remind people if you have a question, send it to the Q&A button, just to there. One question just about oral therapies, Dr. Orlowski. So we have new classes of medicines. We've had new stuff developed fortunately in myeloma. One was a drug called selinexor (Xpovio), which is in a new class. And I know it's been used for some of the sickest people with myeloma and there's been work going on to try to see how it can be used in combination with these other drugs. So you're working on new combinations as well of oral therapies, correct?

Dr. Orlowski:

Correct. As you mentioned, selinexor right now is approved in combination with a corticosteroid for much more advanced myeloma, but recently there was an announcement that one of their trials which looked at bortezomib (Velcade) and dexamethasone with selinexor and compared that to the two drug, bortezomib and dexamethasone combination, in earlier patients did show a benefit and met the primary end point. Of course, the bortezomib was still given as an injection, but the message is, I think that it's a drug that we probably in the future will be using earlier, and the fact that it's an oral medication is certainly an important consideration in this day and age.

Andrew Schorr:
Okay. Well, we're going to talk more about all oral therapies as we go along, because people want to know also, do the oral therapies affect their immune system too? But, let's see the questions we're getting. Somebody asked if we move to just oral meds, what about the labs? Because there's monitoring that goes on. So what about the blood tests?

Dr. Orlowski:
Well, definitely some level of monitoring will still be necessary, because many of these medications do change blood counts in some patients. You mentioned selinexor, and one of the problems with that can be thrombocytopenia or decreased platelets. So, definitely some monitoring will still be needed. And you may need to go in to have that done. That's where a mask would be important to have, if possible. And the key though is still to try to minimize the number of visits. So, for example, for some patients what I have them do is get laboratory studies, and then I follow up with them by telephone. It also may help for you to know things like how the schedule works in your local area.
 
And what I mean by that is often the mornings at these laboratories are very busy, because people who are getting chemotherapy that day may need to come in very early to get blood tests done first, and so it may be wise to get your blood tests done mid-day or afternoon when there's a little bit of a smaller crush of patients and therefore less risk of exposure.

Andrew Schorr:
Right. Okay. We had a little bit of an audio problem. It was going in and out for a second, but I'll just recap a couple of things. So blood testing is still important, but again, that's a discussion with your doctor. Frequency and can it be done close to home, if it doesn't go, maybe you don't have to go to the big hospital. Maybe you can go to an outlying clinic near you. Okay, some questions now, this came in from Marshall, “I've been on daratumumab for about a year. My numbers are still good. How long would it take for my immune system to make somewhat of a comeback if I stopped the daratumumab?” So he's wondering, does the daratumumab affect his immune system, and will his immune system rebound?

Dr. Orlowski:
There are some effects of daratumumab on certain types of immune cells. And often, daratumumab is not just given by itself, but it may be given with other drugs. There's usually a little bit of a steroid as a pre-medication. One thing that could be looked at would be to try to reduce that as much as possible, because it's probably more important at the beginning when the risk of infusion reactions is higher, but we don't really know how long it would take if you were to stop the daratumumab for your immune system to completely recover. And of course, you should only think about stopping in context of a consult with your myeloma expert.

Andrew Schorr:

Right. I think that's the whole thing is, folks, we've been doing many of these webinars in different conditions, and I think this—looking at your specific situation with the healthcare team you trust, whether it's telemedicine, almost like what we're doing on Zoom or a phone call and saying, "Okay, do I need to come to the clinic? Does my schedule change? Where do I get a blood test? Is there any reason to change the therapies I'm on?” All of that is very individualized, right, Dr. Orlowski?"

Dr. Orlowski:
Exactly.

Andrew Schorr:
Okay. All right. Let's look at some other questions. This is from Mary Ella. Mary Ella said, "My husband just had his fourth year check-up with the doctor, and he recently stopped taking dexamethasone. He's on ixozomib (Ninlaro) now. Was this the right thing to do? Is there anything he should be looking at?" Well, first of all, Mary Ella, we don't know your husband's whole story, but basically this is about where he stopped taking dexamethasone. And I think you mentioned about that too, and he's taking an oral therapy. So that switch from an infused to an oral that's been going on, right?

Dr. Orlowski:
Well, first of all, congratulations because four years, and it sounds like he's doing well, is an excellent outcome. And if the disease is at a low level and he's been on the ixazomib and dexamethasone, then stopping the dexamethasone would certainly be appropriate because it does have some immune suppressive properties. So, that's I think a good course of action.

Andrew Schorr:
So we get our lab results, Dr. Orlowski, and for most of us, I know for me as the leukemia patient, it has a lot of H's and L's. It's kind of out of whack. And I think it's probably similar with many myeloma patients. So when we look at these numbers, is there any way we can deduce how affected our immune system is, or should we just go with the assumption that if you have myeloma, you are somewhat immunocompromised, and you need to take precautions? It's not in your lab results by itself—that's something for your doctor to help you know. But, you have to assume you're immunocompromised.

