Tag Archive for: clinical trials

How is Treatment Fitness Determined in Multiple Myeloma?

How is Treatment Fitness Determined in Multiple Myeloma? from Patient Empowerment Network on Vimeo.

How is treatment suitability assessed in myeloma care? Dr. Sikander Ailawadhi, an expert from Mayo Clinic, elaborates on the factors taken into account when determining the appropriateness of treatment for myeloma patients.

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Transcript:

Lisa Hatfield:

Oh, great. Okay. Again, important to see a myeloma specialist to tease out all this information. Thank you. All right. This patient is asking, “I’m 81 and living with comorbidities. The myeloma was diagnosed after bone marrow test. How is treatment fitness determined?” And also a question about that is if you’re given an ECOG status of something you don’t like it, can that be improved after you’ve had treatment?

Dr. Sikander Ailawadhi:

Absolutely.

Lisa Hatfield:

Maybe be eligible for a trial or something.

Dr. Sikander Ailawadhi:

Correct. Correct. That is so important. When this patient mentioned that they’re 81-year-old and they’re living with comorbidities, I think, so when I’m talking to a patient who’s new to me, it’s very important for me to try to tease out what was their performance status or their fitness status prior to myeloma. Because my goal is to try to get them as close to that as possible.

Now if this patient is saying that they were already quite frail before the diagnosis of myeloma and myeloma is added to the frailty, then it becomes a little tricky because we’re starting in a difficult spot. We do determine fitness by asking questions, simple questions like, what can a patient do at baseline? Can they do grocery store or grocery shopping by themselves? Can they walk around the block? Do they get short of breath? Et cetera.

And frankly, there are 81-year-olds who are playing golf every day and are fitter than me. So I’m just saying that age by itself is not the criteria. And, Lisa, like you rightly mentioned, if there are fitness issues coming from the disease itself, then that’s the time that we actually have to work with the treatment, get the treatment started, and then assess the fitness a couple of months later, a couple of cycles later. Because the treatment may have worked and may have improved the fitness quite a bit.


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Navigating Myeloma CAR T-Cell Relapse: Patient Next Steps

Navigating Myeloma CAR T-Cell Relapse: Patient Next Steps from Patient Empowerment Network on Vimeo.

What are next steps for myeloma CAR T-cell patients who experience relapse? Expert Dr. Sikander Ailawadhi from Mayo Clinic explains options for relapsed myeloma patients and shares patient advice.

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See More from START HERE Myeloma

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What Factors Shape Myeloma Treatment Options After Relapse?

Myeloma Treatment Timing: Prior Therapies and FDA Approval Rationale

How is Treatment Fitness Determined in Multiple Myeloma?


Transcript:

Lisa Hatfield:

Okay. So what would be the next steps, Dr. Ailawadhi, for a patient who’s had CAR T and reaches a relapse state or is relapsed?

Dr. Sikander Ailawadhi:

Yep. This is something, unfortunately is the truth of the matter in myeloma at least that we are, we don’t seek cures. We have had some long remissions. I have, for example, patients who are now reaching three, three-and-a-half years of remission on CAR T treatment who received it on clinical trials even before they got FDA-approved.

But, unfortunately, the disease does come back. So what happens is, we are seeing data that the novel, other novel immunotherapies like bispecific antibodies, even the ones who go after the same target as CAR T, BCMA targeting bispecifics, they do have some response rates, good response rates in post CAR T setting. So the bispecific antibodies by themselves may give us 60 to 65 percent response, but in the post CAR T setting, that response might go down to 40, 45 percent. So less responses, but still possible.

There are also bispecific antibodies. There is one available, which is not against BCMA, it is against GPRC5D. That’s a bispecific called talquetamab-tgvs (Talvey). So a novel target. There is…there are of course a lot of clinical trials. There are some clinical trials that are even looking at CAR T post-CAR T. So different kind of a CAR T. Those clinical trials are going out. So what I would suggest is that if your disease progresses after CAR T-cell treatment, you should very strongly consider getting to a specialist myeloma center and get an opinion like you mentioned, Lisa.

That is so important because the choice of treatment is extremely important at that time. And we are trying our best to sequence all the options we have, in a way, actually one of my patients mentioned, one of these days, ”Hey, does that mean that I’m basically buying time till something new and exciting comes along?” And I said, “In a way that is true. That we are trying to stretch all our treatments and get to the point that something new and promising just like CAR T comes, and hopefully we get longer benefits again.”

Lisa Hatfield:

So when you say there’s a possibility of CAR T and then a post-CAR T maybe a second CAR T. Would that be a different target then?

Dr. Sikander Ailawadhi:

So there could be a different target. I have, in fact, I saw a patient who had received one CAR T in a clinical trial and then they were subsequently able to receive a CAR T standard of care, which had been FDA-approved. So they used different CAR Ts, but one was in clinical trials and one was standard of care.


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How Can Myeloma Care Providers Engage Patient Interest in Clinical Trials?

How Can Myeloma Care Providers Engage Patient Interest in Clinical Trials? from Patient Empowerment Network on Vimeo.

