More Answers or More Questions?

| Teresa Miceli

As the 57th Annual Meeting and Exposition of the American Society of Hematology (ASH) comes to an end, I come to the overwhelming sense that I may now have more questions than answers. Yes, we have had a “November to Remember” with three new drugs receiving Food and Drug Administration (FDA) approval for treating relapsed multiple myeloma—Ninlaro (ixazomib), Darzalex (daratumumab), and Empliciti (elotuzumab). The meeting provided so much important information about these drugs and many others, but this stirs the pot of questions:

  • When should these treatments be introduced in the treatment schema?
  • How can these medications be used: monotherapy or combo therapy? Frontline therapy or therapy for relapsed/refractory multiple myeloma patients??
  • What to start with, and how to sequence treatment?

I do not believe I am the only one with questions. I have heard a variety of questions from some of the support group leaders (SGLs) with whom I attended this meeting. These questions included the following:

  • What side effects can I expect from these medications?
  • How will my infusion nurse know the side effects and how to treat them?
  • Should I switch from VELCADE® to Ninlaro (ixazomib)?

I am relieved to say, as a registered nurse, I am not a prescriber and do not have to make treatment decisions. But as a patient advocate, I want to educate patients to help them with their decision-making.

Because multiple myeloma is such a complex, heterogeneous disease, there is not going to be a “one answer fits all” approach. Some clear answers that I have learned through the ASH sessions, discussions with patients, and the International Myeloma Working Group Conference series “Making Sense of Treatment are the following”:

  • Transplant remains an important “tool” in our multiple myeloma “tool box” for those eligible.
  • Health care professionals, at all points of care, remain passionate about curing multiple myeloma.
  • The three-drug combination VELCADE®/Revlimid®/Dexamethasone is superior as induction regimen and will likely become the standard of care.
  • Patients want to be included in decision-making about treatments.
  • If an approach is currently working and is tolerated, there is no need to change.
  • Participation in clinical trials is needed to gain the needed knowledge to find answers to unanswered questions.
  • More treatment options and more sensitive diagnostic testing are needed to reach our goal—a CURE for myeloma.

The many long days running from one session to another at the ASH meeting has come to an end, but now the work begin: Reviewing and deciphering the information provided, educating my support group members and colleagues on the important updates, and continuing to support the amazing patients that live with multiple myeloma every day.

I want to extend my appreciation to the IMF and their sponsors for allowing me to participate in this SGL-Nurse Liaison program another year. My time spent with these wonderful SGLs who give of them self tirelessly is inspirational. A special thank you to Robin Tuohy for her amazing organizational skills that make this event seem effortless, and for her continued confidence in me to recommend my participation.

Follow Teresa on Twitter: @IMFnurseMYELOMA
Multiple Myeloma Sharing Sessions
Rochester, NY

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