Dr. Shaji Kumar on Upfront Combination Treatments in Multiple Myeloma

Shaji Kumar, MD, professor of Medicine, Mayo Clinic, discusses the impact of combination treatments upfront in multiple myeloma.

Using several novel agents in combination upfront— such as bortezomib, lenalidomide, and dexamethasone—has been shown to improve survival. Other triplet combinations, such as carfilzomib-lenalidomide-dexamethasone have also shown promise in multiple myeloma.

These triplet combinations make it more likely that a patient will experience a deep response, and in turn experience longer overall survival (OS), said Kumar. Even if they do not experience longer OS, progression-free survival (PFS) may be improved with a triplet combination, which can improve quality of life, he said.

Often, patients can not go back on a drug once they have progressed on it, but the data that is available right now suggests that the benefit patients get by combining different classes of drugs in the upfront setting is worth the drug not being available to them later on.