Mark Schroeder, MD, assistant professor of medicine, Division of Oncology, Section of Bone Marrow Transplantation and Leukemia, Washington University School of Medicine in St. Louis, Siteman Cancer Center, discusses the tolerability of treatment regimens for patients with relapsed/refractory myeloma.

When patients are treated with regimens that include pomalidomide (Pomalyst), they are typically at risk of developing neutropenia. This often leads to dose reduction—whether it is combining pomalidomide with bortezomib (Velcade) or pomalidomide with daratumumab (Darzalex) and dexamethasone. In general, Schroeder notes, these doublet and triplet regimens are manageable and patients can get through them without any major issues.

Infusion reactions to daratumumab-based regimens are possible, but with split dosing this is particularly avoidable. Infusion time is also lessened in that setting with proper pre-dosing. Because of the lack of single-agent activity with elotuzumab (Empliciti), Schroeder adds, there is still ongoing work testing it in combination with other agents.  

Mark Schroeder, MD

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Dr. Schroeder on Tolerability of Treatment For Myeloma