Day 3 at ASCO brought an interesting session on Global Myeloma, Health Disparities, and the Cost of Drugs. The first presentation, by Dr. Timothy Rebbeck of the Dana Farber Cancer Institute, focused on Myeloma Outcomes and Disparities in African Americans. This population of patients has a 3-4 fold increase in incidence of and death from multiple myeloma compared to other ethnic groups. In addition, African Americans have a 2 fold higher chance of progressing from MGUS or SMM myeloma to symptomatic myeloma compared to other ethnicities. Researchers have also found that
- African Americans are 37% less likely to utilize stem cell transplantation
- African Americans are 21% less likely to receive Velcade treatment
- After stem cell transplant and IMiD treatment was introduced in the 1990s, the magnitude of survival improvement in African Americans was less than 50% of the survival improvement seen in European Americans
In summary, the disparity in myeloma mortality in African Americans is complex but is most probably driven by increased incidence of MGUS and MM in African Americans as well as disparities in treatment. Since MM disease outcomes are better for African Americans compared to European Americans if treatment is equally applied, it is important to find ways to prevent the increased progression from MGUS to MM in this population, as well as increase engagement with the African Americans community in clinical trials.
To see more information on this important topic and discover what our own CoMMpass Study
data has contributed to this research area, listen to our recent CoMMpass Study
: Insights for Patients and Caregivers webinar at https://themmrf.org/resources/education-programs/
Next, Dr. Philippe Moreau of CHU de Nantes-Hotel Dieu presented Global Approaches in Myeloma: Critical Trials That May Change Practice. Dr. Moreau gave a thorough review of the many trials ongoing in myeloma both in Europe and the US and their results, some of which were reported in the oral sessions on Day 1 of ASCO (see the Day 1 blog post for more details). While much data has been collected, more academic trials are needed to determine:
- For younger patients: what is the optimal duration of maintenance therapy after stem cell transplant
- For elderly patients: should they be on continuous therapy
- Optimal scheduling and sequencing for RRMM treatment for all patient groups
This underscores the importance of myeloma patient participation in clinical trials. Only through gathering this critical data can treatment be improved for all MM patients. To find a clinical trial
that may be right for you, contact our myeloma nurse navigators at 888-841-6673, or utilize our on-line clinical trial
finder at https://themmrf.org/resources/clinical-trial-finder/
Finally, Drs. Vincent Rajkumar and Rafael Fonseca of the Mayo Clinic held a spirited debate on the Value and Cost of Myeloma Therapy. While Dr. Rajkumar presented data on rising drug costs and the burden this may place on some myeloma patients, Dr. Fonseca countered with arguments that the newer myeloma drugs, while more expensive, have prolonged patients’ lives, thereby driving down overall healthcare costs due to decreased hospital stays and doctor visits. This is clearly a complex issue with no easy answer, but patient-focused groups such as MMRF continue to work with the myeloma community to ensure availability of existing therapies to all myeloma patients.
Check back tomorrow for highlights from Day 4 at ASCO!