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Vincent Rajkumar: The priorities for what’s next in myeloma research has changed

Photo from Vincent Rajkumar/X

Jun 11, 2024, 10:23

Vincent Rajkumar: The priorities for what’s next in myeloma research has changed

Alexandros Alexandropoulos, Hematologist at Laiko General Hospital, shared a post by Vincent Rajkumar, on X:

“Some open multiple myeloma questions following up on dr.Rajkumars list.

1) Do all patients need biphosphonates? Is it safe to stop them earlier?

2a) Can we deescalate or omit dexamethasone in patients that achieve >CR during induction?

2b) Is 16mg dex equal to 20mg?

2c) Can we omit dex completely in very frail patients using immunotherapy combos?

3) Can we safely omit autologous SCT in standard risk patients if they achieve >CR with a quad combo?

4) Can we predict the subset of standard risk myelomas that don’t need maintanance (low risk MM)?

5) Can we influence the MGUS and SMM trajectory by eliminating a potential antigenic stimulation?”

Quoting Vincent Rajkumar‘s post:

“With recent advances, the priorities for what’s next in myeloma research has changed. Here is what we need to focus on

1) Can we cure myeloma? How?

2) How to improve outcomes for true high risk MM?

3) How can we identify and prevent early progression following initial therapy?

4) How to treat true Penta (including BCMA) refractory myeloma?

5) How to optimally dose bispecifics? 6) How to reduce cost and toxicity of myeloma treatment?

7) How do we use MRD testing to change treatment?

8) How do we best prevent progression of high risk SMM to myeloma?

9) Should we screen as? If so, who and when?

10) How do we reduce racial disparities?

There’s more. But this is a start. We used to lose 15-20% of patients in the first year following diagnosis when I started in the field. Now we hardly lose any in first year, and 4 year survival rates are >70-90% with modern therapy depending on age.”

Source: Alexandros Alexandropoulos/X and Vincent Rajkumar/X

Vincent Rajkumar is a Professor of Medicine at the Mayo Clinic in Rochester, Minnesota, and Chair for the Mayo Clinic Myeloma, Amyloidosis, and Dysproteinemia Group. He also chairs the Board of directors of The International Myeloma Foundation and the Eastern Cooperative Oncology Group (ECOG) Myeloma Committee. His extensive contributions include over 230 peer-reviewed publications, predominantly focusing on multiple myeloma and related plasma cell disorders. Furthermore, Dr. Rajkumar is a Section Editor for multiple myeloma and related disorders for Leukemia and an Associate Editor for the Mayo Clinic Proceedings.