![]() Nevertheless, the main cause of death in MM patients is still the development of drug-resistant disease. The introduction of new drug classes like proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and, more recently, monoclonal antibodies (mAbs) has been the main determinant of the observed OS improvement, together with an improved supportive care. The median overall survival (OS) of newly diagnosed (ND) MM patients improved from 3.9 years for patients diagnosed between 20 to 6.3 years for those diagnosed between 20 to a median OS that is not yet reached in patients diagnosed after 2012. In 2018, MM accounted for 1.2% of all cancer diagnoses and 1.6% of all cancer deaths in Europe. Multiple Myeloma (MM) is a hematologic malignancy caused by the outgrowth of monoclonal plasma cells that leads to end-organ damage. In this article, we focus on results obtained with new-generation multidrug combinations in the treatment of high-risk smoldering MM and newly diagnosed MM, including the potential role of MRD and MRD-driven treatment strategies in clinical trials, in order to optimize and individualize treatment. Long-lasting MRD negativity may prove to be a marker of “operational cure”, although the follow-up of the currently ongoing studies is still too short to draw conclusions. With the newest multidrug combinations, a good proportion of MM patients can achieve MRD negativity. Several scientific efforts have been made to develop reliable and validated techniques to measure minimal residual disease (MRD), both within and outside the bone marrow. The improvement of response rates has prompted the development of new, very sensitive methods to measure residual disease, even when monoclonal components become undetectable in patients’ serum and urine. However, the recent availability of new effective drugs has led to unprecedented high-quality responses and prolonged progression-free survival and overall survival. Heal is meant for duo lanes.Multiple myeloma (MM) is still considered an incurable hematologic cancer and, in the last decades, the treatment goal has been to obtain a long-lasting disease control. Plus, you already have a lot of movement speed on Cassiopeia, you really don't need more, especially when it's so temporary. ![]() ![]() GHOST: Flash is way more efficient, without a single doubt. if you cleanse her Flash Frost, you remove the stun AND her Frostbite won't deal double damage.) if you're facing a heavy CC composition, or if this gives you a clear advantage against a certain champion, such as Anivia (i.e. So only pick it if you feel comfortable with it.īARRIER: Even though I'd rather pick exhaust if I feel like needing a defensive summoner spell, Barrier is still a logical choice on a squishy champion like Cassiopeia.ĬLEANSE: Situational. It is still very useful to come back to lane faster, but doing a great teleport in the middle of a fight can be really dangerous with a champion like Cassiopeia. TELEPORT: After a few tries, I would honestly say this ain't the best summoner spell on Cassiopeia. ![]() It will also help later into the game, e.g. I would totally recommend this spell over ignite against champions like Zed or Talon. If you pick it, I advise that you start with a Sapphire Crystal, as the +250 Mana will allow you to cast an additional + + + combo, which can lead to a kill if followed by ignite.ĮXHAUST: A nice option if you're facing an assassin, or any champion with high burst damage. IGNITE: This spell allows Cassiopeia to win trades in the very early game. Cassiopeia can only rely on her movement speed if she needs to dodge/escape, meaning Flash is a MUST-HAVE on her. Summoner Spells RECOMMENDED SUMMONER SPELLSįLASH: Mandatory. If Twin Fang kills its target, it refunds its mana cost.Īctive: After a brief delay, Cassiopeia blasts enemies in a cone in the target direction, dealing magic damage to all enemies hit.Įnemies facing Cassiopeia are stunned for 2 seconds, and all other affected enemies are instead slowed by 40% for the same duration. If the target is poisoned, Twin Fang deals bonus magic damage and heals Cassiopeia. Miasma has a minimum cast range, and stops upon impacting terrain.Īctive: Cassiopeia launches her fangs at the target enemy, dealing them magic damage. grounded, prohibiting the use of movement abilities. While enemies stand in the clouds, they are: If Noxious Blast hits an enemy champion, Cassiopeia gains bonus movement speed that decays over 3 seconds.Īctive: Cassiopeia spews venom in an arc in front of her, leaving toxic clouds for 5 seconds. She cannot purchase Boots items.Īctive: After a 0.4-second delay, Cassiopeia blasts the target area, poisoning enemies hit and dealing them magic damage over 3 seconds. Cassiopeia gains 4 Movement Speed per level.
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