RELAPSED/REFRACTORY MULTIPLE MYELOMA PATIENTS
Chairmen: Joan Bladé, Sundar Jagannath
How I treat Relapsed/Refractory Multiple Myeloma, Sequence Strategy, Patient Selection
- Does patient need treatment?
- If yes, are they fit or frail (2 drugs)?
- Should salvage be aggressive (3 drugs)?
- Can I reuse a combo that worked before?
- Do I need to change the MOA of the drugs?
- How many new/novel drugs can I introduce?
- What toxicities may be an issue for this patient?
How I treat Refractory Disease and Extramedullary Disease
1. EMD in MM treatment
- Efficacy of alkylating agents and radiation therapy
- Efficacy of Bortezomib
- Limited efficacy of IMIDs
- Potential dissociation between medullary and extramedullary response
2. Treatment of refractory MM
- Doubtful clinical benefit of “stable disease” in clinical trials unless that evident PD is controlled
- Comparator arm in clinical trials: best supportive care with Cyclo/Predni
- Synergistic/additive effect in drug combinations
- clinical judgement: when to offer only palliative care
How I treat Serious Adverse Events
Conclusions and future perspectives
Prevention and treatment of adverse events is of key importance in the management of patients with MM.
- Reduces the need for treatment discontinuation
- Enhances the efficacy of treatment
- Reduces the need for hospitalization
- Reduces mortality