®, McKay, who is an assistant professor of medicine and medical oncologist at the University of California, San Diego, explained how the biologic differences in the genetic profiles of men and women could impact the efficacy of certain treatments, and touched on how the toxicities that some patients experience could vary between younger and older patients.

There is a growing body of evidence that suggests that age and gender play a role in cancer outcomes, and there are multiple factors for this.

They could be biologic, (with) different genetic profiles for men and women and younger and elderly individuals. There's different chemical kinetics, for example, how we process different drugs may be processed differently in men versus women and also based on different ethnicities and presence of different enzymes that help with drug metabolism. We (also) know that toxicity patterns are different between younger and older individuals and male and female patients.

Videos

Many factors impact outcomes in patients with advanced renal cell carcinoma, but recent findings suggest a patient’s age and gender are perhaps more important than previously realized.

Age and Gender Could Factor into Advanced Renal Cell Carcinoma Outcomes

The Basics of Prostate Cancer

Understanding Genetics and Genomics in Prostate Cancer

Learning About Advanced Prostate Cancer

Addressing Racial Disparities in Prostate Cancer

On behalf of ZERO - The End of Prostate Cancer, CURE spoke with Dr. Charles Ryan about prostate cancer – including the basics, genetics of the disease, developments in advanced prostate cancer and racial disparities.

Discussing Trends in Prostate Cancer

Join us for our next Chronic Lymphocytic Leukemia webinar where experts discuss CLL information highly relevant to patients, caregivers and advocates right now. Topics for discussion include:

Join us for our Chronic Lymphocytic Leukemia webinar where experts discuss CLL information highly relevant to patients, caregivers, advocates and discuss patient questions.


EDUCATED PATIENT® CLL Webinar

Understanding Smoldering Multiple Myeloma

Options for Newly Diagnosed Multiple Myeloma

Hope for Relapsed/Refractory Multiple Myeloma

Supportive Care Options for Patients with Multiple Myeloma

Resources from the MMRF

On behalf of the Multiple Myeloma Research Foundation, CURE spoke with five specialists to offer various resources for patients with multiple myeloma.

Learning About Resources in Multiple Myeloma

Understanding the Basics of Chronic Lymphocytic Leukemia

The Future of Frontline Therapy in CLL

Living with CLL as a Chronic Disease

Joining a Chronic Lymphocytic Leukemia Trial

CURE speaks with Dr. Susan O'Brien, on behalf of the Leukemia and Lymphoma Society.

Understanding Chronic Lymphocytic Leukemia

Despite recent advances in the treatment of multiple myeloma, more must be done to find effective treatment options for patients with advanced disease, said Dr. Luciano J. Costa, an associate professor of medicine in the Blood and Marrow Transplantation and Cell Therapy Program at the University of Alabama's Birmingham School of Medicine.

, Costa explained that because current options offer lower response rates of around 30%, more effective solutions are needed for patients who progress after proteasome inhibitors, immunomodulatory drugs​ and monoclonal antibodies.

Even though we had had several advances in therapy for multiple myeloma in the last couple of decades, we still have some substantial challenges which are essentially the patients who progress, whose disease progresses beyond the proteasome inhibitors, immunomodulatory agents and their monoclonal antibodies. There are very few agents in that scenario.

Most of the drugs or most approaches being investigated produce a relatively low rate of response, around 30%. Which is in general, not very durable.

So there's a huge need for drugs or regimens or approaches that could be effective in that population that is triple class refractory and can be performed with a reasonable level of safety.

Despite recent advances in the treatment of multiple myeloma, more must be done to find effective treatment options for patients with advanced disease, according to Dr. Luciano J. Costa.

More Effective Treatment Options are Needed for Patients with Advanced Multiple Myeloma

While the use of CAR-T cell therapy is currently still being investigated in patients with multiple myeloma, Dr. Nina Shah believes that these clinical trials will be what ultimately moves the field forward.

, Shah, an associate professor of medicine at the University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discussed how heavily pretreated, relapsed or refractory patients currently involved in CAR-T trials are helping to pave the way for future breakthroughs, and noted that clinical trial enrollment should always be considered an option for patients.

So far, CAR-T cell therapy for myeloma is still investigational, because we're waiting for FDA approval for the first product. So, because of that, and the way that clinical trials have been run, it's mainly been for relapsed and refractory patients. And when I mean relapsed and refractory … I mean, 

 relapsed and refractory – median lines of treatment for these trials have been like six or seven lines – which might not be how we're going to eventually use it because the inclusion criteria had to have at least three lines and be progressing. But a lot of these patients were way beyond that, just because it's a clinical trial.

We're really excited about the new molecules and cellular therapies and immunotherapies that are coming to the myeloma space. I think each is going to build on the other one. And we may ultimately have combinations and move these more forward.

I am so thankful to all of the myeloma and oncology practitioners who have sent their patients to clinical trials all over the world, because we just could not do it without them. And we wouldn't know any of this without the patient and physician participation and partnerships, so, if anything, I just really hope that I can offer clinical trials to anybody who's watching this so that patients can reap the benefits as well.

While the use of CAR-T cell therapy is currently still being investigated in patients with multiple myeloma, Dr. Nina Shah of the UCSF Helen Diller Family Comprehensive Cancer Center believes that these clinical trials will be what ultimately moves the field forward. 

