The Future of Relapsed/Refractory
Multiple Myeloma Treatment
While the triplet therapy is standard of care for first line, Dr Malek said, quadruplet therapy will likely be used in the first-line setting as well, pending FDA approval. In addition, patients and clinicians are hopeful about the newest intervention, CAR-T therapy, which is currently in clinical trials for MM. “Most experts are thinking we’ll be moving that up in line,” Dr Callander said. But it’s not yet determined how it will fit into the treatment paradigm and whether it will be a substitute for autologous SCT.
In general, treatment of relapsed MM will continue pose a challenge to clinical pathway decision-makers, as it will continue to be important to individualize the treatment to the patient. In addition to treating patients based on disease aggressiveness, the patient’s years in remission, past experience with toxicity, and reaction to various agents, in the future clinicians may also base treatment on the cancer cell’s genetic mutation type, for which data is fast emerging. “It’s not so easy to narrow it down. It’s becoming more personalized medicine,” said Dr Gasparetto.