Dr. Usmani on Management of Early Relapse in Multiple Myeloma

Saad Z. Usmani, MD, FACP, chief of Plasma Cell Disorder, director of Clinical Research in Hematologic Malignancies, Levine Cancer Institute, Atrium Health, discusses the management of early relapse in multiple myeloma.

To determine the next line of therapy for a patient who relapses early, physicians have to think about the type of relapse patients had—–be it clinical or biochemical, prior regimens they had been exposed to, and the type of therapy they progressed on, if they were on treatment. If a patient was exposed to a proteasome inhibitor (PI) or immunomodulatory drug (IMiD), physicians have to know whether they’re refractory or naïve to that therapy. Then, clinicians can determine whether to proceed with a PI or IMiD, says Usmani.

There are many options to consider for these patients, adds Usmani. In addition to the regimens themselves and the depth of response they induce, physicians have to consider evolving treatment patterns in the United States, explains Usmani. Additionally, if a patient was eligible for stem cell transplant but deferred it as part of their first-line treatment, they may be eligible to undergo the procedure now. That may also impact the salvage regimens that are used, concludes Usmani.