What are some ways that myeloma care providers can increase interest in clinical trials? Dr. Craig Cole from Karmanos Cancer Institute and advanced practice provider Charise Gleason share insight on information they provide to patients and ways they improve communication about clinical trials.

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Transcript:

Dr. Nicole Rochester:

I’m going to go to each of you just to share maybe one takeaway that you’d like to leave with the audience. So I’ll start with you, Dr. Cole, one takeaway.

Dr. Craig Cole:

One takeaway. I actually thought about this, but I think that the biggest takeaway is, if I can squeeze two in.

Is that, is to remember that basically they’re all patients want to be involved in clinical trials and the ownership of having patients on clinical trials is really on us to really talk to them over a longitudinal period, to talk about clinical trials, to have them involved. To not look at a patient saying, “No, they don’t want to be on clinical trial.” That you really engage that patient to tell them about really the incredible progress that we’ve made, how competitive clinical trials are and how exciting it is to be part of that research environment. And that would be my one, my two sort of closing thoughts.

Dr. Nicole Rochester:

And what about you, Ms. Gleason?

Charise Gleason:

Dr. Cole said it well. Please discuss this with your patient. Listen to them. Listen to their concerns. Don’t make decisions for them based on bias that maybe you’re bringing in. Don’t make decisions based on maybe it’s too far. Patients drive hours to go on clinical trials, and let’s give them the information and have that conversation.


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How Can Myeloma HCPs and Nurses Help Manage Patient Concerns?

How Can Myeloma HCPs and Nurses Help Manage Patient Concerns? from Patient Empowerment Network on Vimeo.

How can myeloma care providers help in managing clinical trial concerns? Dr. Craig Cole from Karmanos Cancer Institute and advanced practice provider Charise Gleason discuss common concerns that they have encountered with patients and how they addressed the concerns.

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Transcript:

Dr. Nicole Rochester:

How do we mitigate and manage concerns despite all these wonderful things that both of you have shared? I’m sure that patients and family members have concerns about myeloma clinical trials. And so I’ll start with you, Ms. Gleason. And as you hear concerns from patients and families over the years possibly related to fear of randomization, fear of getting the placebo, you all have mentioned some uneasiness about adverse effects. How do you effectively mitigate and manage these concerns with patients and their family members and care partners?

Charise Gleason:

Yeah, you just have to continue to have open communication. And if you’re, if a patient is accustomed to you mentioning clinical trials, then when you present one to them, right? They’re a little more open to it. But not everybody starts with us. And we get referrals in midway and different parts and different paths along the way. But patients we do hear, “I don’t want to get a placebo.” Or you’ll mention a clinical trial and somebody will say, “Am I ready for hospice?” And it’s, you have to go back and start that education again that, no, you’re getting good treatment on this, a registry trial, for instance, you’re going to get standard of care treatment plus or minus something else, right? And so we really have to go back and educate that you are getting treatment. You’re going to be watched closer than any of our other patients actually.

You’ve got a whole team around you that’s talking about your trial and our patients every week. And so I think that our excitement and our being positive, we can get those patients to enroll on trials. I think something that makes me really happy is, we keep a list of every treatment line, and when you go through and it’s like standard of care, clinical trial, clinical trial, standard..it’s we’ve done the right thing then, right? Our patient has had full advantage of what’s available to them when we do that.

Dr. Nicole Rochester:

That’s wonderful. Thank you for sharing that. 

What about you, Dr. Cole? Do you have anything to add with regard to managing the concerns that come up?

Dr. Craig Cole: 

Yeah. The one thing that I tell patients, and I tell patients one-to-one, and when I do talks for some of the efficacy groups that I tell lots of patients that. That in 2024, myeloma trials are incredibly competitive. And the only, the best, best drugs, now float to the top as part of our clinical trial portfolio. There were days I remember begging companies for clinical trials saying, “Please, please think about myeloma.” And we were struggling.

Now, it is incredibly competitive, and that competition does a fantastic thing for patients because what we see in the clinical trial portfolio are drugs that are safer and safer and safer, and drugs that are more effective and more effective. When you go to these meetings and the expectation is that our response rate needs to be over 60 percent, then you know that the clinical trial mail you, that we work with them, is of a super high quality, which you really can’t say for a lot of other types of cancer.

So I tell patients that their fears that they have are absolutely justified. And one thing we teach the fellows, the residents and the medical students, is that you validate those concerns and you listen to those concerns and you don’t ignore it or blow through it. That you absolutely…those are the most important parts of that conversation. And if you don’t validate it, the patient says, “Well, I have a fear of randomization.” And you go, “Hmm, there’s no such thing.” Then that’s not validating. And that’s not even listening. That’s just moving on because you don’t have that concern, but you’re not bringing that, you’re not validating the patient’s concern. And so you have to be very, very careful in doing that because there are multiple studies that have shown those are the big concerns.

