nccn multiple myeloma guidelines

nccn multiple myeloma guidelines

Front Pharmacol. Accessibility Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. At a median follow-up of 16 months, the overall response rate was 84%. J Clin Oncol 2018;36:2035–2043. National Cancer Institute. These NCCN Guidelines Insights highlight some of the important updates and changes in the 1.2020 version of the NCCN Guidelines for Multiple Myeloma. J Clin Oncol 2012;30:2946–2955. to save searches and organize your favorite content. Cancer Stat Facts: Myeloma. “They contain the most accessible, comprehensive information about myeloma treatment for patients and practicing physicians and the NCCN myeloma panel’s decisions prove that the age of novel therapies and the possibility of prevention has arrived. These NCCN Guidelines Insights highlight the important updates/changes specific to the myeloma therapy options in the 2018 version of the NCCN Guidelines. The 3-year OS was 70% and 72%, respectively (HR, 1.27; P=.5).24, Consistent with these results, the more recent phase Ib CHAMPION-2 study evaluated the safety and tolerability of twice-weekly carfilzomib (3 different doses) in combination with cyclophosphamide and dexamethasone for the treatment of patients with newly diagnosed MM. Maintenance with proteasome inhibitors has also been evaluated in randomized trials. Dimopoulos MA, Roussou M, Gavriatopoulou M, . Carfilzomib, cyclophosphamide, and dexamethasone in patients with newly diagnosed multiple myeloma: a multicenter, phase 2 study. To participate in this journal CE activity: (1) review the educational content; (2) take the posttest with a 66% minimum passing score and complete the evaluation at https://education.nccn.org/node/86150; and (3) view/print certificate. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Significant updates have been made to the 1.2020 version of the NCCN Guidelines for Multiple Myeloma. Lenalidomide maintenance after autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis. If proteinuria predominantly consists of light chains with high serum levels of free light chain, and the cause of renal insufficiency can be attributed to myeloma, a renal biopsy may not be necessary. Author information: (1)Presented by Kenneth C. Anderson, MD, Dana-Farber Cancer Institute, Boston, Massachusetts. The phase III trial TOURMALINE-MM3, which studied 2 years of maintenance with ixazomib versus placebo in patients who had achieved at least a partial response following induction therapy and a single AHCT, showed that ixazomib improved PFS (median, 26.5 months [95% CI, 23.7–33.8] vs 21.3 months [95% CI, 18.0–24.7]; HR, 0.72; 95% CI, 0.58–0.89).39 The risk of developing secondary malignancies was similar in the control arm and in patients receiving maintenance ixazomib. Results were recently published of the phase III, open-label, multicenter, randomized OPTIMISMM study that evaluated the safety and efficacy of pomalidomide/bortezomib/dexamethasone (n=281) versus bortezomib/dexamethasone (n=278) in patients with relapsed/refractory MM who previously received lenalidomide.42 After a median follow-up of 15.9 months, significantly improved PFS was seen in the pomalidomide arm (median, 11.20 vs 7.10 months; HR, 0.61; 95% CI, 0.49–0.77; P42. Combination daratumumab/carfilzomib/dexamethasone was studied in a phase Ib, open-label, nonrandomized, multicenter study in patients (n=82) with relapsed/refractory MM. Lenalidomide maintenance after stem-cell transplantation for multiple myeloma. Integrate into professional practice the updates to the NCCN Guidelines for Multiple Myeloma, Describe the rationale behind the decision-making process for developing the NCCN Guidelines for Multiple Myeloma. Prevention and treatment information (HHS). Colored markings in the algorithm show changes and the discussion aims to further the understanding of these changes by summarizing salient portions of the panel's discussion, including the literature reviewed. 2020 Nov 30;12(12):3576. doi: 10.3390/cancers12123576. Blood 2014;124:63–69. Lenalidomide and dexamethasone for the treatment of refractory/relapsed multiple myeloma: dosing of lenalidomide according to renal function and effect on renal impairment. Knudsen LM, Hippe E, Hjorth M, . Available at: Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group, Findings of whole body computed tomography compared with conventional skeletal survey in patients with monoclonal plasma cell disorders—a study of the International Myeloma Working Group, Baseline bone involvement in multiple myeloma—a prospective comparison of conventional x-ray, low-dose computed tomography, and 18flourodeoxyglucose positron emission tomography in previously untreated patients, Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma, Multiple