Daniel Sherbenou, MD, PhD, associate professor, Division of Hematology, University of Colorado (UC) Health’s Blood Disorders and Cell Therapies Center, UC Medicine, discusses selecting between available treatment options for patients with late relapsed multiple myeloma.

Selinexor (Xpovio) is a useful, oral agent for this patient population, Sherbenou says. Twice-weekly dosing with selinexor plus dexamethasone conferred some limiting toxicities to patients; however, once-weekly dosing in combination with bortezomib (Velcade) and dexamethasone has been well tolerated, Sherbenou says. 

CAR T-cell therapy is likely the preferred treatment regimen for patients with late relapses, but selinexor may be used as bridging therapy or in the post–CAR T-cell therapy setting. As such, most patients will receive CAR T-cell therapy and selinexor within the course of their disease.

The BCMA-directed antibody-drug conjugate belantamab mafodotin-blmf (Blenrep) is also available for use in the late-relapsed setting; however, the ocular toxicities associated with the agent and the need for ophthalmologic exams before each dose limit the agent’s utility, Sherbenou concludes.

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Daniel Sherbenou, MD, PhD, discusses selecting between available treatment options for patients with late relapsed multiple myeloma.  



Dr. Sherbenou on Selecting Treatment in Late Relapsed Multiple Myeloma 

Daniel Sherbenou, MD, PhD, associate professor, Division of Hematology, University of Colorado (UC) Health’s Blood Disorders and Cell Therapies Center, UC Medicine, discusses future directions with maintenance therapy in patients with relapsed/refractory multiple myeloma who received CAR T-cell therapy.

Optimization of maintenance therapy in the post–CAR T-cell therapy setting for patients with multiple myeloma is an evolving area of research, Sherbenou says. Moreover, understanding resistance to CAR T-cell therapy and what therapy to give following progression on CAR T-cell therapy are important research efforts.

It may be that flexible combination regimens that are not built with proteasome inhibitor– or immunomodulatory agent–backbones will have utility in the post–CAR T-cell therapy setting, Sherbenou explains. Moreover, minimal residual disease status may guide adjustments to maintenance therapy selection in this patient population, Sherbenou concludes.

Daniel Sherbenou, MD, PhD, discusses future directions with maintenance therapy in patients with relapsed/refractory multiple myeloma who received CAR T-cell therapy.



Daniel Sherbenou, MD, PhD

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Dr. Sherbenou on Selecting Treatment in Late Relapsed Multiple Myeloma

Dr. Sherbenou on Future Directions With Maintenance Therapy in Multiple Myeloma