Michael Green, MD, Northern California Oncologist, discusses his preferred treatment regimens for patients with multiple myeloma in early relapse.

As multiple myeloma is a heterogenous disease, there is no standard regimen for patients in early relapse. If a patient does experience early relapse, Green individualizes the regimen to the patient based on the patient’s disease characteristics. Additionally, a physician must consider whether a patient has renal insufficiency or compromise to their kidneys, Green says. Choosing a treatment regimen also depends on whether a patient has liver disease or is experiencing neuropathy, as well as their functional abilities.

Sequencing is another factor to be mindful of, explains Green. Since there are many options for patients, it is important to keep in mind what a patient may need down the line. A physician has to be cognizant of what they use now because it will impact what is available for the patient in the future, concludes Green.

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Dr. Green on Treatment Regimens for Patients With Multiple Myeloma in Early Relapse

Michael Green, MD, Northern California Oncologist, discusses early relapse in multiple myeloma.

There are a variety of treatment options for early relapse in multiple myeloma, but physicians have to account for patient preference, comorbidities, past therapies, the pace of the relapse, and biological determinants of health, says Green. By doing that, physicians can create a treatment strategy that improves patient's lives.

Since multiple myeloma is such a heterogeneous disease, physicians cannot use a standard algorithmic approach. Instead, physicians have to evaluate whether the disease has a rapid clinical progression, a low velocity biochemical progression, or high-risk cytogenetics versus more standard-risk features. All of that needs to be kept in mind, notes Green.

The broad classes of therapies that are utilized are proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies. The combinations vary between all the available agents. Some specific agents include carfilzomib (Kyprolis), pomalidomide (Pomalyst), and daratumumab (Darzalex).

Michael Green, MD

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Dr. Green on Treatment Regimens for Patients With Multiple Myeloma in Early Relapse

Dr. Green on Early Relapse in Multiple Myeloma