myeloma lesion detection with whole body CT versus radiographic skeletal survey, Role of 18F-FDG PET/CT in the assessment of bone involvement in newly diagnosed multiple myeloma: preliminary results, Positron emission tomography-computed tomography in the diagnostic evaluation of smoldering multiple myeloma: identification of patients needing therapy, 18F-FDG PET/CT focal, but not osteolytic, lesions predict the progression of smoldering myeloma to active disease, Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma, Predictive value of longitudinal whole-body magnetic resonance imaging in patients with smoldering multiple myeloma, F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma, Prospective evaluation of magnetic resonance imaging and [, F]fluorodeoxyglucose positron emission tomography-computed tomography at diagnosis and before maintenance therapy in symptomatic patients with multiple myeloma included in the IFM/DFCI 2009 trial: results of the IMAJEM study, Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications, PET/CT improves the definition of complete response and allows to detect otherwise unidentifiable skeletal progression in multiple myeloma. Initial treatment of cast nephropathy includes administering appropriate myeloma therapy and providing adequate supportive care. The NCCN Guidelines for Multiple Myeloma provide recommendations for diagnosis, evaluation, treatment, including supportive care, and follow-up for patients with myeloma. A skeletal survey has been the standard for assessing bone disease in any individual with suspected myeloma for decades.4 However, this technique has significant limitations related to lower sensitivity compared with advanced imaging. Bethesda, MD 20894, Copyright He J, Schmerold L, Van Rampelbergh R, Qiu L, Potluri R, Dasgupta A, Li L, Li Y, Hu P, Nemat S, Smugar SS, Zeltzer P, Appiani C, Li Q, Mehra M, Richarz U. Adv Ther. Clinical Trials: NCCN believes that the best management of any patient with cancer is in a clinical trial. The NCCN Guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to cancer treatment. Goldschmidt H, Lokhorst HM, Mai EK, . Bringhen S, Petrucci MT, Larocca A, . Multiple Myeloma, Version 3.2017, NCCN Clinical Practice Guidelines in Oncology. Mellqvist UH, Gimsing P, Hjertner O, . Ballester OF, Tummala R, Janssen WE, . 2016 May;38 Suppl 1:110-22. doi: 10.1111/ijlh.12504. As endorsed by The Leukemia & Lymphoma Society and the Multiple Myeloma Research Foundation, the NCCN Guidelines For Patients, as produced by the National Comprehensive Cancer Network (NCCN), explains testing and treatments for multiple myeloma, as well as provides information to help patients with multiple myeloma make informed treatment decisions. Br J Haematol 2003;121:749–757. Baseline bone involvement in multiple myeloma—a prospective comparison of conventional x-ray, low-dose computed tomography, and 18flourodeoxyglucose positron emission tomography in previously untreated patients. Oral ixazomib maintenance following autologous stem cell transplantation (TOURMALINE-MM3): a double-blind, randomised, placebo-controlled phase 3 trial. Whole-body diffusion-weighted MRI: a new gold standard for assessing disease burden in patients with multiple myeloma? Clin Lymphoma Myeloma Leuk 2017;17:433–437. Cancers (Basel). Clinical Trials: NCCN believes that the best management of any cancer patient is in a clinical trial. Rasche L, Alapat D, Kumar M, . Combination of flow cytometry and functional imaging for monitoring of residual disease in myeloma, Low expression of hexokinase-2 is associated with false-negative FDG-positron emission tomography in multiple myeloma, Daratumumab plus lenalidomide and dexamethasone for untreated myeloma, Carfilzomib, cyclophosphamide, and dexamethasone in patients with newly diagnosed multiple myeloma: a multicenter, phase 2 study, Phase 1/2 study of weekly carfilzomib, cyclophosphamide, dexamethasone in newly diagnosed transplant-ineligible myeloma, Once-weekly versus twice-weekly carfilzomib in patients with newly diagnosed multiple myeloma: a pooled analysis of two phase I/II studies, A multicenter, open-label, phase 1b study of carfilzomib, cyclophosphamide, and dexamethasone in newly diagnosed multiple myeloma patients (CHAMPION-2), Phase 1/2 trial of ixazomib, cyclophosphamide and dexamethasone in patients with previously untreated symptomatic multiple myeloma, All-oral ixazomib, cyclophosphamide, and dexamethasone for transplant-ineligible patients with newly diagnosed multiple myeloma, Lenalidomide maintenance after stem-cell transplantation for multiple myeloma, Lenalidomide after stem-cell transplantation for multiple myeloma, Continuous lenalidomide treatment for newly diagnosed multiple