Dr. Green on Early Relapse in Multiple Myeloma

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).