Brandon Blue, MD, medical oncologist, Malignant Hematology, Health Outcomes and Behavior Program, Moffitt Cancer Center, discusses the importance of early intervention in relapsed/refractory multiple myeloma.

In multiple myeloma, indices in the blood, urine, and bone marrow can indicate a patient is progressing before they develop symptoms, Blue explains. This is called a biochemical relapse. 

In cases of biochemical relapse, it is important to start patients on the next line of therapy quickly because disease progression could lead to the development of kidney failure, fractures, or lytic lesions that can significantly impair a patient’s quality of life (QOL), Blue explains. Moreover, because multiple myeloma remains an incurable disease, maximizing QOL is an important factor for good outcomes.

Ultimately, patients with a biochemical relapse in the blood, urine, or bone marrow should be started on treatment to get their disease under control before symptoms arise, Blue concludes.

Videos

Brandon Blue, MD, discusses the importance of early intervention in relapsed/refractory multiple myeloma.  



Dr. Blue on the Importance of Early Intervention in Relapsed/Refractory Multiple Myeloma 

Brandon Blue, MD, oncologist, Malignant Hematology, Health Outcomes and Behavior Program, Moffitt Cancer Center, discusses treatment considerations for patients with relapsed/refractory multiple myeloma.

Many options in the treatment armamentarium for patients with multiple myeloma have been compared with each other or doublet chemotherapy and have demonstrated some degree of benefit, according to Blue. However, it is important to determine which options patients are sensitive or refractory to, and what the associated toxicities are with each approach, Blue says. For example, many of these patients experience kidney issues or kidney failure, and as such, dose reductions or the exclusion of immunomodulatory drugs may be necessary, Blue adds.

Proteasome inhibitors and other classes of medicines have been investigated with monoclonal antibodies, as well as in other lines and with other mechanisms, to ensure that those combinations provide benefit to patients, Blue explains. More options have become available and it is now encouraged to combine agents with different mechanisms of action, especially now that there are data to support the use of drugs beyond daratumumab (Darzalex), such as isatuximab (Sarclisa), Blue concludes. 

Brandon Blue, MD, discusses treatment considerations for patients with relapsed/refractory multiple myeloma.

Dr. Blue on Treatment Considerations for Relapsed/Refractory Multiple Myeloma

Brandon Blue, MD, oncologist, Malignant Hematology, Health Outcomes and Behavior Program, Moffitt Cancer Center, discusses the utility of carfilzomib (Kyprolis) in relapsed/refractory multiple myeloma.

Bortezomib (Velcade) and carfilzomib should be considered for patients who are sensitive to proteasome inhibitors (PI), Blue explains. If a patient has a good response with frontline bortezomib, using carfilzomib, a second-generation PI, could be used. Carfilzomib can be used in combination with multiple agents, including daratumumab (Darzalex), isatuximab-irfc (Sarclisa), and pomalidomide (Pomalyst), Blue says.

Several options can be utilized to capitalize on the mechanism of action associated with PIs, Blue continues. Moreover, PIs have demonstrated a progression-free survival advantage, as well as increased rates of minimal residual negativity, which is associated with improved outcomes for patients, Blue concludes.

Articles

Brandon Blue, MD, discusses the utility of carfilzomib in relapsed/refractory multiple myeloma. 


Brandon Blue, MD

Articles

Dr. Blue on the Importance of Early Intervention in Relapsed/Refractory Multiple Myeloma

Dr. Blue on Treatment Considerations for Relapsed/Refractory Multiple Myeloma

Dr. Blue on the Utility of Carfilzomib in Relapsed/Refractory Multiple Myeloma