 Also, bringing up the things that are facilitators for clinical trials, that if there is an opportunity for reimbursement for travel or reimbursement for hotel stays or reimbursement that we say that this trial has a reimbursement program, or if we say that use other things that help facilitate clinical trials like speaking to the family, not just speaking to a patient, but speaking to the caregiver and speaking to the extended family that that patient will have a conversation with are really important conversation because the more people that you can talk to, that’s part of that patient’s decision-making group, which can be very different from patient to patient based on their culture, the more likely you are to get a consensus among that decision-making group for the patient to go on a clinical trial.

Dr. Nicole Rochester:

Those are great tips


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How Can Myeloma HCPs Initiate Clinical Trial Conversations?

How Can Myeloma HCPs Initiate Clinical Trial Conversations? from Patient Empowerment Network on Vimeo.

How can myeloma healthcare professionals start clinical trial conversations? Dr. Craig Cole from Karmanos Cancer Institute shares how he initiates conversations with newly diagnosed patients and how myeloma community groups also help patients and families.

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Transcript:

Dr. Nicole Rochester:

That’s an amazing success story. Thank you for sharing that. What about you, Dr. Cole, with regard to potential strategies for healthcare providers, what are some things that they can implement for initiating these clinical trial conversations early in the journey, particularly in the current environment?

Dr. Craig Cole:

Yeah. And Ms. Gleason had mentioned this at kind of the top of our talk about having those conversations on day one. On day one of our patients coming in either as a second opinion, as a new diagnosis, as in whatever setting, we talk about…we have a list that we go through with the patient that talks about their stage or the disease, how we’re going to follow up. And there’s a line that I have to address, which is, clinical trials. So I mentioned our clinical trials, I mentioned on day one. And I think one strategy that other healthcare providers can take is that, even if you don’t have a clinical trial at that time, so right at this moment, we don’t have an upfront clinical trial.

We have one for maintenance therapy, post-transplant, but we don’t have an upfront trial. I mention that. I say that there are clinical trials that are available for your myeloma. Right now we don’t have a clinical trial for upfront myeloma, but we can refer you for a second opinion for an upfront trial if you’re interested or…and we have a clinical trial in maintenance.

So that sets the groundwork that we’re going to talk about clinical trials on every visit. And that it doesn’t come as a surprise. Because the last thing you want to do is that someone is having a relapse and you say, “Oh, we’re going to talk about clinical trials today.”  Because then it’s like, “Oh my goodness, this is a desperation.” This is a desperation move, and it puts a lot of anxiety when you frame it, and we need to do this now as opposed to having on day one.

The second thing that I think really helps is getting patients involved in the myeloma community, especially with the support groups having not only the patients, but their care providers and families involved in the myeloma community. Because the myeloma communities through a lot of the support agencies like the IMF, the MMRF, the HealthTree, they have a very strong clinical trial culture. And when patients get involved, not only is that empowering to see other myeloma patients doing well, but to hear other myeloma patients talk about their experiences in clinical trials really, really helps. And I think the last thing that we use to help patients, go through clinical trials, is a couple of other things, is one, every time we talk about treatment options,  if that is maintenance, if that is smoldering, if that is a relapsed/refractory therapy, we always put clinical trials in that conversation.

 Again, even if we don’t have that clinical trial at our institution, we talk about this as an option that we could refer you out to. And, and then we always talk about…I think one other little thing is that every visit that patients have, I somehow include some of the new things that are happening in myeloma. Now, my patients kind of expect it. They expect. They know when December and June is because when I see them after ASH and ASCO and sometimes they’re like asking, “So what’s new?” And once we get into that groove, they see, gosh. There are response rates that are off the charts with some of these new things. These patients are involved in clinical trials and the myeloma and multiple myeloma research is progressing at such a rate and things are getting better that patients want to be involved in it.

So we’re always talking about new things. Do I go into depth of detail with talquetamab (Talvey) and pomalidomide (Pomalyst). I don’t go into depth of detail. And I say, where I was this clinical trials at our last ASH meeting that combined these two drugs for a relapsed/refractory myeloma, even patients who were refractory to some of the drugs you’re on now. And response rate was like 100 percent. And then when I talk about those clinical trials in the future, they’ll remember, man, that guy was talking, he’s all upset about these clinical trials. Maybe I want to be involved in them. So that’s kind of my few strategies that I use. 

Dr. Nicole Rochester:

I love that. And what I really hear both of you saying is this idea of normalizing conversations about clinical trials and not introducing them as like a Hail Mary, so to speak, but really from the very beginning, letting patients and care partners know that this is a viable treatment option. So I think that is wonderful. And I can say like, your excitement is contagious for me, so I can only imagine how excited the patients that you work with feel.


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How Can Myeloma Nurses Start Clinical Trial Conversations at Start of Care?

How Can Myeloma Nurses Start Clinical Trial Conversations at Start of Care? from Patient Empowerment Network on Vimeo.

What are some strategies for myeloma nurses to initiate clinical trial conversations at the outset of care? Advanced practice provider Charise Gleason explains methods her clinic has used for advanced practice providers and the improvements they have observed in their clinical trial participation rates.

