Dr. Madduri on the Standard of Care for Transplant Eligible Patients With Myeloma

Deepu Madduri, MD, assistant professor, Mount Sinai Hospital, discusses the standard of care for transplant eligible patients with multiple myeloma.

In terms of current induction treatment, results from the IFM 2009 study indicated that transplant is superior to no transplant. Another area of active investigation is consolidation, maintenance, and minimal residual disease (MRD) negativity, explains Madduri. As it stands, every patient with multiple myeloma is being tested for MRD negativity.

With regard to consolidation, physicians are investigating the importance of consolidation posttransplant. Some studies have demonstrated a progression-free survival benefit, but not as much of an overall survival benefit, adds Madduri. In terms of maintenance, lenalidomide (Revlimid) is the standard of care following transplant. However, lenalidomide may not be sufficient for patients with high-risk disease. In that case, physicians can defer to prior studies that have shown that bortezomib (Velcade) maintenance is a good choice for high-risk patients as well as for those with renal insufficiency, concludes Madduri.