Podcasts about velcade

Episode 184: Multiple Myeloma BasicsSub-Interns and future Drs. Di Tran and Jessica Avila explain the symptoms, work up and treatment of multiple myeloma. Written by Di Tran, MSIV, Ross University School of Medicine; Xiyuan Yang, MSIV, American University of the Caribbean. Comments by Jessica Avila, MSIV, American University of the Caribbean. Edits by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Di: Hi everyone, this is Di Tran, 4th year medical student from Ross university.  It's a pleasure to be back.  To be honest, this project is a part of teamwork of two medical students, myself and another 4th year, her name is XiYuan.  She came from the AUC. Unfortunately, due to personal matters she was unable to make it to the recording today which makes me feel really sad. Jessica: My name is Jessica Avila, MSIV, American University of the Caribbean.Di: The topic we will present today is Multiple Myeloma. Multiple myeloma is typically a rare disease and it's actually a type of blood cancer that affects plasma cells in the bone marrow.Jessica: Let's start with a case: A 66-year-old male comes to his family doctor for an annual health checkup. He is not in any acute distress but he reports that he has been feeling tired and weaker than usual for the last 3 months. He also noticed that he tends to bruise easily. He has a history of arthritis and chronic joint pain, but he thinks his back pain has gotten worse in the last couple of months. Upon checking his lab values, his family doctor found that he has a calcium level of 10.8 and a creatinine level of 1.2, which has increased from his baseline. Given all that information, what do you think his family doctor is suspecting? And what kind of tests she can order for further evaluation?Di: Those symptoms sound awfully familiar – are we talking about the CRAB? You know, the diagnostic criteria for Multiple Myeloma.Jessica: Exactly! Those are called “myeloma-defining events.” Do you remember what those are?Di: CRAB criteria comes in 4 flavors.  It's HYPERCALCEMIA with >1mg/dL, RENAL INSUFFICIENCY with serum creatinine >2mg/dL, ANEMIA with hemoglobin value 10% plasma cells, PLUS any one or more of the CRAB features, we can make the official diagnosis of multiple myeloma. Di:  Before we go deeper, let's back up a little bit and do a little background.  So, what do we know about the immunoglobulins, also known as antibodies? Back from years of studying from medical school, we know that the plasma cells are the ones that producing the antibodies that help fight infections.  There  are various kinds that come with various functions.  Each antibody is made up of 2 heavy chains and 2 light chains.  For heavy chains, we have A, D, E, G, M and for light chains we have Kappa and Lambda.Jessica: Usually, the 5 possible types of immunoglobulins for heavy chains would be written as IgG, IgA, IgD, IgE, and IgM.  And the most common type in the bloodstream is nonetheless the IgG. Di: What is multiple myeloma? In myeloma, all the abnormal plasma cells make the same type of antibody, the monoclonal antibody.  The cause of myeloma is unknown, but there are lots of studies and evidence that show a number of potential etiologies, including viral, genetic, and exposure to toxic chemicals, especially the Agent Orange, which is a chemical used as herbicide and defoliant. It was used as a chemical warfare by the U.S. military during the Vietnam War from 1961 to 1971.Jessica: We need to order some specific blood tests to see if there is elevated monoclonal proteins in the blood or urine. So, to begin with we'll need to take a very thorough history and physical exam. Next, we'll do labs, such as CBC, basic metabolic panel, calcium, serum beta-2 microglobulin, LDH, total protein, and some not so common tests: serum protein electrophoresis (SPEP), immunofixation of blood or urine (IFE), quantitative immunoglobulins (QIg), serum free light chain assay, and serum heavy/light chain ratio assay.If any of the results is abnormal, we should consider referring our patient to an oncologist.Di: Interesting! I read that Multiple Myeloma symptoms vary in different patients.  In fact, about 10-20% of patients with newly diagnosed myeloma do not have any symptoms at all.   Otherwise, classic symptomatic presentations are weakness, fatigue, increased bruising under the skin, reduced urine output, weakened bones that is likely prone to fractures, etc. And if multiple myeloma is highly suspected, a Bone Marrow biopsy should be done with testing for flow cytometry and fluorescent in situ hybridization (FISH). Actually, if any of the “Biomarkers of malignancy (SLIM)” is met we can also diagnose multiple myeloma even without the CRAB criteria. Jessica: The diagnosis is made if one or more of the following is found: >= 60% of clonal plasma cells on bone marrow biopsy, > 1 lytic bone lesion on MRI that is at least 5mm in size, or a biopsy confirmed plasmacytoma. Di: Imaging comes in at the final step especially if we able to find one or more sites of osteolytic bone destruction > 5mm on an MRI scan.Jessica: What if the bone marrow biopsy returns > 10% of monoclonal plasma cells, but our patient doesn't have either the CRAB or the Biomarker criteria? Di: That's actually a very good question, since Multiple Myeloma is part of a spectrum of plasma cell disorders. That's when smoldering myeloma comes into play. It is a precursor of active multiple myeloma. Smoldering myeloma is further categorized as high-risk or low-risk based on specific criteria.A less severe form is called Monoclonal Gammopathy of Undetermined Significance, or simply MGUS, with < 10% bone marrow involvement. Those are diagnoses we give once we rule out actual multiple myeloma, which are defined by the amount of M-protein in the serum.Jessica:  When to get started on treatment? Multiple Myeloma is on a spectrum of plasma cells proliferative disorders, starting from MGUS to Smoldering Myeloma, to Multiple Myeloma and to  Plasma Cell Leukemia.  Close supervision/active watching is enough for MGUS and low risk Smoldering Myeloma. But once it has progressed to high-risk smoldering myeloma or to active Multiple Myeloma, chemotherapy is usually required. Some situations may require emergent treatment to improve renal function, reduce hypercalcemia, and to prevent potential infections.Di: As of 2024, treatment of Multiple Myeloma comprises the Standard-of-Care approved by the FDA. In fact, the quadruple therapy is a combination of 4 different class of drugs that include a monoclonal antibody, a proteasome inhibitor, an immunomodulatory drug, and a steroid. Jessica: They are Darzalex (daratumumab), Velcade (bortezomib), Revlimid (lenalidomide) and dexamethasone.  Other treatment plans for Multiple Myeloma include chemotherapy, immunotherapy, radiation therapy (for plasmacytomas) and stem cell transplants. The patient will also be on prophylaxis acyclovir and Bactrim while on chemotherapy. Sometimes anticoagulants are also considered because the chemo increases the risk of venous thromboembolic events.Di: Although the disease is incurable, but with the advancing of novel therapies and clinical trials patients with multiple myeloma are able to live longer.  Problem is the majority of patients diagnosed with Multiple Myeloma are older adults (>65), the risk of falling is adding to multiple complications of the disease itself, such as bone density loss, pain, neurological compromises, distress and weakness.  Palliative care may come in help at any point in time throughout the course of treatment but is most often needed at the very end of the course. Jessica, can you give us a conclusion for this episode?Jessica: Multiple Myeloma may not be the most common cancer, but we have to be aware of the symptoms and keep it in our differential diagnosis for patients with bone pain, easy bruising, persistent severe headaches, unexplained renal dysfunction, and remember the CRAB: HyperCalcemia, Renal impairment, Anemia and Bone lesions.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:International Myeloma Foundation. (n.d.). International Myeloma Working Group (IMWG) criteria for the diagnosis of multiple myeloma. https://www.myeloma.org/international-myeloma-working-group-imwg-criteria-diagnosis-multiple-myeloma Laubach, J. P. (2024, August 28). Patient education: Multiple myeloma symptoms, diagnosis, and staging (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/multiple-myeloma-symptoms-diagnosis-and-staging-beyond-the-basics.University of California San Francisco. (n.d.). About multiple myeloma. UCSF Helen Diller Family Comprehensive Cancer Center. https://cancer.ucsf.edu/research/multiple-myeloma/about Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