Download Resource Guide  |  Descargar guía de recursos

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Transcript:

Dr. Nicole Rochester:

We’ve been talking about this team-based approach. We know that nurses serve as key coordinators of care in the myeloma trial setting, as well as other members of the healthcare team. So from your perspective, what are some recommended strategies that you can share to encourage advanced practice providers, specifically how to initiate the clinical trial conversation at the outset of care?

Charise Gleason:  

First, we need to educate our advanced practice providers. So for new APPs coming into our system, part of their onboarding is the research mission, exposing them to the clinical trials, exposing them to what we have available. We have a weekly research meeting, I’m sure Dr. Cole has similar practices. And then our group has a separate meeting once a week, where we meet for two hours. The myeloma team, we have APPs who are off that day who call in for this meeting, because we go over our patients, we talk about what clinical trials are available, that’s just how we practice and we think about that.

I would like to add to that, referring to a center early is so essential as well, and for us to start having that conversation. And I’ll talk a little bit to build on something Dr. Cole said with our patient population.In Atlanta, in our database, 40 percent of our data is based on Black patients. And we enroll about 32 percent to 33 percent of Black patients on clinical trials. And what our work on trials has showed us too, if you give the same access to every patient, you have good outcomes and good outcomes for Black patients, if not better, than white patients. So we all need to be versed on that, whether you’re the research nurse, the clinic nurse, the physician, the advanced practice. And so we really do bring that approach to taking care of our patients.

 And then, managing those side effects and having that open dialogue. So patients aren’t surprised by things. And I’ll use talquetamab (Talvey), for instance. We have a patient who is still on the original trial, who relapsed on a BCMA targeted therapy. Early on, these side effects were new to everybody. And she wanted to come off the trial month end. And it was that education piece and working with her, holding the drug, that now almost two years later, she’s still in remission, tolerating the drug. And so those are the stories and these are the experiences we have. We’re giving really good drugs on clinical trials, and patients are responding well.


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How Can Myeloma HCPs Overcome Unforeseen Practice Related Barriers?

How Can Myeloma HCPs Overcome Unforeseen Practice Related Barriers? from Patient Empowerment Network on Vimeo.

What are some solutions to myeloma patient care barriers? Expert Dr. Craig Cole from Karmanos Cancer Institute discusses barriers and solutions he has encountered with his patients and how patient comfort levels with clinical trials have improved.

Download Resource Guide  |  Descargar guía de recursos

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Transcript:

Dr. Nicole Rochester:

Dr. Cole, I’m going to turn the conversation back to you. As a physician, I know that often, there are some barriers just as part of our everyday practice that can hinder our work. And so I’d love for you to speak to any unforeseen or outdated practice related barriers that you feel may hinder your work, and the work of your colleagues specifically as it relates to myeloma trials. And then if you could also share some potential solutions to those barriers.

Dr. Craig Cole:

Yes, super good question. I love this question. There are a lot that are out there that I…barriers that I hear providers talk about at other academic centers and in the community. One is that patients don’t want to go on clinical trials that they…and some of that is subconscious bias. Sometimes those are true, true bias. We know the FDA knows all the drug companies all, and I think every myeloma provider knows that there have been horrific disparities in the enrollment of patients in clinical trials based on race and age and ethnicity that the FDA looked at some of the data of trials that were going for FDA approval, and found that over the past 10 years, and that in those trials, that only 4 percent of the population of the trials were Black.

While in the United States, the number of Black myeloma patients is about 20 percent, over 20 percent of the myeloma population. So that’s a huge disparity. And what I hear is that while older patients and Black and Hispanic and Asian patients don’t want to go on clinical trials, and that’s not true. That’s been shown in multiple clinical trials that actually, the patients of different ethnicities and races actually are more likely to go on clinical trials than other racial groups. And so I think that it’s really important to keep that in mind that patients really…that really the ownership of getting a patient on a clinical trial is really on us to present the clinical trial option to them with every single conversation that we have.

Some of the other barriers to clinical trials is, and Ms. Gleason had mentioned this, what they do at through the Emory system is that, well, the nurses and the other staff in the cancer center aren’t aware of the clinical trials, that when a patient goes through the clinic, they talk to more than just the provider. They talk to the treatment nurses, they talk to the intake people, they talked to the MAs, they talked to the scheduling people.

And there was a study that was done a few years ago in looking at patients who were given consent forms and declined clinical trials. And they found that a lot of patients declined clinical trials, well, because they said that, well, their doctor didn’t want them on the trial. And when they looked further into that, they saw that, well, the doctor offered them a clinical trial, but when they discussed the clinical trial with a nurse practitioner, when they discussed that trial with a treatment nurse or the MA or any of the other staff, when they didn’t know about the clinical trial, that was considered well, if you don’t know about the clinical trial, it must not be good for me. And then they withdrew from the trial.

