‘I Do Not Believe That More Is Better, We Need To Be Smarter’ Says Dr. James Berenson To Cure Panelists
We had an amazing discussion on Myeloma Treatment without Transplant with none other than Dr. James R. Berenson, from the IMBCR. Dr. Berenson was very matter of fact and began the Cure Panel Talk Show with his anecdote of how he ‘stumbled into’ myeloma research field having seen a relative lose his fight against the condition. Dr. Berenson emphasized throughout the panel discussion that his treatment method was based on the philosophy of ‘letting people live their lives’ without detrimental effects on their quality of life. According to Gary Petersen, editor of myelomasurvival.com Dr. Berenson is on the ‘Least treatment is the Best’ end of the ‘Treatment Continum’ where ‘More Treatment is the Best’ is at the extreme opposite end.
And truly so, Dr. Berenson talked about the person as a whole requiring treatment to manage a cancer rather than aggressively treating the condition, ‘We need to think about the whole body and not the cancer alone.’
Stem cell transplant is one of the normal courses of myeloma treatment and incidentally three of our panelists who are all over the 5 year survival mark (except Matt Goldman) have had stem cell transplants. To my direct question of when he would recommend a transplant, if he ever does, he was clear ‘I would never recommend a transplant.’
In answer to Gary Petersen’s questions on, Dr. Berenson’s treatment philosophy for low risk patients, survival statistics, and whether new novel drugs would help patients live longer, Dr. Berenson was very candid. He said that most of the data that boasted of long-term survival provides only short-term benefits. These look good on published papers, are good for pharmaceutical companies and academic institutions. ‘They are not good for patients’. Starting slowly does not mean that we are sitting on the sideline.
‘My philosophy is not to put patient under any kind of risk. I do not consider high risk as defined by Mayo Clinic as high risk’. High-risk categorization has changed over the years with new treatments/drugs being made available and hence many factors like chromosome 13, 14, 16 are not high risk any more. Only about 5% of patients benefit from transplants and the same amount of people benefit similarly by starting on Velcade too. Hence, ‘I do not believe that more is better, we need to be smarter’, said doctor in reply to Jack Aiello’s queries on how or when can the patient decide whether or not to consider transplant as a treatment option.
To the question on whether Zometa had an anti-myeloma activity and what his protocol of prescribing Zometa was, Dr. Berenson came all out in support of Zometa and said people respond to Zometa and barring a few passable side effects, he was of the opinion that Zometa should be continued.
Pat’s query on what works best for patients who have stopped responding to Velcade/Revlimid, brought in reference to two new drugs, Carfilzomib and Pomalidomide. Combination drug therapies where the Velcade was replaced with the new approved drug, Carfilzomib or Pomalidomide with Revlimid and clinical trial results showing improved results opens up more avenues to new combination drug therapies.
Matt Goldman’s question on whether Dr. Berenson’s research also investigates causes of myeloma was answered in the affirmative and he went on to list some of the factors that may cause multiple myeloma with studies continuing. He mentioned having come across couples having myeloma indicating whether it is something that is spread or whether environmental factors are responsible. Dr. Berenson quoted pesticide exposure, silicon implants in women, computer use, family history of MGUS, lupus, rheumatoid arthritis as some of the other causes of multiple myeloma.
Dr. Berenson also shared his ASH presentation topics with the panel.
This and much more was discussed on the panel. Listen to it HERE.