The Evolving Treatment Paradigm for Transplant Ineligible MM

EP: 1.The Evolving Landscape of Newly Diagnosed Multiple Myeloma

EP: 2.Highlights from ASH 2023 in Transplant-Eligible NDMM

EP: 3.Advances in the Treatment of High-Risk MM

EP: 4.Role of Transplant and MRD in Newly Diagnosed MM

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EP: 5.The Evolving Treatment Paradigm for Transplant Ineligible MM

EP: 6.Treatment of Multiple Myeloma at Early Relapse

EP: 7.Potential Role for CAR T-Cell Therapy in MM at Early Relapse

EP: 8.Updates on BCMA-Targeting Bispecifics in MM

EP: 9.Real-World Evidence and Selecting Optimal Bispecifics in Multiple Myeloma

EP: 10.Step-Up Dosing Practices for Bispecifics in Multiple Myeloma

EP: 11.Adverse Effects Related to Bispecifics in Multiple Myeloma

EP: 12.GPRC5D-Targeting Bispecifics in Multiple Myeloma

EP: 13.CAR T-Cell Therapy in Multiple Myeloma: Role in the Treatment Landscape

EP: 14.Treatment Considerations and Sequencing in Multiple Myeloma

This is a video synopsis/summary of a Peer Exchange featuring Krina K. Patel, MD, MSc; Amrita Krishnan, MD; Caitlin Costello, MD; Saad Z. Usmani, MD, MBA, FACP; and Rafat Abonour, MD.

The discussion focuses on initial treatment approaches for transplant-ineligible multiple myeloma patients. Historically, doublet regimens were used, but data now supports triplet regimens like lenalidomide-bortezomib-dexamethasone (RVd) and daratumumab (dara) plus RVd as superior for progression-free and overall survival, with manageable toxicity. The phase 3 SWOG trial is comparing Dara-lenalidomide-dexamethasone and RVd triplets. Adding anti-CD38 monoclonal antibodies to lenalidomide-based triplets as quadruplet regimens further improves responses.

Results from the phase 3 IsKia trial adding isatuximab to RVd were recently announced, demonstrating improved progression-free survival vs RVd alone. Balancing efficacy, toxicity, quality of life, and goals of care is still needed, especially in frailer patients where depth of response may not correlate with clinical benefit. Ongoing studies are evaluating quadruplet safety and efficacy specifically in frail, elderly transplant-ineligible populations.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.