Dr. Wolf Discusses Treatment Options for Multiple Myeloma

Jeffrey Wolf, MD, clinical professor, Department of Medicine, director, Myeloma Program, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses treatment options for patients with multiple myeloma.

Wolf says that in the rapidly evolving space of multiple myeloma, the use of initial triplet therapies should be emphasized for patients with newly diagnosed disease. For example, patients with renal involvement may recieve the triplet of cyclophosphamide with bortezomib (Velcade) and dexamethasone. Those with renal failure are often admitted for high-dose cyclophosphamide, high-dose dexamethasone, and a proteasome inhibitor. A plasma exchange is sometimes done as well in these patients, Wolf adds.

Patients who present with multiple myeloma who do not have high-risk disease are often given an immunomodulatory triplet such as lenalidomide (Revlimid) with bortezomib and dexamethasone. This regimen can be given to patients of all ages, regardless of transplant eligibility, says Wolf. However, doses are adjusted by age and frailty.