So just like what they do, what Ms. Gleason had said, we have an all-in approach. We make sure that the treatment nurses, the MAs, the intake people know what we’re doing, know about our clinical trials, because that’s the fun part about what we do. The fun part is when we say, look, my goodness, this four-drug therapy had a 100 percent response rate. That shouldn’t be left in the physician compartment. It really shouldn’t be left in the provider compartment. That excitement should be clinic-wide. And when you have that all-in approach where everybody’s involved, everyone’s excited about clinical trials, it produces a culture of clinical trials that everybody wants to be part of, and the patients then can jump on that bus and feel comfortable participating in the trial.

Dr. Nicole Rochester:

Wow. Thank you for elucidating that. Both the issue of the health disparities that we see in clinical trials and the need to diversify that clinical trial patient population, some of those biases that exist, as well as really lifting up this idea of creating a culture of clinical trials.I love the language that you use for that and the idea that everyone throughout the entire clinical encounter needs to be both aware of, and excited about the clinical trials that are underway. 


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Jamal’s Story: A Quest for Clarity in the Face of Advanced Prostate Cancer

Jamal’s Story: A Quest for Clarity in the Face of Advanced Prostate Cancer from Patient Empowerment Network on Vimeo.

Advanced prostate cancer patient Jamal’s diagnosis came as a shock in his mid-50s. Watch as he shares his experience from diagnosis, a second opinion, and treatment and his key advice for staying on the path of patient empowerment.

Disclaimer: This cancer patient story has been edited to protect the privacy of certain individuals, and the names and identifying details have been changed.

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Transcript:

My name is Jamal, and I was diagnosed in my mid-50s with advanced prostate cancer. I’m a Black man, and my prostate cancer diagnosis came as a surprise. The only unusual thing I had experienced was a slightly weaker urinary stream, which I dismissed as nothing at the time.

Even though I go for annual medical checkups, my high PSA level was discovered during free prostate cancer screenings at my church. I was referred to an oncologist who ordered a biopsy and CAT scan to aid in my diagnosis and treatment. After receiving my results, I was informed of my advanced prostate cancer diagnosis and was pretty shocked. My oncologist recommended hormone therapy and surgery to remove my prostate. Like many people, I was worried about the idea of having surgery. I decided to get a second opinion from another oncologist.

I really liked the second oncologist as soon as I met her. I really felt like she was truly listening to me and to my concerns about surgery. After looking at my test results, she recommended hormone therapy that might need follow-up with a novel hormonal therapy to treat my advanced prostate cancer. I felt both relief and hopeful about my treatment plan.

Even though I experienced some side effects of fatigue and loss of libido, my hormonal therapy was effective. My wife was also an amazing  care partner during this time. My initial treatment was enough to take care of the cancer, and I continue to get scans every six months to ensure that I remain cancer-free. I’m feeling well and enjoy a full life with my wife, kids, and grandkids. I also enjoy hiking, tennis, and traveling.  I’m so grateful to my family and friends for their support, and I’m happy to share my cancer story to help others who are newly diagnosed. Cancer is scary, but your journey can be eased with the help of excellent oncology care and support from those who love you.

Some of the things I’ve learned on my advanced prostate cancer journey include:

  • Empower yourself by getting a second opinion if you feel like you want one. A second opinion is nothing to feel guilty about in your journey to seek your best advanced prostate cancer care.
  • Seek care or a consultation at an academic cancer center if possible. These institutions are better equipped to stay abreast about the latest advanced prostate cancer treatment options.
  • Ask about clinical trial options. There may be programs that will help you with travel, lodging, and other uncovered expenses.
  • If you feel like you can help others, join a support group to share your story. Sharing my story has been a blessing in disguise so that I can help others who may be suffering in silence.

​​These actions for me were key to staying on my path to empowerment.

Evolving Myeloma Clinical Trial Discussions Amid a Dynamic Treatment Landscape

Evolving Myeloma Clinical Trial Discussions Amid a Dynamic Treatment Landscape from Patient Empowerment Network on Vimeo.

How can discussion about myeloma clinical trials continue to expand? Experts Dr. Beth Faiman from Taussig Cancer Institute and RuthAnn Gordon from Memorial Sloan Kettering Cancer Center discuss how clinical trial communication has changed and some specific points of communication that are helpful.

Download Resource Guide|Descargar guía de recursos

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Transcript:

Dr. Nicole Rochester:

Dr. Faiman, as the myeloma treatment landscape continues to expand thanks to clinical trials, how are clinical trial conversations evolving, and what do you feel should be top of mind?

Dr. Beth Faiman:

That’s an excellent question. Over 20 different drugs are available in various combinations. And so we talked about sequencing very briefly about having patients that have access to clinical trials, making sure they’re not exposed to this class, or maybe they needed to be exposed to this class of drug before they can get drug B, for example. And so sharing mutual information through shared decision-making, again, the patients sharing information and goals of care, the provider and healthcare team mutually sharing information, bring in your social worker or pharmacist, etcetera, and then you can mutually agree on a treatment for the patient. And so that is something we did not have 20 years ago. There were very few effective agents.

