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Invited Commentary
September 2015

Multiple Myeloma—Better Drugs Ask for More Stringent Evaluations

Author Affiliations
  • 1Department of Hematology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, the Netherlands
JAMA Oncol. 2015;1(6):754-755. doi:10.1001/jamaoncol.2015.2009

In this issue of JAMA Oncology, Korde and colleagues1 report an elegant pilot study of carfilzomib combined with lenalidomide and dexamethasone (CRd) for 45 patients with newly diagnosed multiple myeloma (NDMM). Their study renders 3 important conclusions that are a prelude to the future of myeloma treatment. First, with this combination of effective and well-tolerated drugs, more and deep responses can be achieved across different prognostic subgroups defined by fluorescent in situ hybridization (FISH). Second, the level of tumor reduction goes beyond morphological complete response (CR) as is shown by serial measurements of minimal residual disease (MRD). In addition, in a group of 12 patients with high-risk but asymptomatic smoldering multiple myeloma, substantial disease eradication was observed, resulting in MRD negativity in all patients. Finally, this study is an example of informative clinical research.