Rafael Fonseca MD Chair, Department of Medicine Mayo Clinic in AZ Of the following frontline options for transplant-ineligible MM, which would you recommend?

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Presentation transcript:

Rafael Fonseca MD Chair, Department of Medicine Mayo Clinic in AZ Of the following frontline options for transplant-ineligible MM, which would you recommend? • Rd until progression Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida Mayo Clinic College of Medicine Mayo Clinic Comprehensive Cancer Center

Disclosures Consulting: AMGEN, Genzyme, BMS, Otsuka, Celgene, Medtronic, Lilly, Millennium, Binding Site, Onyx, Bayer Speakers Bureaus: None Research: Cylene, Proteolix Patent for FISH based prognostication in MM - about $1500 per year Registered independent Believe in stem cell transplant Dislike wasting your time with this slide

IMIDs Thalidomide Lenalidomide Pomalidomide

E4A04

Blood 2008

Blood 2008

Cytogenetic Category and Age

Cytogenetic Category and Age Kappor, P Blood 2009 Fonseca, R Br J Haematol 2011

Is this unique to myeloma? CML European studies of imatinib Tamoxifen and breast cancer Lung cancer

What not to do when treating the elderly: Mix lenalidomide & alkylators Use injections Use melphalan Use growth factor Interfere with QOL Use too much steroid Ask patients to drive too much

Drive through “Thanks your for shopping at Starbucks. We will have your Rd pills in a second”