Our Co-Chair, Sagar Lonial, Winship Cancer Institute at Emory University, Atlanta, US, presents the results of the randomized phase III trial, E3A06, of lenalidomide versus observation alone in intermediate- and high-risk smoldering myeloma (SMM). This interview was conducted from ASCO 2019 in Chicago, US, where Professor Lonial also presented this data to a full audience. This trial has demonstrated, for the first time, that early intervention can prevent organ damage in SMM. One major difference in this study, compared to previous studies, was the use of modern imaging which identified and excluded patients with myeloma.
Take home message: high-risk SMM (as defined by Mayo 2018 or IMWG updated criteria) should receive early therapy. The study results, and Professor Lonial, recommend lenalidomide alone or lenalidomide in combination with dexamethasone.