myeloma, Updated outcomes and impact of age with lenalidomide and low-dose dexamethasone or melphalan, prednisone, and thalidomide in the randomized, phase III FIRST trial, Updated analysis of CALGB (Alliance) 100104 assessing lenalidomide versus placebo maintenance after single autologous stem-cell transplantation for multiple myeloma: a randomised, double-blind, phase 3 trial, Lenalidomide maintenance after autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis, Bortezomib before and after high-dose therapy in myeloma: long-term results from the phase III HOVON-65/GMMG-HD4 trial, Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/GMMG-HD4 trial, Bortezomib consolidation after autologous stem cell transplantation in multiple myeloma: a Nordic Myeloma Study Group randomized phase 3 trial, Phase 3b UPFRONT study: safety and efficacy of weekly bortezomib maintenance therapy after bortezomib-based induction regimens in elderly, newly diagnosed multiple myeloma patients [abstract], Consolidation and maintenance therapy with lenalidomide, bortezomib and dexamethasone (RVD) in high-risk myeloma patients, Oral ixazomib maintenance following autologous stem cell transplantation (TOURMALINE-MM3): a double-blind, randomised, placebo-controlled phase 3 trial, Daratumumab plus carfilzomib and dexamethasone in patients with relapsed or refractory multiple myeloma, Phase 2 study of all-oral ixazomib, cyclophosphamide and low-dose dexamethasone for relapsed/refractory multiple myeloma, Pomalidomide, bortezomib, and dexamethasone for patients with relapsed or refractory multiple myeloma previously treated with lenalidomide (OPTIMISMM): a randomised, open-label, phase 3 trial, A phase I/II trial of cyclophosphamide, carfilzomib, thalidomide and dexamethasone (CYCLONE) in patients with newly diagnosed multiple myeloma: final results of MTD expansion cohort, Oral selinexor-dexamethasone for triple-class refractory multiple myeloma, Renal failure in multiple myeloma: presenting features and predictors of outcome in 94 patients from a single institution, Renal function in newly diagnosed multiple myeloma—a demographic study of 1353 patients, Renal failure in multiple myeloma: reversibility and impact on the prognosis, Bortezomib-based triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis, International Myeloma Working Group recommendations for the diagnosis and management of myeloma-related renal impairment, Lenalidomide and dexamethasone for the treatment of refractory/relapsed multiple myeloma: dosing of lenalidomide according to renal function and effect on renal impairment, Pomalidomide plus low-dose dexamethasone in patients with relapsed/refractory multiple myeloma and renal impairment: results from a phase II trial, High-dose chemotherapy and autologous peripheral blood stem cell transplantation in patients with multiple myeloma and renal insufficiency, Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: a Center for International Blood and Marrow Transplant Research Analysis, Disclosure of Relevant Financial Relationships. Kumar SK, Callander NS, Alsina M, Atanackovic D, Biermann JS, Chandler JC, Costello C, Faiman M, Fung HC, Gasparetto C, Godby K, Hofmeister C, Holmberg L, Holstein S, Huff CA, Kassim A, Liedtke M, Martin T, Omel J, Raje N, Reu FJ, Singhal S, Somlo G, Stockerl-Goldstein K, Treon SP, Weber D, Yahalom J, Shead DA, Kumar R. J Natl Compr Canc Netw. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) Multiple Myeloma Version 1.2011 NCCN.org The NCCN Guidelines™ are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. Clinicians must understand the treatment evolution and guidelines for administration of available therapies in the … Multiple myeloma guidelines nccn - The profile of gene expression, in addition, can separate the patients fashionable or excess risk of disorder, but this takes a look at it has not yet been established in the usual practice. Cancer Invest 2013;31:206–211. FDG-PET/CT also has been shown to identify more lesions than plain radiographs and to detect lesions in patients with negative skeletal surveys.9–11 It is important to note that if PET/CT is selected instead of whole-body low-dose CT, the imaging quality of the CT part of the PET/CT should be equivalent to a whole-body low-dose CT. Usually the CT part is used only for attenuation correction, which is not sufficient to assess myeloma bone disease and stability of the spine. Target Audience: This activity is designed to meet the educational needs of physicians, nurses, pharmacists, and other healthcare professionals who manage patients with cancer. Available at: http://seer.cancer.gov/statfacts/html/mulmy.html. NCCN: Multiple myeloma. 