Dr Usmani on Unmet Needs in the Treatment of High-Risk Multiple Myeloma

Saad Z. Usmani, MD, MBA, FACP, hematologic oncologist, chief, Myeloma Service, Memorial Sloan Kettering Cancer Center, discusses unmet needs in patients with high-risk multiple myeloma being treated in the frontline setting, highlighting areas of potential further exploration within this landscape.

At the 2023 SOHO Annual Meeting, Usmani shared a presentation on the frontline treatment of patients with newly diagnosed, high-risk multiple myeloma. In this presentation, Usmani emphasized that once patients have achieved a deep response through treatment with initial induction therapy, the decision to recommend transplantation depends on the patients’ age and other comorbid features. Furthermore, maintenance strategies involving the administration of a proteasome inhibitor and an immunomodulatory drug play a pivotal role in sustaining disease control, he emphasizes. Notably, patients should stay on this regimen unless tolerability issues arise or the efficacy of the drugs diminishes, Usmani says. 

However, it is important to underscore that this frontline maintenance approach highlights the existence of disease biologies that lack effective therapeutic options, he continues. Treatments directed at BCMA- and GPRC5D may help investigators achieve their goals for providing effective treatments for more patients, Usmani says. Overall, the ultimate goal of any multiple myeloma therapy is to establish sustained, deep minimal residual disease negativity, which is particularly important for patients at high risk for disease recurrence, he notes.

Looking to the future, Usmani highlights that these novel therapies will be further explored in clinical trials. Additionally, there are ongoing investigations into the potential benefits of certain small molecules, he says. Emerging cellular modifications and therapeutics designed to target specific genetic alterations, such as the 4;14 translocation, are of particular interest, Usmani emphasizes. Overall, these areas represent significant unmet needs within the multiple myeloma treatment landscape, and striving to tailor therapies to each unique biological subset of high-risk patients within this arena is of importance, he concludes.

Clinicians referring a patient to MSK can do so by visiting msk.org/refer, emailing referapatient@mskcc.org, or by calling 833-315-2722.