TARGET AUDIENCE
This activity is intended for medical oncologists, hematologists, hematology-oncology fellows and other healthcare providers involved in the treatment of hematologic cancers.

OVERVIEW OF ACTIVITY
Multiple myeloma (MM) is a plasma cell neoplasm that accounts for approximately 12% of all hematologic cancer and carries one of the worst ratios of death to new cases. It is characterized by the production of monoclonal protein (M-protein) in the blood, and upon development and proliferation in the marrow, the disease often invades adjacent skeletal structures, resulting in the clinical presentation of bone pain. Patients with smoldering (asymptomatic) or Stage I active myeloma may be observed without active therapy because these presentations often follow an indolent course for many years, although this paradigm may be changing for patients considered to be at high risk. On the other hand, the disease course of advanced myeloma is uniformly aggressive, but the introduction of new agents with significant activity has improved outcomes and allowed patients longer periods of remission. Both novel proteasome inhibitors and immunomodulatory agents have effectively transformed the care of patients with newly diagnosed and relapsed/refractory MM, and the emergence of a number of recently approved novel agents with unique mechanisms of action or delivery will likely continue to rapidly alter standard treatment algorithms.

In order to offer optimal patient care, including the option of clinical trial participation, the practicing clinician must be well informed of these advances. Featuring information on the latest research developments along with expert perspectives, this CME program is designed to assist medical oncologists with the formulation of up-to-date clinical management strategies for the care of patients with MM.

LEARNING OBJECTIVES

• Develop a long-term care plan for patients with smoldering MM, considering the applicability of existing and emerging clinical trial data.
• Appreciate available research data informing the use of a monoclonal antibody directed at CD38 as a component of induction therapy for patients eligible or ineligible for stem cell transplant, and effectively identify if and how this strategy should be integrated into clinical care.
• Customize induction, consolidation and maintenance therapeutic approaches for active MM in the post-transplant and nontransplant settings, considering patient- and disease-related factors, including cytogenetic profile.
• Apply published research data and other clinical factors in the best-practice selection, sequencing or combining of available therapies in the nonresearch care of patients with relapsed/refractory MM.
• Design and implement a plan for recognizing and managing side effects and toxicities associated with existing and recently approved systemic therapies to support quality of life and continuation of treatment.
• Appreciate available data documenting the activity of chimeric antigen receptor T-cell therapy, bispecific T-cell engagers and antibody-drug conjugates designed to target BCMA (B-cell maturation antigen), and use this knowledge to identify patients with MM who may be appropriate for participation in clinical trials evaluating these approaches.
• Recall the design of ongoing clinical trials evaluating other novel investigational approaches for MM, and obtain consent from appropriate patients for study participation.

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Penn State College of Medicine and Research To Practice. Penn State College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

For questions about CME credit, either email continuinged@pennstatehealth.psu.edu or call (717) 531-6483 and reference course number G6488-20-T.

CREDIT DESIGNATION STATEMENT
CME credit is no longer available for this issue

HOW TO USE THESE CME ACTIVITIES
Audio Program: This CME activity consists of an audio component.
CME credit is no longer available for this issue

Video Program: This CME activity consists of a video component.
CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
It is the policy of Research To Practice and Penn State College of Medicine to ensure balance, independence, objectivity and scientific rigor in all their educational programs. All faculty, planners and managers participating in this activity are required to disclose any relevant financial relationship(s) they (or spouse/partner) have with a commercial interest that benefits the individual in any financial amount that has occurred within the past 12 months; and the opportunity to affect the content of CME about the products or services of the commercial interest. Research To Practice and Penn State College of Medicine ensured that any conflicts of interest were resolved before the educational activity occurred.

FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

S Vincent Rajkumar, MD
Edward W and Betty Knight Scripps Professor of Medicine
Mayo Clinic
Rochester, Minnesota

No relevant conflicts of interest to disclose.

Paul G Richardson, MD
Clinical Program Leader
Director of Clinical Research
Jerome Lipper Multiple Myeloma Center
Department of Medical Oncology
Dana-Farber Cancer Institute
RJ Corman Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Advisory Committee: Amgen Inc, Celgene Corporation, Janssen Biotech Inc, Karyopharm Therapeutics, Oncopeptides, Takeda Oncology; Contracted Research: Bristol-Myers Squibb Company, Celgene Corporation, Oncopeptides, Takeda Oncology.

Nina Shah, MD
Associate Professor of Medicine
University of California, San Francisco
Division of Hematology-Oncology
San Francisco, California

Advisory Committee: Amgen Inc, Genentech, GlaxoSmithKline, Indapta Therapeutics, Karyopharm Therapeutics, Nektar, Oncopeptides, Precision Biosciences, Sanofi Genzyme, Seattle Genetics, Surface Oncology; Contracted Research: bluebird bio, Celgene Corporation, Janssen Biotech Inc, Sutro Biopharma Inc; Data and Safety Monitoring Board: Janssen Biotech Inc; Ownership Interest: Indapta Therapeutics.

Irene M Ghobrial, MD
Professor of Medicine
Director, Clinical Investigator Research Program
Director, Michele and Stephen Kirsch Laboratory
Harvard Medical School
Dana-Farber Cancer Institute
Boston, Massachusetts

Advisory Committee and Consulting Agreements: Adaptive Biotechnologies, Bristol-Myers Squibb Company, Celgene Corporation, GlaxoSmithKline, Janssen Biotech Inc, NOXXON Pharma, Sanofi Genzyme, Takeda Oncology.

EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, EMD Serono Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, A GSK Company, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

PENN STATE COLLEGE OF MEDICINE — Faculty and staff involved in the development and review of this activity have disclosed no relevant financial relationships.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice and Penn State College of Medicine do not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from Celgene Corporation, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Oncopeptides and Takeda Oncology.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: September 2019
Expiration date: September 2020