Saad Z. Usmani, MD

Case Review of a 75-Year-Old Woman with Multiple Myeloma 

First-Line Treatment Options and Subsequent Risks Facing Multiple Myeloma Patients

Data Analysis from the Phase 3 MAIA Study 

The MAIA & PEGASUS Trial and Managing Patients Receiving DRd 

The Impact of COVID-19 on Treating Patients With Multiple Myeloma 

Current and Future Treatment Options for Multiple Myeloma Patients 

Case: A 75-Year-Old Woman With Multiple Myeloma

An active 75-year-old woman presented with new onset back pain and a 10-month history of fatigue, mild sensory neuropathy

PMH: hypercholesterolemia, diabetes, and atrial fibrillation; all medically controlled

PE: bony tenderness appreciated on the hips and lower back

Labs: Hb 10.2 g/dL, calcium 11.1 mg/dL, LDH 186 U/L, creatinine 1.3 mg/dL, albumin 3.7 g/dL, beta-2 microgloblulin 3.6 mcg/mL, potassium 1100 g/dL, M-protein 2.6 g/dL, lambda free light chains 4.1 mg/dL

X-ray showed L4 vertebral compression fracture

Skeletal survey showed multiple lytic lesions in femur

Bone marrow shows 40% clonal plasma cells IgG k with hyperdiploidy FISH

Patient is ineligible for ASCT due to comorbidities

Initiated treatment with daratumumab + lenalidomide + dexamethasone

Videos

Saad Usmani, MD, presents a case of a 75-year-old woman with multiple myeloma.

A 75-Year-Old Woman With Multiple Myeloma

Saad Z. Usmani, MD, division chief of the Plasma Cell Disorders Program and director of Clinical Research in Hematologic Malignancies at the Levine Cancer Institute, Atrium Health, discusses the phase 2 SWOG 1211 trial investigating bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (RVd) with or without elotuzumab (Empliciti) for patients with newly diagnosed, high-risk multiple myeloma.

The primary end point for SWOG 1211 was progression-free survival (PFS). Usmani says the assumption for this study was the RVd arm would have a PFS of about 2 years based on previous data, and the PFS would be improved to 3.5 years with the addition of elotuzumab.

After a median follow-up of 53 months, the primary end point was not met, according to Usmani. Both arms had a similar median PFS, with 34 months for patients on RVd and 31 months for patients receiving RVd plus elotuzumab. Overall survival and overall response rate did not have differences in the 2 groups either. There were higher grade 3 toxicities, such as infection rates and neuropathy, observed in the elotuzumab arm.

The investigators were surprised to see that both arms did better compared with historical data, even in patients who had tandem transplants on total therapy. The median PFS was 26 months in the previous studies looking at this regimen. Usmani says it was concluded that although the trial did not reach its primary end point, it makes a strong case for proteasome inhibitor immunomodulatory drug-based therapy model for patients with high-risk multiple myeloma.

<< View more resources and information regarding multiple myeloma

Saad Z. Usmani, MD, discusses the phase 2 SWOG 1211 trial investigating bortezomib, lenalidomide, and dexamethasone with or without elotuzumab for patients with newly diagnosed, high-risk multiple myeloma.

SWOG 1211 Shows Longer Efficacy Than Historical Data for Multiple Myeloma

Saad Z. Usmani, MD, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Carolinas HealthCare System, highlights some of the ongoing studies presented at the 2017 ASH Annual Meeting.

An Overview of Recent Studies in Patients With Multiple Myeloma

Saad Z. Usmani, MD, Chief of the Plasma Cell Disorders Program, Levine Cancer Institute/Carolinas HealthCare System, discusses the MMprofiler in multiple myeloma.

Gene expression profiling has been studied in the prognostication of multiple myeloma for over a decade, Usmani says. Now, different tools are making their way to the clinical setting, one of which is the MMprofiler.

Findings of the VTD arm of the phase III Gimema-MMY-3006 study were presented at the 2017 ASH Annual Meeting. This study investigated the MMprofiler with SKY92 combined with ISS to identify high- and low-risk patients with multiple myeloma.

Saad Z. Usmani, MD | Authors

Articles

A 75-Year-Old Woman With Multiple Myeloma

SWOG 1211 Shows Longer Efficacy Than Historical Data for Multiple Myeloma

An Overview of Recent Studies in Patients With Multiple Myeloma

MMprofiler with SKY92 Combined with ISS to Identify Risk Status in Multiple Myeloma