I like to remind patients when we provide clinical trial consent forms, that the language is written by lawyers, but it’s intended to protect you. I overemphasize that this is voluntary, and you can withdraw your consent at any time. But I try to go back and highlight why there’s stringent, plus or minus one day, maybe you can’t take off three days to go on a holiday weekend, because we really need to dose this drug on that day and obtain this blood information. So again, having the patients understand what’s involved in the clinical trials and then being able to provide information.

I like to also offer handouts. So the International Myeloma Foundation has clinical trials and diversity handouts. And then another one that I really like is by the FDA that describes the importance of clinical trials. I give that to everybody. So at diagnosis, if you’re on a standard care treatment, you’re not receiving a clinical trial. Everybody that comes into my office that I see for myeloma amyloidosis and related disorders, I would say, “You are a candidate for clinical trial now, but if I or somebody else does not involve you or ask you to participate, then ask us. Just ask us about clinical trials.” I even have a pen that says “Ask me about clinical trials” so that everybody can see it.

Dr. Nicole Rochester:

I love the idea of a pen. Wonderful. Well, let’s move on to how to educate and mentor nursing professionals. Both of you are nursing professionals, and you’ve clearly highlighted in this program so far the importance of the role of nurses in this clinical trial process. So, Ms. Gordon, I’m going to go to you. We know that one significant challenge for some providers is actually initiating conversations about clinical trials and also determining the appropriate timing. Can you speak to whether care variation may pose challenges in community hospital settings, perhaps compared to academic hospitals?

RuthAnn Gordon:

Yeah, absolutely. I think one of the most important things about when to talk to the patient is every time, anytime, right? I think that we should be asking them if they’re interested in clinical trials. If they haven’t been engaged in that, we should be talking to them about, “You know, there’s maybe a chance at some time in our partnership together that we will be talking about clinical trials.” And introducing that up front I think is really important so that we don’t leave clinical trials sort of as a last thought and the patient have that feeling. And I think that for the community setting, that’s one of the things that may be a challenge, is because it is hard to put a patient on a clinical trial and run it from a community setting.

So it’s, how do we give them the support and resources so that it’s not so hard and that they do offer it and talk to their patients as much as possible about it? And I feel like that’s what we need to do more with these partnerships with academic settings, is that we have to give them support so that it’s not so hard, and that that clinical trials first of mind to them when they’re planning care for their patients.


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Dr. Kami Maddocks: Why Is It Important for You to Empower Patients?

Dr. Kami Maddocks: Why Is It Important for You to Empower Patients? from Patient Empowerment Network on Vimeo.

What benefits can patients and care providers see from empowering patients? Expert Dr. Kami Maddocks from The Ohio State University Comprehensive Cancer Center explains benefits that she’s seen in her patients and ways that she helps encourage deepening of their knowledge and capacity for informed treatment decisions.

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Dr. Isaac Powell: Why Is It Important for You to Empower Patients?

Transcript:

Dr. Kami Maddocks

I think empowering patients is so critical, because I think when they understand their disease better, the treatment options, or why they’re not receiving treatment and kind of what their journey could look like, that they overall do much better. I think when a patient comes in, I like to give them my explanation of their disease, make sure that I am answering all of their questions, information. Some patients have read a lot before they come in and some have not read a lot. I like to provide them with websites or areas of information that I know is accurate and up-to-date information and encourage them once they read that to give us a call.

We also provide them some written information and I have a 24-hour line. And I always encourage patients, I don’t know whether you’re getting treatment and having a side effect, whether you’re at home worrying about a symptom, whether you have a question about what’s going on, I don’t know that you’re worried unless you let me know.

So I like to encourage patients, if you have questions, concerns, please reach out. We also have a portal where patients can ask non-urgent questions if they’d rather have it in writing, but I think making sure that they know we’re here to help them. I think offering information on clinical trials, I encourage patients if they have questions or concerns on the information they’re provided that they think about second opinions.

And patients that I see for second opinions I like them to know that you’re getting great treatment locally or this treatment is something that you don’t have to drive here for if you need treatment. But I’m always available if there’s other concerns or something doesn’t seem right. So I think making sure that patients’ questions are answered. I think making sure that they are comfortable getting other opinions if they need to and making sure that they know that if they have concerns they should reach out and not worry or use Google but use us to help them.

What Is the Role of Bispecific Antibody Therapy in the Future of Myeloma Care?

What Is the Role of Bispecific Antibody Therapy in the Future of Myeloma Care? from Patient Empowerment Network on Vimeo.

From the 2023 American Society of Hematology (ASH) annual meeting in San Diego, Dr. Peter Forsberg discusses how new data and learnings around bispecific antibodies may allow this newer myeloma therapy to be used more broadly in the clinical setting.

Dr. Peter Forsberg is associate professor of medicine at the University of Colorado School of Medicine and is a specialist in multiple myeloma. More about Dr. Forsberg.

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Dr. Peter Forsberg | Myeloma Research News From the 2023 ASH Annual Meeting

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Questions to Ask Your Doctor About CAR T-Cell Therapy

What Myeloma Patients Need to Know About Bispecific Antibodies

What Myeloma Patients Need to Know About Bispecific Antibodies

Transcript:

Dr. Peter Forsberg:

The role of bispecific antibodies is one that’s evolving quickly. We’ve had new therapies approved over the past 12 months. We may get more approvals in the future. And we’re certainly going to get increasing data around using those treatments in our clinics outside of the controlled clinical trial setting as well as maybe information around more diverse utilization in different treatment settings.   