Clinical Trials Are Pivotal in the Evolution of CAR-T Cell Therapy in Multiple Myeloma

In the multiple myeloma landscape, therapies are often proven to be safe and effective in the relapsed and refractory setting before they make their way into the frontline setting via an investigation in clinical trials.

’s sister publication, Dr. Betsy O’Donnell, a medical oncologist in the Multiple Myeloma Disease Center and director of Lifestyle Medicine at Massachusetts General Hospital (MGH), discussed these research efforts, and explains why the future in this disease space looks promising, thanks to the current research in CAR-T cell therapies and the use of combination therapies.

There’s a lot going on, obviously, in the relapsed/refractory myeloma setting and that’s where all of our novel therapies emerge from and march their way forward into our armamentarium. Certainly, things targeting BCMA are very exciting, and there are upcoming studies incorporating CAR-T cells in the upfront setting as well for high-risk patients. So, all of that is really exciting.

On a personal level, we’ll be leading a study of the combination similar to that used in the GRIFFIN study, however, we’ll be using ixazomib (Ninlaro), which is the oral proteosome inhibitor, in combination with lenalidomide (Revlimid), dexamethasone, and daratumumab (Darzalex) for transplant-ineligible patients. That is a trial that I think is exciting, because it offers the opportunity to have a mostly oral regimen for older patients.

And I think we, too, at MGH are soon to open a trial looking at carfilzomib (Kyprolis) in combination with lenalidomide, dexamethasone, and isatuximab-irfc (Sarclisa).

So, there are some great combinations out there and a lot of great work being done in the upfront setting.

The future of multiple myeloma is heading toward combination therapies and CAR-T cell treatments, according to Dr. Betsy O'Donnell.

An Expert Discusses the Future of Multiple Myeloma Treatments

When a person hears they have cancer, their first immediate thought likely revolves around surviving the disease. But once a patient’s disease is in remission, the focus then shifts toward living.

“Therapeutic trials are very, very important because thanks to them, our patients are living longer,” said Dr. Narjust Duma, a thoracic oncologist at the University of Wisconsin Carbone Cancer Center, in an interview with 

®. “But we also need to stop and ask how our patients are living.”

Sexual Health Assessment in Women with Lung Cancer (SHAWL) study

, discussed why it is important for more research to be conducted to assess the quality-of-life of patients with cancer.

I think it's extremely important. Therapeutic trials are very, very important because thanks to them, our patients are living longer. But we also need to stop and ask how our patients are living. Yes, they may be here with us longer, but are they spending more time at home and less time in the hospital? Are they spending more time with their grandchildren, which is one of the things I hear very often from my patients, which is what you want to do? I want to spend time with my grandchildren, or with my kids. So, that is all important because surviving lung cancer is not only seeing the tumors shrinking, it's also that you're able to do the things you want to do when you are receiving the treatment that's making the tumor shrink.

And I also have conversations with my patients in which we decide stopping treatment to preserve the quality of life or completing treatment that can potentially prolong their life. Many of them prefer to stop treatment to maintain their quality of life. So, you can see how this is so important to our patients, that knowing that they may stay around for less time — a week, a month or two — they prefer to stop cancer-directed therapy to maintain their quality of life. That's what our patients are telling us, which is why this subject is so important. Because it affects them every day, they don't see (the oncologist) every day, but they have to deal with the symptoms and the side effects every day.

“Therapeutic trials are very, very important because thanks to them, our patients are living longer,” said Dr. Narjust Duma. “But (physicians) also need to stop and ask how our patients are living.”

More Quality-of-Life Research ‘Extremely Important’ for Patients with Cancer

The onset of the COVID-19 pandemic has forced oncology centers to transition into intensive care units, while oncologists are making emergency rounds. As a result, this has also put a halt on emerging research in supportive care.

, Dr. Ricahrd J Gralla details some of the interesting studies he and his colleagues at the Albert Einstein College of Medicine had to put on hold. Studies ranging from toxicities associated with PD-1 and PDL-1 agents in patients with lung cancer to looking at the timing of treatment and when they could switch treatment depending on side effects.

Most institutions, and for ours, studies that we were doing in supportive care in cancer were put on complete hold. And some studies that we were looking at, to really simplify antiemetics in many settings and really home in and prove we've had to put that on hold. There were some interesting areas that we were looking at where we were trying to predict, using some very interesting information, toxicities with anti PD-1 PDL-1 agents, could we predict from a genetic profile who's more likely to have those side effects and also do the same genes that we were looking at, predict the likelihood of response. That's partially based on the immune-genetics of thyroid disease, and we're trying to combine that. So, I hope we can get back to that fairly soon our chief of medicine at Montefiore. Dr. Yale, Tomer is an expert in this area. And as an immunologic endocrinologist, he's been very helpful to our thinking in this way into guiding some of our work.

Also, we've been looking at, can we tell within just two cycles of treatment within six weeks, who's likely to be benefiting from treatment and who is not? And is that a time early on to be able to make a change, and it's looking way beyond imaging, but also using patient reported outcomes to try to predict these things very early on. So far, the results are very encouraging.

So maybe we can get back to all of those when we have less COVID in our midst.

Dr. Richard J. Gralla discusses some of the studies in supportive care that have been put on hold due to the ongoing COVID-19 pandemic. 