b'u From Page 33the objective response rate) was higher (72.3%) thancan tolerate better, hence leading to improved out-in the early era (63.8%). For younger patients, thecomes,hesaid.Thisalsohighlightstheneed objective response rate was about the same in bothto study symptom burden in both patient popula-eras (75% in the early era versus 75.9% in the mod- tions, something that our group is also looking into. ern era). The researchers observed no change in theWhile younger patients in the modern era seem to proportion of older patients who discontinued treat- have a similar overall survival, it may be that they ment due to adverse events. are now able to achieve this with fewer side effects Olderadultsalsoexperiencedmarkedimprove- from their treatment regimen.ments in survival as the number of first-line treat- The study also is the first to describe real-world ments increased. Among older patients, median pro- patterns of lab and biomarker testing rates in a cohort gression-free survival improved from 28.3 monthsthat includes both older and younger patients. All in the early era to 63.3 months in the modern era.patients who received first-line treatments received Younger patients, on the other hand, showed almosthemoglobulinandplatelettestingbeforehand. no improvement in median progression-free survivalAbout one-sixth did not receive immunoglobulin M between eras.(IgM) testing, a rate that did not differ significantly Onepossibleexplanation,Halwaninoted,isbetweeneras.AlthoughMYD88mutationstatus thatnewertreatmentsareatleastaseffectiveasscreening,apredictorforsurvivalandtreatment older regimens, if not more so, but are also oftenresponse, is recommended as an essential workup in less toxic (and therefore more tolerable) to olderthe 2016 National Comprehensive Cancer Network patients.Thisallowsolderpatients,whowouldGuidelines,lessthanone-quarterofpatients not have tolerated effective treatment previously,received MYD88 screening before beginning first-to now receive more effective treatments that theyline treatment.Source: Chien, H-C, Morreall, D, Patil, V, Rasmussen, KM, et. al. Treatment Patterns and Outcomes in a Nationwide Cohort of Older and Younger Veterans with Waldenstrm Macroglobulinemia, 20062019. Cancers. Published April 4, 2021.DOI: 10.3390/cancers13071708. 38'