Dr. Orlowski:
I think it's a little bit of both. I would definitely assume that every patient with myeloma has some level of immune compromise. But there are some laboratory studies that can give you a little bit of an idea of whether you are more or less immune-compromised. You can, for example, look at the immunoglobulin levels. Those would be the IgG and the IgA and the IgM. If those levels are below normal, then you're probably a patient who may be slightly more at risk compared to if those numbers are normal. And we also do things like look at the total white blood cell count, the absolute neutrophil count and the absolute lymphocyte count. And if those are depressed, then that also we know from many years of experience does put you at increased risk of infection.

Andrew Schorr:
Okay. You mentioned about IgG and immunoglobulin. I get that actually monthly. And so I've wondered that's infused, and I know in some conditions I'm not sure about myeloma, Medicare, et cetera will pay for it to be done at home, but not in my condition it doesn't. So I have to go to the clinic, and I've been doing it for two years, monthly. So what about that related to continuing immunoglobulin infusion and on what frequency?

Dr. Orlowski:
Well, if you're already on gamma globulin therapy, that typically is because you've had some infections already and your IgG levels were low beforehand. And I would probably suggest to continue that if you've had it before. I think the bigger question is, would that from a prophylactic perspective, reduce the risk of coronavirus infection, and we just don't have the data, unfortunately.
 
And the ideal gamma globulin preparation would be a prep that contains antibodies to the coronavirus from patients who've been through the infection and recovered. But, each lot of gamma globulin is pooled from thousands or even tens of thousands of patients. And right now, we just don't have enough people who have recovered from the coronavirus and then donated serum or plasma that there are probably no preparations that have a large amount of antibodies available. But I think in the future, that may be something to look at.

Andrew Schorr:
Right. And actually, I know we interviewed in another specialty, a physician from Mount Sinai in New York, and I think they're starting work on that. And you know what's going on in New York. And so I've wondered whether antibodies from someone who's recovered could help me in the future with a gamma globulin infusion and have additional protection. But I didn't know that they pooled it from thousands of people. So, I can see it's going to be a while.
 
All right. That relates to research then, Dr. Orlowski. So first of all, multiple myeloma research, there are people on this program who are in a multiple myeloma clinical trial and thank you for doing that, folks. And thank you, Dr. Orlowski, and your peers for helping lead it. So what happens with these trials now? And is the FDA relaxing any rules about some of the interaction you need with the trials site so that maybe the trial can continue, but there are ways of doing it with less travel, if you will?

Dr. Orlowski:
Yeah, great question. A lot of the trials, of course, are sponsored by our partners in industry, and there are differences between trials. So you should definitely talk to either the physician who manages your care through the trial or the research nurse that is involved, because there is going to be some difference from one study to another, but in general there has been an attempt to relax the guidance lines so that there are fewer tests and fewer visits.
 
You should definitely ask about that. And through SWOG, which you mentioned earlier, we are also doing the same thing. For example, we have a post-transplant maintenance study right now, which was open and enrolling patients. And one of the things that we've done is we've extended the period during which patients can enroll so that hopefully once this coronavirus passes over, people will still be eligible for the trial.

Andrew Schorr:
Okay. So, that's about going into a trial. If you're in a trial, then the research nurse, who you've probably gotten to know, folks, be in touch to find out what's changing or not. But if you can continue or if it can be made easier for you, that would be great, because we need to move research forward. So that's my next question, Dr. Orlowski, and that is we've made a lot of progress. Not enough yet, but a lot in multiple myeloma, many new drugs, you're testing new combinations, you have new kinds of drugs.
 
We've referred to some of that here. Do you feel that this can continue? For instance, you have medical meetings that are now going to happen virtually. There's a big one, American Society of Clinical Oncology in June, and there are others, the European Hematology Association, that I imagine will be virtual. I'm not sure—and then the meetings we'll see later in the year. Do you feel that your discussions with your peers about what you know about myeloma and how to move, please God, towards a cure that's continuing?

Dr. Orlowski:
Well, we've all learned a new skill set in running these meetings virtually over WebEx and Zoom and other applications. And I do think that communication between experts will continue at a high level. Where research may be impacted is that some institutions and academic centers in order to protect the faculty and researchers have put research on hold, and some clinical trials have been put on hold. And, of course, the economic situation may impact on funding levels from various research organizations as well. So this is something that we have to monitor very closely and continue to advocate for as much as we can.

Andrew Schorr:
Okay, folks, we have Dr. Orlowski who said he could be with us just a few more minutes. So if you have a question, hit that Q&A button at the bottom of the screen and we'll take a few more questions before we have to go. So, people always want to know beyond the handwashing or staying at home, is there something else they can do to put them in the best possible situation? And I know you get asked a lot about this, but supplements, for instance, about zinc. So we added a question from Rose, wanted to know about zinc deficiency, and is there something she should do that could help put her in a stronger position?

