John Theurer Cancer Center Multiple Myeloma Expert Contributes to Development of International Treatment Guidelines

New guidelines provide alternative treatment options for patients in countries where certain drugs are unavailable

The International Multiple Myeloma Working Group published new guidelines in Lancet Oncology to manage relapsed or refractory multiple myeloma (MM), an incurable blood cancer that affects the plasma cells located in the bone marrow. David H. Vesole, M.D., Ph.D., Co-Director of the Myeloma Division and Director of Myeloma Research at the John Theurer Cancer Center at Hackensack University Medical Center, is part of the working group that developed the guidelines.

Guidelines for Choosing Optimal Treatment Strategies

With seven different classes of approved therapeutic agents — including alkylators, steroids, proteasome inhibitors, immunomodulatory agents, histone deacetylase inhibitors, monoclonal antibodies, and selective inhibitors of nuclear export — which can be combined and used with or without high-dose therapy and autologous stem-cell transplantation (ASCT), it can be challenging for physicians to choose the optimal treatment strategy for patients with MM.

The guidelines recommend treatments for patients with relapsed and refractory disease who have received one previous line of therapy, as well as those who have received two or more previous lines of therapy. They also address:

• The treatment of patients with and without lenalidomide refractory disease
• Patients who are progressing on frontline daratumumab-based combinations
• The role of salvage ASCT.

Addressing Limitations of Drug Access In Certain Countries

Further, the guidelines integrate the issue of drug access in low-, middle-, and high-income countries, making them useful for international physicians.

“To develop the guidelines, the working group went over studies of approved drugs and phase 2 and phase 3 clinical trials of drugs that are coming down the pike,” said Dr. Vesole. “The guidelines also reflect that some drugs are not available in certain parts of the world and take into consideration the limitation of available agents and provide alternative treatment options.”

Dr. Vesole, who has been a part of the working group for 20 years, said the development of the guidelines was an international effort that represents the evolution of MM treatments.

“As one of the leading MM treatment centers in the country, John Theurer Cancer Center is proud to contribute scientifically to the development of the guidelines,” said Dr. Vesole. “Our myeloma division has also been involved in many of the clinical trials that have advanced MM care.”