Covid19 vaccines roll out began in mid December 2020, with the Moderna and Pfizer-BioNTech vaccines as the first widely available shots. However these vaccines use the mRNA technology for which there is virtually no data – and will likely not be available for months – as to how they might affect pregnant women and their babies. There is also a widespread confusion amongst women who are breastfeeding and are trying to conceive. The U.S. Centers for Disease Control and Prevention (CDC) says “People who are pregnant and part of a group recommended to receive the COVID-19 vaccine may choose to be vaccinated.” Although many pregnant women have taken the vaccine so far with a leap of faith, the dilemma persists.
We are talking to reproductive endocrinologist & virologist Dr Cindy Duke of Nevada Fertility Institute to get answers to common questions and clear the air around myths related to use of COVID19 vaccines in women who are pregnant, breastfeeding or trying to conceive naturally/via ART, and dig deeper into why the CDC quotes “they are unlikely to pose a significant risk for people who are pregnant.”
Multiple myeloma patients are often immunosuppressed for months following treatments such as maintenance therapies, immunosuppressive drugs, hematopoietic cell transplant (HCT) and CAR-T therapies. They are at higher risk for serious complications from the SARS-CoV-2 virus leading to hospitalizations and ICU admissions. There is no data available on the efficacy and safety of the currently available vaccines in this population and the myeloma patient community is confused whether they should or should not get vaccinated. However, the American Society of Transplantation and Cellular Therapy (ASTCT) and the American Society of Hematology (ASH) supports that this vulnerable population of patients should be prioritized to be vaccinated as early as possible along with their caregivers when vaccine supply permits. We are talking to infectious disease expert Dr Zainab Shahid of Levine Cancer Institute / Carolinas Healthcare System to understand the various nuances around Covid19 vaccinations in multiple myeloma patients and learn more about the appropriate time of administration.
The FDA recently granted priority review to a new drug application for melflufen (INN melphalan flufenamide), in combination with dexamethasone. Melflufen is intended for use as a first choice for patients with multiple myeloma whose disease is refractory to at least one proteasome inhibitor, one immunomodulatory agent, and one anti-CD38 monoclonal antibody (triple-class refractory). Melflufen is a peptide-drug conjugate (PDC) that targets aminopeptidases and rapidly releases alkylating agents into tumor cells. The combination treatment demonstrated encouraging efficacy and a manageable safety profile in heavily pretreated patients. The myeloma panel is taking a deep dive on melflufen with Dr. Paul G. Richardson from Dana Farber Cancer Institute and will touch upon the details of the trials, side effects and treatment regimen.