8600 Rockville Pike Am J Hematol 2016;91:499–502. Bringhen S, Mina R, Petrucci MT, . Blood Cancer J 2018;8:70. Category 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Clipboard, Search History, and several other advanced features are temporarily unavailable. Author information: (1)Robert H. Lurie Comprehensive Cancer Center of Northwestern University, USA. The National Comprehensive Cancer Network (NCCN) guidelines for the management of frontline and relapsed/refractory multiple myeloma were … Epub 2020 Nov 19. Combination ixazomib/cyclophosphamide/dexamethasone has been shown to be tolerable and efficacious in patients with newly diagnosed MM.26,27 A phase II study evaluating this regimen in the relapsed/refractory setting in patients with a median age of 63.5 years also found it to be well tolerated. Cancer statistics, 2019. The heterogeneity of relapsed/refractory multiple myeloma (MM) and an increasing number of therapeutic options in this setting has resulted in a complex environment for treatment decisions. These NCCN Guidelines Insights highlight some of the important updates and changes in the 1.2020 version of the NCCN Guidelines for Multiple Myeloma. Hillengass J, Moulopoulos LA, Delorme S, . Although the benefit of mechanical removal of free light chains has not been established, limited evidence supports the use of plasmapheresis or high-cutoff dialysis to reduce pathogenic light chains. N Engl J Med 2019;381:727–738. Before completing these requirements, be sure your NCCN profile has been updated with your NAPB e-profile ID and date of birth. Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: a Center for International Blood and Marrow Transplant Research Analysis. New regimens were included as options for the treatment of relapsed/refractory MM in the 1.2020 version of the NCCN Guidelines (see MYEL-F, pages 1159–1161). The doublet regimens were removed from the page listing therapies for transplant candidates with the rationale that doublets would be recommended for patients who would not be considered for initial treatment with a 3-drug regimen, such as those not initially eligible for transplant. Those with renal insufficiency had higher rates of thrombocytopenia and lenalidomide discontinuation than those without renal insufficiency. This activity is supported by an unrestricted educational grant from Gilead Sciences, Medical Affairs. These NCCN Guidelines Insights focus only on the updates specific to imaging recommendations for MM; treatment options for newly diagnosed transplant-eligible and transplant-ineligible candidates, maintenance therapy, and previously treated MM; and management of renal disease in patients with MM. “The NCCN Guidelines underscore how far we have come in treating myeloma,” said Myeloma Crowd founder Jenny Ahlstrom. Boccia RV, Bessudo A, Agajanian R, . Multiple factors need to be considered when determining the next best therapy. Mediterr J Hematol Infect Dis. Sonneveld P, Schmidt-Wolf IG, van der Holt B, . Myeloma therapy using bortezomib-containing regimens should be initiated as soon as possible to decrease the production of nephrotoxic clonal immunoglobulin.48 Bortezomib/dexamethasone containing regimens can be administered to patients with severe renal impairment and those on dialysis and do not require renal dose adjustment.46 If the 2-drug bortezomib/dexamethasone regimen is used as initial treatment, a third drug that does not require dose adjustment can be added, including cyclophosphamide, thalidomide, an anthracycline, or daratumumab. Merz M, Hielscher T, Wagner B, . These NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) are updated annually, This study found that that 56 mg/m2 of carfilzomib combined with weekly cyclophosphamide and dexamethasone was effective and had manageable toxicity.25. Palumbo A, Hajek R, Delforge M, . The NCCN Guidelines for Multiple Myeloma provide recommendations for diagnosis, workup, treatment, follow-up, and supportive care for patients with monoclonal gammopathy of renal significance, solitary plasmacytoma, smoldering myeloma, and multiple myeloma. Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma. Rasche L, Angtuaco E, McDonald JE, . Updated analysis of CALGB (Alliance) 100104 assessing lenalidomide versus placebo maintenance after single autologous stem-cell transplantation for multiple myeloma: a randomised, double-blind, phase 3 trial. NCCN Guidelines Insights: Multiple Myeloma, Version 3.2016. Leukemia 2018;32:383–390. For follow-up of patients with MM after primary treatment (see MYEL-5, page 1158), the NCCN panel recommends advanced imaging (ie, whole-body FDG-PET/CT, low-dose CT scan, whole-body MRI without contrast) as clinically indicated, and using the same imaging modality used during the initial workup for the follow-up assessments. In addition, concomitant