Dr Mikhael on the Importance of Disparities Research in Multiple Myeloma

Joseph Mikhael, MD, professor, Applied Cancer Research and Drug Discovery Division, the Translational Genomics Research Institute, City of Hope Cancer Center; chief medical officer, The International Myeloma Foundation; consultant hematologist, director, Myeloma Research, HonorHealth Research Institute, discusses the importance of continually advocating for further research focused on disparities in treatment outcomes for patients with multiple myeloma.

For the past 2 decades, Mikhael has been engaged in and has observed the culmination of efforts to improve disparities in multiple myeloma. Of these, Mikhael highlights 2 two critical areas of interest among academic teams and the International Myeloma Foundation.

First, the exploration of health equity in multiple myeloma has been a focal point for ongoing research. There are profound disparities in multiple myeloma, particularly in African American communities where incidence and mortality rates are significantly higher, Mikhael emphasizes.

At the 2023 ASH Annual Meeting, numerous presentations centered on social determinants of health and their impact on outcomes in this disease space, he explains. One notable study explored the Black perspective on clinical trial participation, underscoring the need for greater diversity in these trials, Mikhael details. Subgroup analyses of large-scale studies such as the phase 3 DETERMINATION trial (NCT01208662) have also shed light on potential racial and ethnic variations in outcomes with novel therapies like CAR T-cell therapy and bispecific antibodies. Such disparities may impact the incidence of toxicities, such as cytokine release syndrome (CRS) and infections, in both Latino/Hispanic Americans and African American patients, he adds.

Disparities research in multiple myeloma is also focused on engendering patient-centric studies. One such investigation assessed patient perspectives during CAR T-cell therapy treatment and their experiences with CRS, he says. This study emphasizes the central role of patients in ongoing research, Mikhael says, adding that it was heartening to see abstracts explicitly focused on patient experiences and quality of life.

Another notable study is evaluating dexamethasone dosing strategies and their effect on patient outcomes. Through an evaluation of historical data on dexamethasone, the study suggested that reduced dexamethasone dosing did not negatively impact outcomes. This suggests that dexamethasone dose reduction is a viable strategy that will be increasingly used going forward, he explains. Overall, witnessing the increasing body of research on both health equity and patient experiences in multiple myeloma has been rewarding, Mikhael concludes.