Is It Safe for Myeloma Patients to Stop Maintenance Therapy?
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Published on February 12, 2019
Can multiple myeloma patients stop maintenance therapy if their blood markers are low? Is there a patient subset that requires less maintenance treatment? Noted myeloma expert Dr. Ajay Nooka, from the Winship Cancer Institute, discusses clinical trial data on maintenance therapy after a transplant, patients who achieve minimal residual disease (MRD) negativity, and the potential for relapse. Watch now to find out more.
This town meeting is sponsored by Amgen, Janssen Pharmaceuticals and Adaptive Biotechnologies. It is produced by Patient Power in partnership with Winship Cancer Institute of Emory University.
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Transcript | Is It Safe for Myeloma Patients to Stop Maintenance Therapy?
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.
Jack Aiello:
Dr. Nooka, I'm sure you've been asked this question before. Nance online asks, what do you think about stopping maintenance for a while to give patients a rest if blood markers are normal with low M protein?
Dr. Nooka:
This is a great question. I think in every clinical practice I get asked at least once. So my take on this is, really the way that I put it is the clinical trial Dr. Kaufman mentioned earlier which was looking at transplant versus no transplant. So transplant versus no transplant, patients achieved MRD negativity, no transplant, has an option to receive transplant at the time of the progression, the transplant has started, completed transplant, completed consolidation went on to maintenance.
What they did was this is a French study where they gave maintenance for a limited duration of time. They gave the maintenance for a year, and they checked for MRD negativity in all these patients. So everybody that achieved the greatest MRD depth of response at 10 to the part of minus 6, which is one in a million cells they're not able to find, even those patients, 20 of them, 20 percent of them dropped down for the disease to relapse after they stopped the maintenance.
So that is one thing that, as Dr. Kaufman pointed previously, the majority of the patients who achieved MRD negativity of 10 to the power of minus 6 are the ones that went through the transplant, but stopping the maintenance should not be the goal, should not be the indication of when you reach 10 to the power of minus 6.
So I think we're very early in the stage at this point of trying to say define those starting groups. Who are those patients who can—who we can safely stop all this maintenance as we all agree that there is a subset of patients that don't need to be on maintenance for longer, but this is too early to make the decision, and in the year, yes, there will be an answer to this question.
Jack Aiello:
We just don't know who those patients are that can stop, right?
Dr. Nooka:
Yep.
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.