As part of a CancerNetwork® Frontline Forum program, Joselle Cook, MBBS; Matthew James Pianko, MD; Luciano Costa, MD, PhD; and Timothy Schmidt, MD, reviewed key data updates and real-world practice findings in newly diagnosed multiple myeloma (NDMM), and how they may impact patient subgroups including those with transplant-ineligible NDMM. Cook, a hematologist specializing in the management of patients with multiple myeloma at the Mayo Clinic in Rochester, Minnesota; and Pianko, a hematologist in the Division of Hematology and Oncology at The University of Michigan-Ann Arbor, led one part of the discussion. They discussed efficacy results from studies including the phase 3 MAIA study (NCT02252172), which assessed daratumumab (Darzalex) plus lenalidomide (Revlimid) and dexamethasone vs lenalidomide plus dexamethasone in previously untreated multiple myeloma. They also spoke about the selection of patients with transplant ineligible multiple myeloma for triplet vs doublet induction therapy regimens and potential disparities in care for patients of racial and ethnic minorities. “We need trials to accommodate patients who are working [and patients] who are unpartnered, [and] we need to do more to understand the biologic drivers [of multiple myeloma] in Black patients,” Cook said. “Even though we have this explosion of [new] therapies onto the scene, we still have so much to do to make access to these novel treatments accessible and more equitable for everyone.” Costa, a professor of Medicine and director of the Multiple Myeloma Program at The University of Alabama at Birmingham, and Schmidt, assistant professor in the Division of Hematology, Medical Oncology, and Palliative Care within the Division of Medicine at The University of Wisconsin, also discussed updates in the multiple myeloma space, which included a review of findings from the phase 2 GRIFFIN trial (NCT02874742). In this trial, investigators assessed daratumumab plus lenalidomide, bortezomib (Velcade), and dexamethasone as a treatment for patients with transplant-ineligible NDMM. Costa and Schmidt also spoke about approaching consolidation and maintenance therapy for patients with transplant-ineligible NDMM. “As we're trying to move treatments into earlier lines of therapy—particularly things like bispecifics and CAR T—improving access is [something] that we as a field and as a community need to address,” Schmidt said.  Don't forget to subscribe to the “Oncology On-The-Go” podcast on Apple Podcasts, Spotify, or anywhere podcasts are available.

