Dr. Callander on Selecting a Frontline Treatment Strategy in Multiple Myeloma

Natalie S. Callander, MD, a professor of medicine of the the Division of Hematology/Oncology at the University of Wisconsin Carbone Cancer Center, discusses selecting a frontline treatment strategy for patients with multiple myeloma.

When selecting treatment for patients with newly diagnosed multiple myeloma, it’s important to select an approach that produces deep responses with limited adverse effects, Callander says. If a patient is experiencing organ dysfunction related to their disease, reversing the condition should be a priority, Callander adds. Although a patient may appear to be quite ill, it's important to determine whether symptom bother is because of their disease or due to a preexisting condition, which could make them less fit for treatment.

Although determining transplant eligibility is often done upon diagnosis, this is a factor that can change over time as patients demonstrate clinical improvements, Callander explains. For patients who may undergo an autologous stem cell transplant, it's necessary to select a regimen that will not interfere with stem cell collection, adds Callander.

With many agents emerging in the paradigm, the hope is that some of these options will induce deep responses in patients, Callander says. One of the main areas of debate are the questions of whether a triplet or quadruplet should be used in this patient population and whether a doublet regimen still shows benefit in some patients, Callander concludes.