Dr. Zonder on Induction Therapy in Newly Diagnosed Multiple Myeloma

Jeffrey Zonder, MD, associate professor of oncology and medicine, Barbara Ann Karmanos Cancer Institute, Wayne State University, discusses induction therapy in the treatment of patients with newly diagnosed multiple myeloma.

Both carfilzomib (Kyprolis) and bortezomib (Velcade) can be used as part of a patient’s induction regimen, explains Zonder, but there is a split in opinion regarding early incorporation of carfilzomib into treatment. The ongoing phase III ENDURANCE trial will be an important aspect in answering this question. In the trial, patients will be randomized to receive lenalidomide (Revlimid) and dexamethasone with either bortezomib (VRD) or carfilzomib for 9 months, followed by lenalidomide maintenance therapy.

Zonder says that his default has traditionally been VRD, though some physicians will substitute carfilzomib in for patients with high-risk disease. Zonder adds that this is an option—it is not yet the default standard across the country.