Dr. Usmani on Treatment of Newly Diagnosed Myeloma

Saad Z. Usmani, MD, FACP, chief of Plasma Cell Disorder, director of Clinical Research in Hematologic Malignancies, Levine Cancer Institute, Atrium Health, discusses the treatment of patients with newly diagnosed multiple myeloma.

The frontline treatment of multiple myeloma has evolved over the last decade, Usmani says. The field has shifted from single-agent therapy to triplet regimens. This current paradigm is based on pivotal data from trials like SWOG S0777, FIRST, and most recently, the MAIA and ALCYONE studies for patients with transplant-ineligible disease. In MAIA and ALCYONE, the addition of the anti—CD20 agent daratumumab (Darzalex) to therapy improved survival.

In general, patients with newly diagnosed multiple myeloma are still put into 2 broad buckets: transplant eligible and ineligible. Practitioners tend to make that assessment as the patient is undergoing induction treatment, Usmani says. In terms of triplet regimens, most physicians tend to use lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone.