Dr. Jagannath on Role for Two-Drug Combinations, Carfilzomib Triplet in Multiple Myeloma

Sundar Jagannath, MD, director of the Multiple Myeloma program and professor of Medicine (Hematology and Medical Oncology) at the Tisch Cancer Institute, Mount Sinai Cancer Center, discusses induction therapy for multiple myeloma.

Although it has been demonstrated that the three-drug regimen of lenalidomide, bortezomib, and dexamethasone is one of the most effective options for multiple myeloma induction therapy, there are circumstances where other options may be preferred, says Jagannath.

In patients presenting with rental impairment there are challenges in using lenalidomide as an immunomodulatory molecule. Instead, oncologists may want to substitute thalidomide. For frail patients, a two-drug approach may be better than a three-drug combination.

Also, new data has shown that carfilzomib may be more potent than bortezomib, so that agent in combination with lenalidomide and dexamethasone may be a choice for selected patients.