So, I think these are going to be medicines that are used much more broadly in the future than they are now. Right now, they have a really impactful role in a certain group of patients.  

I think that’s going to become something that’s broader in the future. And I really do think there’s something that’s going to help us to improve on already a really good group of options in earlier relapsed settings and maybe even upfront treatment of myeloma in the future. 

So, a lot to be figured out, a lot of refinement in the future about how and when to use these treatments. But it’s very clear that they’re going to have a huge impact in different settings.  

Dr. Peter Forsberg | Myeloma Research News From the 2023 ASH Annual Meeting

Dr. Peter Forsberg | Myeloma Research News From the 2023 ASH Annual Meeting from Patient Empowerment Network on Vimeo.

Myeloma specialist Dr. Peter Forsberg reviews highlights from the 2023 American Society of Hematology (ASH) annual meeting. Dr. Forsberg shares what this promising news means for patients as well as advice for talking to your doctor about emerging therapies.

Dr. Peter Forsberg is associate professor of medicine at the University of Colorado School of Medicine and is a specialist in multiple myeloma. More about Dr. Forsberg.

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Developing Research and New Myeloma Treatment Options 

Transcript:

Dr. Peter Forsberg:

My name is Peter Forsberg. I’m an associate professor at the University of Colorado. I am a specialist in multiple myeloma and other plasma cell disorders. And I’m here at ASH, where it’s always the most exciting time of the year for those of us in the hematology and hematologic/oncology community, where we are getting all the breaking information around all kinds of diseases.  

But a really exciting time in terms of new findings for myeloma and the other diseases we deal with.   

I think it covers a really broad spectrum. That’s been one of the really exciting things about myeloma over the past decade really is that we’ve had developments in so many different directions in terms of new therapies, new options for patients who need later line treatments, new options improving early line therapy.  

Certainly exciting to have a couple of very big studies that are being presented this year, two Phase III trials that look at four drug combinations in the newly diagnosed myeloma setting, which both show fantastic effectiveness. So, hopefully, really going to help expand that for patients with new myeloma to get really the best treatment out of the gate. And then, really maturing data around new immune therapies, both in the settings where they’re currently approved, which are sometimes later lines for myeloma patients. And then, more data on earlier lines for those therapies where they’re likely to be used in the very near future.   

At this meeting and over the past year, and ASH is always a big summation of a lot of the research that’s going on at any given time, the breakthroughs that are happening in myeloma, the innovation that’s happening in myeloma is very impactful for patients. It’s giving us great, improved options for earlier line patients allowing them to live better, live longer, preserving quality of life and then, giving us diverse new options in relapsed myeloma where we’ve had good tools but the broadening of that toolbox is very exciting.   

And it allows new and really effective options across all kinds of patient types. So, it’s really impactful across different settings.  

Patients shouldn’t hesitate to ask what are the new and developing treatment options, to ask their physicians are there new treatment options for myeloma that might be a fit for me now or in the future? Don’t hesitate to think about what might come down the road, even if you’re in a steady place with your myeloma because things are changing quickly.  

Our options now are different than they were six or 12 months ago and they’re going to be different six or 12 months from now.  

So, don’t hesitate to ask what’s new, what’s coming, should I meet with a myeloma specialist to discuss some of those specific options and whether they’re a fit for me. So, don’t hesitate to be the squeaky wheel a little bit and say what might be out there for me now or in the future.  

Expert Perspective | Understanding the Recent FDA CAR T-Cell Therapy Warning

Expert Perspective | Understanding the Recent FDA CAR T-Cell Therapy Warning from Patient Empowerment Network on Vimeo.

The Food and Drug Administration (FDA) announced in December 2023 that it is investigating reports of secondary cancers in some patients who have undergone CAR T-cell therapy, noting that “the overall benefits of these products continue to outweigh their potential risks for their approved uses.” Timothy Schmidt, a myeloma specialist, shares his perspective on the recent news.

Dr. Timothy Schmidt is an Assistant Professor in the Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care at the University of Wisconsin School of Medicine and Public Health. More about Dr. Schmidt.

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Myeloma Research Highlights From ASH 2023

Myeloma Research Highlights From ASH 2023

Transcript:

Dr. Timothy Schmidt:

So, in terms of the FDA update about CAR T-cell therapies, there was a recent warning, essentially, about an increased risk for a specific type of lymphoma involving T cells. And we don’t really know a whole lot about this just yet. But what we do know is that these events are rare and that we need to investigate it further. I think as of right now, this is not a huge area of concern for most of us, myself included. 

When we have patients who are candidates for CAR T-cell therapy in multiple myeloma, generally, this means that patients are in need of a very effective treatment to get their disease under control and to do so for a long period of time. And the potential benefit of this therapy dramatically outweighs any of these kinds of long-term consequences or these newer things that are starting to develop. Now, I do think that this is something that we’re going to need to continue to keep an eye on. And we certainly can’t ignore this, especially as we start to move CAR T-cell therapy into earlier lines of therapy. 