Today we are talking to Barry Greene, CEO of Sage Therapeutics. Barry has had an amazing career spanning over 30 years in the biotech industry. Prior to Sage Barry was President of Alnylam shepherding it with John through its evolution from basic science through commercial product launch. Prior to ALNY Barry was general manager of Oncology at Millennium where he was directly involved in the approval and launch of Velcade. He is currently a member of the board of the Pharmaceutical Research and Manufacturers of America. 

Dr. Dominic Brandy discusses Natural Insights into Cancer with Dr. Ben Weitz. [If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]    Podcast Highlights 2:25  Dr. Brandy explained that his journey started in September 2017 when he and his wife were on a Viking cruise and he read the book, How Not To Die by Dr. Michael Greger.  How Not To Die has lots of scientific references and shows that eating a plant based diet is associated with lower rates of cancer and other chronic diseases, including diabetes, cardiovascular disease, and dementia. Gregor also discusses the Blue Zones where Dan Buettner looked at regions in the world where people lived the longest, including Loma Linda, California, where most people are Seven Day Adventists and they are vegetarian, don't drink alcohol, and exercise a lot. The average woman there lives 10 years longer and the average man lives 14 years longer than the average American.  Dr. Brandy started right then to eat a plant based diet. 6:25  When Dr. Brandy came home the last week of September he was doing a surgery case and he felt a pop in his right collarbone.  This pain then got worse and worse and on November 10th he went to pick up a container of water and his clavicle cracked in half.  He went to the Urgent Care center and got an x-ray. Then he got an MRI and his orthopedic surgeon told him that he either had multiple myeloma or a cancer metastasis. He had a biopsy and lab work, which confirmed IgA multiple myeloma free Kappa chain. Dr. Brandy's oncologist recommended a triple drug regimen of a common medication for myeloma, a corticosteroid and Velcade, a proteasome inhibitor. Dr. Brandy accepted with the first two medications but rejected Velcade, because its common side effects include peripheral neuropathy, which is bad for a surgeon.  Then Dr. Brandy researched every thing he could do from a diet, lifestyle, and nutritional supplement perspective and started employing them.  He started taking various herbs, employed exercise, stress reduction, sleep, intermittent fasting, detoxification, and every month his numbers kept getting better and by six months he was in a complete remission.     Dr. Dominic Brandy is a plastic surgeon and anti-aging expert, but after being diagnosed in 2017 with multiple myeloma, an incurable blood cancer, he plunged himself into cancer research. He is now coaching cancer patients.  In addition to conventional therapy, he has adopted a natural approach to fighting cancer that includes a whole food plant based diet, daily exercise, and targeted nutritional supplements.   And now he has written a book, Beat Back Cancer Naturally, and he wants to share his approach with patients looking to prevent or treat cancer.   His website is NaturalInsightsIntoCancer. Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.     Podcast Transcript Dr. Weitz:            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com. Thanks for joining me, and let's jump into the podcast.                                 Hello, Rational Wellness podcasters. I'm very excited today that we'll be speaking with Dr...

