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    Innovative strategies help fight multiple myeloma: What every exec should know


    Major advances have occurred over the past two decades in treating multiple myeloma, and these advances are progressing rapidly today, says Gerry Messerschmidt, MD, FACP, chief medical officer of Precision Oncology. Many innovative strategies and combinations of approved and experimental therapies have a high likelihood of gaining approval and becoming standard use. “This means more therapy, more often, and thus, potential financial ramifications for payers of myeloma treatment,” Messerschmidt said.

    As a clinical oncologist and an executive with a leading oncology development provider specializing in clinical trial execution, biomarker services, and analytics, Messerschmidt is tuned into the changes in the myeloma landscape.

    Managed Healthcare Executive (MHE) recently spoke with Messerschmidt about new therapies on the radar, and how they could impact treatment.

    MHE: What are healthcare executives’ major challenges in the area of multiple myeloma?

    MesserschmidtMesserschmidtMesserschmidt: The main challenge for healthcare executives is maintaining a working understanding of approved therapy and standard therapy versus experimental therapy. Today, proteasome inhibitors (PIs), immune modulators (IMiDs), and a steroid are standard and approved therapies, as are many chemotherapies. First-line therapy is usually 2 or 3 drugs and, if possible, many recommend autologous hematopoietic stem cell transplant, once or more than once. Transplants are neither approved by regulatory agencies nor reviewed; however, one transplant is clear standard therapy in many institutions and more than one is often standard in select institutions. Data support both positions.

    Many newer drugs are also in development to treat multiple myeloma and will be arriving on the market this year and over the next several years. Maintaining a working knowledge of these products and their pros and cons compared with other drugs requires examining information from the drug developer, the literature and the providers.

    The healthcare executive must rely on hematologists and pharmacists to review, discuss, and recommend the drugs and procedures for newly diagnosed multiple myeloma through last therapy. All will need to recognize that an algorithm designed today could be outdated in several months. Rapid additions of new therapies and clinical data measuring interventions will continually occur over the next decade.

    MHE: How can these challenges be met or avoided?

    Messerschmidt: Decisions to incorporate therapies into a standard treatment design can be based on the literature, experiencing meeting presentations by experts, FDA approval, and other data reviews available. However, direct experience by the site with these new drugs and procedures can also provide physicians, pharmacists, and healthcare specialists with invaluable experience. Participating in many clinical trials allows hospitals and clinics to understand these new therapies more closely and assess based on prior experience.

    This often occurs in private practice groups by actually using a newly approved drug on several appropriate patients and assessing the efficacy and toxicity with their patients. This is not possible in many treatment situations where only formulary or approved and paid-for cancer products are available.

    Clinical trials often provide cancer patients with new, cutting-edge therapies while offering healthcare experts the firsthand experience that can expedite data review and formulary selection when approved.

    Next: What are some promising developments readers should watch?



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