amyloidosis and monoclonal immunoglobulin deposition should be suspected when renal insufficiency or albuminuria is present without high levels of light chains. NCCN Guidelines Version 3.2016 Multiple Myeloma NCCN Guidelines Index Multiple Myeloma Table of Contents Discussion Note: All recommendations are category 2A unless otherwise indicated. Updated outcomes and impact of age with lenalidomide and low-dose dexamethasone or melphalan, prednisone, and thalidomide in the randomized, phase III FIRST trial. Blood Cancer J 2015;5:e364. Treatment Pattern and Outcomes in Newly Diagnosed Multiple Myeloma Patients Who Did Not Receive Autologous Stem Cell Transplantation: A Real-World Observational Study : Treatment pattern and outcomes in patients with multiple myeloma. However, in small cohorts, functional imaging sequence for MRI called diffusion-weighted imaging was shown to have superior sensitivity to detect residual disease compared with FDG-PET/CT.18–20 Furthermore, unlike FDG-PET/CT, MRI does not expose patients to radiation. Hydration, bisphosphonates, denosumab, and/or calcitonin are recommended to reduce calcium levels in the case of hypercalcemia. Participation in clinical trials is especially encouraged. Nursing (ANCC): NCCN designates this educational activity for a maximum of 1.0 contact hour. Siegel RL, Miller KD, Jemal A. Dialysis may be required in selected patients, in addition to prompt institution of antimyeloma therapy. Eur Radiol 2008;18:51–58. © 2019-2020 National Comprehensive Cancer Network. Unable to load your collection due to an error, Unable to load your delegates due to an error. STOCKHOLM - March 22, 2021 - Oncopeptides AB (publ) (Nasdaq Stockholm: ONCO), a global biotech company focused on the development of therapies for difficult-to-treat hematological diseases, today announces that PEPAXTO ® (melphalan flufenamide) has been included in the new Multiple Myeloma Clinical Practice Guidelines of the National Comprehensive Cancer Network ® (NCCN) in Oncology. The NCCN Guidelines for Patients sheets are available to read and download for free online and via the NCCN Patient Guides for Cancer mobile app. When possible, consistent with NCCN philosophy, the panel strongly encourages patient/physician participation in prospective clinical trials. In the IMAJEM trial, both PFS (P=.011) and overall survival (OS; P=.033) were significantly better in patients with negative FDG-PET/CT results before initiation of maintenance therapy.15 An analysis by Walker et al16 showed that conventional MRI normalizes over a prolonged period of time, making FDG-PET/CT superior for follow-up. Intravenous fluids should be started promptly in patients with MM and renal disease to decrease the renal tubular light chain concentration, with a goal urine output of 100 to 150 mL/h. J Clin Oncol 2016;34:3609–3617. Clin Cancer Res 2015;21:4384–4390. The panel added new regimen options in the 1.2020 version for both transplant-eligible and transplant-ineligible patients with newly diagnosed MM. The most common adverse events reported during treatment were thrombocytopenia in 73% of patients, fatigue in 73%, nausea in 72%, and anemia in 67%. Bortezomib consolidation after autologous stem cell transplantation in multiple myeloma: a Nordic Myeloma Study Group randomized phase 3 trial. © National Comprehensive Cancer Network, Inc. 2019. Eur J Nucl Med Mol Imaging 2006;33:525–531. 2018 Jan;16(1):11-20. doi: 10.6004/jnccn.2018.0002. Prospective evaluation of magnetic resonance imaging and [18F]fluorodeoxyglucose positron emission tomography-computed tomography at diagnosis and before maintenance therapy in symptomatic patients with multiple myeloma included in the IFM/DFCI 2009 trial: results of the IMAJEM study. Hematol Oncol Clin North Am. Kyle RA, San-Miguel JF, Mateos MV, Rajkumar SV. Careers. This agent induces apoptosis of MM cells by selectively inhibiting nuclear export compound that blocks exportin 1 (XPO1), forcing nuclear accumulation and activation of tumor suppressor proteins, and inhibiting nuclear factor κB and the translation of oncoprotein mRNAs, such as c-myc and cyclin-D. Selinexor in combination with dexamethasone was studied in the phase IIb STORM trial in patients with relapsed/refractory MM who had multiple prior therapies and were refractory to IMiDs (lenalidomide and pomalidomide), proteasome inhibitors (bortezomib and carfilzomib), and the CD38 antibody (daratumumab).44 A total of 122 patients were included in the intent-to-treat population. 