In this podcast episode, Beth Faiman, PhD, MSN, APRN-BC, AOCN, discusses clinical considerations for diagnosis and optimal treatment selection for initial management of patients with multiple myeloma. Topics in this podcast include:IMWG criteria for diagnosing smoldering and active myelomaRisk stratification of smoldering myeloma with 2/20/20 criteria and active myeloma with R-ISS stagingIndividualizing initial treatment for ASCT-ineligible myelomaSelecting optimal initial treatment for ASCT-eligible myelomaPresenter: Beth Faiman, PhD, MSN, APRN-BC, AOCNNurse PractitionerCleveland Clinic Taussig Cancer InstituteCleveland, OhioCE/AAPA credit available by visiting the online program: https://bit.ly/3ee9IvsLink to full program, including downloadable slidesets: https://bit.ly/3ee9Ivs

Nancy Simonian is president and CEO of Syros Pharmaceuticals. Her conversation with Nature Biotechnology covers going against the advice of her mentor to take a job at Biogen; the long, winding path to approval for the multiple myeloma drug Velcade; and assisting her father in the operating room as a girl. See acast.com/privacy for privacy and opt-out information.

In this podcast episode, Suzanne Lentzsch, MD, PhD, and  Saad Z. Usmani, MD, MBA, FACP, discuss how they select optimal treatment for relapsed/refractory (R/R) multiple myeloma (MM) and answer audience questions from a live webinar. Topics include:Selecting optimal triplet regimen after first relapseSequencing treatment options after multiple relapsesManaging patient expectations when selecting treatmentsEmerging treatment options for R/R MMPresenters:  Suzanne Lentzsch, MD, PhDDirector, Multiple Myeloma and Amyloidosis ProgramProfessor of MedicineDivision of Hematology/OncologyColumbia University Medical CenterNew York, New YorkSaad Z. Usmani, MD, MBA, FACPClinical Professor of MedicineDepartment of Hematologic Oncology & Blood DisordersDivision ChiefPlasma Cell Disorders DivisionLevine Cancer Institute/Atrium HealthCharlotte, North CarolinaSupported by educational grants from Amgen; Bristol-Myers Squibb; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Oncopeptides.Link to full program, including an downloadable slidesets and an on-demand webcast:https://bit.ly/3gjr62p

Heather Wolff joined Decibel in February 2018 as the head of clinical development operations for Decibel Therapeutics. Heather is responsible for Decibel’s clinical operations, regulatory operations, medical writing and data management functions, providing leadership around the company’s development programs. She has a long track record in clinical development, with a focus on building and leading data management groups. Widely recognized as a leader in the space, she has been a key member of both large and small companies including Infinity Pharmaceuticals, Millennium Pharmaceuticals (Takeda), Accenture (ACE), Synta Pharmaceuticals and Genetics Institute (Wyeth). She played a role in successfully gaining FDA approval for Wyeth’s rhBMP-2 in the U.S. and E.U., and also facilitated the acquisition of sNDAs for Millennium’s Velcade product. Heather graduated from Skidmore College with a B.A. in English.

At last year's ASH meeting, there was excitement around a new antibody drug conjugate targeting a protein called BCMA from Glaxo Smith Klein. Results from their Phase I study showed that patients who had relapsed immunomodulators (like Revlimid), proteasome inhibitors (like Velcade) and even monoclonal antibodies (like daratumumab), responded when taking this drug alone (60% response rate). Learn more from Dr. Maria Chaudhry of Ohio State University about current studies using this new drug and when patients could consider it in the course of their treatment.  Thanks to our episode sponsor, Celgene. 

Deborah Dunsire was a general practitioner in South Africa when a motorcycle drove her into industry. And that side trip, ultimately routing her to Boston, is still going on. She built the North American Oncology unit at Novartis, launched Gleevec, ran Millennium after the millennium, realized the value in Velcade, took a foray into Forum, and recently announced her latest role, President and CEO of XTuit Pharmaceuticals.