Dr. Hari on Treatment Considerations for Relapsed/Refractory Multiple Myeloma

Parameswaran Hari, MD, MRCP, the Armand J. Quick/William F. Stapp Professor of Hematology, and the chief of the Division of Hematology/Oncology, Department of Medicine, at the Medical College of Wisconsin, discusses treatment strategies for patients with relapsed/refractory multiple myeloma.

Treatment decisions for patients with relapsed/refractory disease is based on several factors such as the aggressiveness of the relapse, number of prior relapses, previous treatments, and responses to those treatments, according to Hari. From there, compiling a list of available agents that the patient has either not received or that they may be sensitive to, would be the next step, adds Hari.

For example, if a patient relapses after treatment with a particular agent is stopped and a significant amount of time has passed, between 3-6 months, then that patient would be considered sensitive to that agent, Hari explains. Conversely, if the patient relapses while actively receiving treatment, then they would be considered to be refractory to that regimen, adds Hari.

The modern myeloma paradigm is focused on continuous maintenance therapy. In the future, there will be multiagent maintenance regimens that patients may relapse on, Hari says. If that happens, then it's important to seek out alternative agents that the patients haven't been exposed to or an agent that was used in a previous setting after a considerable amount of time, Hari concludes.