Manni Mohyuddin reflects on the analysis of SLiM MM versus traditional CRAB MM

Manni Mohyuddin shared on X:

“Finally an analysis of SLiM MM versus traditional CRAB MM.

Glad to see this. Was disappointing that the obvious lead-time bias was not pointed out, and instead the obviously better outcomes for SLiM MM (due to earlier detection/indolent biology) was used to make an argument for treating SLiM MM.

When we see such results, IMO, rather than delve into a basic science explanation (clonal evolution etc etc etc), we should start by calling it what it is: lead-time bias.

https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.19624

Given how poorly the SLiM MM criteria have aged (2 year progression risk to CRAB MM actually 30%, rather than 80% which is what it was thought to be in 2014), this paper further reinforces that such patients should not be treated.

(Also inclusion of such patients in MM newly diagnosed clinical trials will lead to improved outcomes compared to earlier trials, even if other treatments the same. Perhaps thats contributing to excellent outcomes of IMROZ VRd control arm).”

Source: Manni Mohyuddin/X

Dr. Manni Mohyuddin is an Assistant Professor at the Huntsman Cancer Institute, University of Utah, specializing in oncology. He is mainly interested in myeloma, supportive care, end-of-life management, and implementing cost-effective, evidence-based treatment strategies.