Highlights

• …and it’s not endorsed by the International Myeloma Working Group of which I’m a member, and there’s no criteria, it’s not in the NCCN guidelines, it’s not in any guidelines that we should be treating smoldering myeloma right now outside of a clinical trial…

   

• …we are a very aggressive group, and we’re kind of outliers, so we transplant over 90% of our patients. That being said, yes, our referrals know that we transplant 90% of the patients, so the ones that they don’t think we should transplant, they don’t send them to us for a consult. […] We will transplant people up to age of 80 and sometimes even a little higher than 80. Renal failure, no renal failure, everything’s covered.

   

• So, we are not currently FDA-approved or NCCN-approved to do quadruplets, using monoclonal antibodies, not to say that we may or may not do that in the future. In almost all of our patients we use KRd, carfilzomib/lenalidomide/dexamethasone, two or three cycles, then they go to transplant. […] We essentially never use Velcade if we have a choice because of the toxicity profile of Velcade versus carfilzomib. Do I think that we’ll go to a dara-KRd regimen? My guess is we will not, that would be the logical next sequence, but if we only give a couple of cycles to get that little bit deeper response, and expose patients to dara upfront versus waiting till a relapse, it’s probably something we’re not going to do, but I’m not certain about that right now. My guess is we won’t change our regimen much.