Dr. Usmani on Treatment Considerations in Relapsed/Refractory Multiple Myeloma

Saad Z. Usmani, MD, FACP, chief of Plasma Cell Disorders, director of Clinical Research in Hematologic Malignancies, Levine Cancer Institute, Atrium Health, discusses treatment considerations in relapsed/refractory multiple myeloma.

Patient-related factors such as age, comorbidities, and socioeconomic status may guide treatment selection in the relapsed/refractory setting, says Usmani.

Additionally, whether the patient lives in an urban, suburban, or rural area may influence treatment scheduling, as well as the patient’s access to stem cell transplant and clinical trials, explains Usmani.

Disease-related factors may also play a role in treatment selection. A patient with a more aggressive relapse may be symptomatic or have circulating plasma cells. Additionally, they may have extramedullary disease, renal failure, or other genomically high-risk features at presentation, says Usmani.

Finally, prior therapy-related factors such as a history of stem cell transplant, proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies are important to consider in treatment selection. Past toxicities, durability of response, and new comorbidities may also shed light on the optimal treatment strategy, concludes Usmani.