Dr. Orlowski:
Well, zinc deficiency is an issue in terms of a number of health problems, and infection can be one of them. I don't know that we have any data specifically about the coronavirus. If you feel that you may be zinc-deficient, then some supplementation is probably reasonable and unlikely to be of any harm as long as you follow the recommended doses.

Andrew Schorr:
Okay, so putting all this together then, communication with your doctor, telemedicinewhich many institutions like yours, but most that I talked to are all doing that now. If you are developing some symptoms, it could be the flu or something else. So you're going to call first, you're not going to rush to the emergency room. And then one other question is, with things like the flu, someone, even a myeloma patient might call their primary care doctor. Given that there could be a variety of things going on, including even with their medicines, would you recommend that they call the hematology office?

Dr. Orlowski:
It depends a little bit on the level of experience that your primary care physician has with infections and cancer patients. There are some outstanding primary care doctors out there who have great experience. And then there are others whose experience may be more limited. It's probably safest to try to contact both, is what I would do.

Andrew Schorr:
Okay. Dr. Orlowski, so you mentioned that the data, like at the outset of the program, you said you searched for myeloma and coronavirus, and you didn't see any scientific papers, but now you're talking to your peers in myeloma around the world. So do you suspect that before too long there will be some data that you all will be sharing related to the experience of myeloma patients with the virus?

Dr. Orlowski:
Well, I'm very confident that we will see more data moving forward. I think we always have to be a little bit careful to look at, for example, the study design and the study size, because a report on a couple of cases may or may not turn out to be representative of what's going on, but there definitely will be more data coming. Sadly, as you all know, there are many people in the United States with coronavirus. And unfortunately, some of those will be people with myeloma, and that will inform a little bit what we will do moving forward.

Andrew Schorr:
Okay. One thing I just wanted to cover, we talked about many people with myeloma, but not all are older, so that's a risk factor, as well as having myeloma—co-morbidities. So some people who are older have diabetes, some people may have cardiovascular issues, so that comes into play as well to increase your risk. Maybe you could explain that.

Dr. Orlowski:

I think the other risk factor is any kind of pulmonary disease, for example, COPD from a smoking history. The potential is there that if you have asthma that if you were to contract the coronavirus that there could be greater complications. I think smoking is not a factor that has been investigated yet. But if you are a current smoker, despite the fact that it's very stressful time, and it's easy to say, “Quit smoking,” but I do think anything you can do to reduce your risk during this time is worth it. And I would definitely consider making that change as well.

Andrew Schorr:
Okay. And just so we understand when the virus goes into someone's lungs, though then my understanding is it does begin to affect the cardiovascular system as well.

Dr. Orlowski:

It can. It is a virus that can have multiple effects in the body. The lungs, of course, are the ones that are most affected, but as with any infection, there is stress on the cardiovascular and pulmonary system that occurs. So the healthier you are going into it, the better. And, of course, avoiding exposure is the most important thing.

Andrew Schorr:
Okay. Well, as we wrap this up, I just want to thank you, and, Dr. Orlowski, we see the interviews and videos with physicians around the world and we know, first of all, we want to thank you for your dedication to the myeloma community and taking time to do this today. I'd appreciate getting the slides from you, and we'll post those on Patient Power as well. And just for your colleagues at MD Anderson devoted to ending cancer and your research moving forward, thank you for all you do. As I have been saying on programs, you all are our angels, and we really appreciate your dedication. We'll do our part, handwashing, maybe masks if we go out, getting younger people if we can to get groceries for us, and we'll get through it. And just to wrap up, are you hopeful, Dr. Orlowski, as daunting as this virus is, that we can get to a better place?

Dr. Orlowski:
I do believe that with all of the great minds and great technology that we have now and the number of people that are, of course, focusing on this coronavirus situation that we will soon have therapeutics as well as a vaccine. I'll give you one example. There actually is now a mouse model that you can use in the laboratory to study coronavirus, where the gene that the virus attaches to on the surface of the cell before infecting the cell, which normally isn't present in the mouse, has actually been put into the mouse so that you can actually infect a mouse with the virus and that will allow a lot more studies to be done, including prevention and treatment studies with mouse models.

Andrew Schorr:

Okay. Well, that's where it starts, folks. Often with mice, and we learn from that and we go from there and hopefully we can accelerate. Thank you, Dr. Robert Orlowski, the Director of the Myeloma program at MD Anderson, for sharing time with us today and this insight. We wish you and your colleagues and your families all the best. Thanks for being with us, Bob.

Dr. Orlowski:
Well, best health wishes to everyone. And I did also want to give a shout out to all of the physicians and nurses and providers who are on the front lines, which includes people, for example, in the emergency rooms and other locations, because they're doing an incredible job and need all the support that we can give them.

Andrew Schorr:
Absolutely. And I want to thank one of the companies in industry, Karyopharm, for helping provide educational support for this program. And I want to thank folks in industry who are researching with you and so many of the researchers around the world to move this forward rapidly and also think of combination therapies and new approaches that can help people do better. I'm Andrew Schorr, with Dr. Robert Orlowski from MD Anderson. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.


 
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