2021 Jan;38(1):640-659. doi: 10.1007/s12325-020-01546-0. Blood 2009;114:2068–2076. Recent Advances in the Treatment of Patients with Multiple Myeloma. The PFS and OS were also similar. Biology (Basel). Lancet Haematol 2017;4:e431–442. At a median follow-up of 15.2 months, the median PFS was 14.2 months, with a trend toward better PFS in patients aged ≥65 versus <65 years (median, 18.7 vs 12.0 months; HR, 0.62; P=.14).41 Therefore, the NCCN panel included this all-oral regimen as an “Other Recommended” option for relapsed/refractory MM. Updates in Version 2.2014 of the NCCN Guidelines for Multiple Myeloma from Version 1.2014 include: NCCN Guidelines Version 2.2014 Multiple Myeloma - Updates MYEL-3 Added the following footnote to Smoldering (asymptomatic) myeloma: “A relatively small randomized prospective study has shown benefit of early treatment with lenalidomide and dexamethasone for a subset of patients with … This site needs JavaScript to work properly. Updates in Version 3.2018 of the NCCN Guidelines for Multiple Myeloma from Version 2.2018 include: MYEL-4 • Active (symptomatic) myeloma, primary treatment: added denosumab as an option for the prevention of skeletal-related events for all Eur J Cancer 2019;106:89–98. Jens Hillengass, MD, Panel Member, has disclosed that he receives consulting fees/honoraria from Amgen Inc, Janssen Pharmaceutica Products, LP, Adaptive Biotech, DRG LLC, Oncotracker, and Xian Janssen. Bortezomib-based triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis. Conditioning with reduced-dose melphalan has outcomes comparable to standard-dose melphalan and should be considered in those who are otherwise eligible for the procedure.52,53. Lee MS, Lim SH, Yu AR, Hwang CY, Kang I, Yeo EJ. In patients with myeloma, renal insufficiency, defined as elevated serum creatinine level of >2 mg/dL or established glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2, is usually due to light chain cast nephropathy, but other causes must be considered, including hypercalcemia, volume depletion, and hyperuricemia as well as nephrotoxic medications or intravenous contrast. Oncopeptides announces that PEPAXTO® is included in new Multiple Myeloma guidelines of National Comprehensive Cancer Network® News provided by. Multiple myeloma (MM) accounts approximately 1.8% of all cancers and slightly more than 17% of hematologic malignancies in the United States.1 Myeloma is most frequently diagnosed in people aged 65 to 74 years, with the median age being 69 years.2 The American Cancer Society has estimated 32,110 new myeloma cases will be diagnosed in the United States in 2019, with an estimated 12,960 deaths.3. Kumar SK, Buadi FK, LaPlant B, . The panel recommends a baseline dental exam and monitoring for ONJ in all patients receiving a bone-modifying agent and monitoring for renal … National Cancer Institute. Selinexor was recently approved for the treatment of myeloma. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. Low expression of hexokinase-2 is associated with false-negative FDG-positron emission tomography in multiple myeloma. The updated criteria for the diagnosis of myeloma represent a paradigm shift in the approach to myeloma and have considerable impact on the management of the disease. Cancer statistics, 2017. eCollection 2021. All-oral ixazomib, cyclophosphamide, and dexamethasone for transplant-ineligible patients with newly diagnosed multiple myeloma. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Niesvizky R, Flinn IW, Rifkin RM, . The NCCN Multiple Myeloma Panel members have developed guidelines for the management of patients with various plasma cell dyscrasias, including solitary plasmacytoma, smoldering myeloma, multiple myeloma, systemic light chain amyloidosis, and Waldenström's macroglobulinemia. Median PFS was 35.7 months in the once-weekly group and 35.5 months in the twice-weekly group (HR, 1.39; P=.26). 2021 Jan 1;13(1):e2021012. The NCCN Guidelines for Multiple Myeloma provide recommendations for diagnosis, workup, treatment, follow-up, and supportive care for patients with monoclonal gammopathy of renal significance, solitary plasmacytoma, smoldering myeloma, and multiple myeloma. Leukemia 2016;30:417–422. PET/CT improves the definition of complete response and allows to detect otherwise unidentifiable skeletal progression in multiple myeloma. International Myeloma Working Group recommendations for the diagnosis and management of myeloma-related renal impairment. The sensitivity of skeletal survey and whole-body low-dose CT in the long bones is not significantly different; the difference is mainly in detection of abnormalities in spine and pelvis.5,6 In a study of 29 patients, CT showed osteolytic lesions in 5 patients (17%), whereas skeletal survey results were negative.7 Studies have shown that whole-body low-dose CT is superior to skeletal survey radiographs in areas that are difficult to visualize using skeletal surveys, such as the skull and ribs.8.

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