Dr. Fonseca on Weighing the Risks With Potential Benefits of Quadruplet Regimens in Myeloma

Rafael Fonseca, MD, interim director of Mayo Clinic Cancer Center and director, Innovation and Transformational Relationships at Mayo Clinic, weighs the risks and benefits of quadruplet regimens in patient with multiple myeloma.

The question of whether a quadruplet regimen is necessary in myeloma has been raised, particularly because of the potential for toxicities, according to Fonseca. However, the incremental toxicities associated with a these regimens are generally minimal. In fact, proteasome inhibitors and corticosteroids represent a greater challenge with regard to toxicity compared with quadruplets, says Fonseca.

Although there is an added expense that is incurred due to the extra agents included in these regimens, the long-term pharmacokinetic outcomes of quadruplets in this population is highly anticipated, according to Fonseca. If some patients are able to convert deep responses into durable ones and if some are able to avoid relapse, then the downstream benefit of these approaches could be monumental, Fonseca concludes.