Gail G. McCray
Atlanta, GA

My musings today on MM started with morning discussions with fellow support group leaders (SGLs) about topics we all must become more comfortable in speaking about and finding the best resources to address. Topics include palliative care and hospice – a new definition, maintaining your best sexual self through the varied trials of MM diagnosis and treatment, and ASKing for help in financing our care. Cancer is an expensive life partner – we hear that help from pharma companies and others is underutilized.
Moving to the data presentations at the 56th American Society of Hematology (ASH) Annual Meeting, the definitions of MM are being revised. Going from MGUS to smoldering to active MM are more well-defined with categories including high risk, intermediate risk, and standard risk. It’s a different disease among individuals in the MM population, and can change over time in an individual. There is something about the Gene Expression Profile (GEP) that is important, cytogenetics I think it is called. Then there is the “light chain” abnormality that we have more to learn about.

Look for next-generation drugs – daratumumab is promising. One SG member reported complete remission from a single agent therapy after only 2 months – for the first time in life after a diagnosis in 2000 and two transplants where he was in remission for 4 years the first time and 3 ½ years the second time. Trials are underway now for daratumumab with Revlimid (lenalidomide) and dexamethasone. Another drug in clinical trials, ixazomib (MLN9708), can mean a more comfortable once per week therapy. SAR650984 is an anti-CD38 monoclonal antibody. Did your eyes just glaze over? Who names these drugs anyway – is there any logical rhyme or reason for the complexity in naming them? C’mon! With all the next-generation therapies, we can begin to look at MM as more of a chronic disease than an incurable blood cancer.

Finally, we are learning that targeted therapy is our future. MM treatment will be individualized therapy – for each individual genetic abnormality. So far, everyone got the memo to thank the patients and families who contributed to their research. This is fantastic. I think the translational research – Bench to Bedside to Curbside – is so much more successful with a fully engaged patient/family team. Keep the TEAM  strong. Your thoughts?