Dr. Vij on the Optimal Induction Therapy in Multiple Myeloma

Ravi Vij, MD, MBA, professor of medicine, Division of Oncology, Section of Bone Marrow Transplant, Washington University School of Medicine, Siteman Cancer Center, discusses the optimal induction therapy in the treatment of patients with multiple myeloma.

Transplant remains the standard of care in eligible patients, says Vij, as it is known to demonstrate a superior progression-free survival. The optimal induction regimen is unknown, explains Vij, though most physicians will use bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd).

In the frontline setting, carfilzomib (Kyprolis) is being examined as a potential substitute for bortezomib—in some cases, it is already being implemented into practice. The use of carfilzomib is being driven by studies that have demonstrated a superior depth of response compared with what has been seen historically. Physicians are eagerly awaiting the randomized study comparing frontline carfilzomib, lenalidomide, and dexamethasone with VRd, says Vij, which will help determine the optimal induction regimen.