But as of right now, I would not weigh this very heavily in my decision whether to do a CAR T-cell therapy for somebody with multiple myeloma. 

What Should Myeloma Patients Ask About Developing Research?

What Should Myeloma Patients Ask About Developing Research? from Patient Empowerment Network on Vimeo.

Myeloma research is evolving quickly, so what should patients ask their doctor to stay up to date? Dr. Timothy Schmidt, a myeloma specialist, shares advice.

Dr. Timothy Schmidt is an Assistant Professor in the Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care at the University of Wisconsin School of Medicine and Public Health. More about Dr. Schmidt.

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Myeloma Research Highlights From ASH 2023

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Myeloma CAR T-Cell Therapy: How Does It Work and What Are the Risks? 

Transcript:

Dr. Timothy Schmidt:

I think that in terms of new and developing options, patients should be asking their healthcare provider, their oncologist if they have experience using some of these newer drugs, specifically, the bispecific antibodies and CAR T-cell therapies. 

A lot of centers are starting to use these, particularly academic centers and some larger community centers as well. But not everywhere has experience using these. And so, asking your provider if it’s something that they would be a candidate for, particularly if the current treatment that patients are on is not working. And if your provider is not necessarily familiar with them, do they know somebody who is.  

And could you go at least for a discussion to talk to a myeloma specialist about whether these medications are right for you or whether there’s a clinical trial that they might be a candidate for, because what we’ve learned is that earlier implementation of some of these really effective therapies can really be a big deal for patients with myeloma. 

Patients can learn more about clinical trials from a variety of different outlets. I think the first place to start is with your local provider, your oncologist, asking that person if there is a clinical trial available. Most likely, the local provider is going to be able to point the patient in the right direction or at least let them know if something is going to be feasible for them. After that, often it involves reaching out to a local center, an academic center and getting a referral to somebody to see what is available at that site.   

But there are also a variety of websites that can be used to search for clinical trials if there are particular patients who are very interested in specific therapies, CAR T, bispecifics, or others that you can look around and try to find places that would be best for them. 

Myeloma Research Highlights From ASH 2023

Myeloma Research Highlights From ASH 2023 from Patient Empowerment Network on Vimeo.

Dr. Timothy Schmidt, a myeloma specialist, walks through research and treatment news from the recent 2023 American Society of Hematology (ASH) annual meeting.

Dr. Timothy Schmidt is an Assistant Professor in the Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care at the University of Wisconsin School of Medicine and Public Health. More about Dr. Schmidt.

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What Should Myeloma Patients Ask About Developing Research

What Should Myeloma Patients Ask About Developing Research?

Expert Perspective | Understanding the Recent FDA CAR T-Cell Therapy Warning

Expert Perspective | Understanding the Recent FDA CAR T-Cell Therapy Warning

Developing Research and New Myeloma Treatment Options

Developing Research and New Myeloma Treatment Options

Transcript:

Dr. Timothy Schmidt:

So, there’s constantly a lot of new information and data coming out about multiple myeloma and new therapies. I would say at this ASH ’23 meeting, I think the biggest highlight is further confirmation of the utility of using CD-38 antibodies in patients with newly diagnosed multiple myeloma. We have a plenary abstract for the use of isatuximab (Sarclisa) in combination with carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone (Decadron) that I’m anxiously awaiting hearing the data of later today, as well as a late breaking abstract talking about the use of daratumumab in combination with bortezomib (Velcade), lenalidomide, and dexamethasone. 

And both of these are studies that appear to show superiority of a four-drug regimen over a three-drug regimen. And we’re certainly looking forward to seeing the finalized data presented and extending the implementation of these highly effective therapies for patients with newly diagnosed multiple myeloma.  

I think what we’re also seeing here is just further data being presented about bispecific antibodies, CAR T-cell therapies, and other novel combinations in the relapsed and refractory setting, as well as some really interesting insights coming out in terms of the myeloma pre-cursor setting of MGUS from the IStopMM Trial and some other research. So, really excited to learn more about how to use all of these exciting new tools that we’ve got for patients with multiple myeloma across the disease spectrum.  

So, what this news means for myeloma patients is that outcomes are getting better. What it means is that we now know how best to use some of these tools that we’ve been developing for over a decade now in terms of maximizing responses, maximizing the number of patients who achieve remission and not just achieve remission but have a lasting remission in that first-line setting. And this is really going to lead to improved survival as well as improved quality of life when we start seeing year upon year of really high-quality survival from most of our patients with multiple myeloma. 

We’re also learning how best to use some of the even newer therapies. T-cell directing therapies such as CAR T-cells and bispecific antibodies. We are incredibly excited about how effective these drugs are for patients with multiple myeloma. 

And these are things that we’re already using in the clinic. And it’s important for patients to be aware so that when it becomes time to use these strategies that we can make sure that all patients have access to them.