Dr. Hari on Current State of Frontline Therapy in Myeloma

Parameswaran Hari, MD, MRCP, the Armand J. Quick/William F. Stapp Professor of Hematology, and the chief of the Division of Hematology/Oncology, Department of Medicine, at the Medical College of Wisconsin, discusses the current state of frontline therapy in multiple myeloma.

The frontline treatment of patients with myeloma is changing, says Hari. Physicians have been fortunate to have several new classes of drugs that have been FDA approved in the past 5 to 6 years. Now, patients have access to immunomodulatory agents, proteasome inhibitors, steroids, alkylators, and antibodies, with more to come, he adds. Due to the advances made with frontline therapy, more patients are achieving complete responses (CRs), stringent CRs, and even minimal residual disease negativity.

Now, the goal of frontline therapy is to reach a deep remission, whereas a decade ago the primary concern was to achieve some sort of disease control, explains Hari. If patients receive a transplant, that translates into a more prolonged progression-free survival (PFS). The field may get to a point where transplant becomes optional. However, to date, studies have shown that transplant is the best way of achieving a long PFS, he concludes.