Dynamic Frailty Assessment Underscores Need for Ongoing Evaluation in Transplant-Ineligible Multiple Myeloma: With Hira Mian, MD, MSc, FRCPC

Welcome to OncLive On Air®! I’m your host today, Jax DiEugenio.

In today’s episode, we had the pleasure of speaking with Hira Mian, MD, MSc, FRCPC, an associate professor in the Department of Oncology at McMaster University in Toronto, Canada, about the role of dynamic frailty assessment in the management of transplant-ineligible patients with newly diagnosed multiple myeloma. At the 2025 International Myeloma Society Annual Meeting, Dr Mian presented a dynamic frailty analysis from 2 phase 3 trials: MAIA (NCT02252172), which evaluated daratumumab (Darzalex) in combination with lenalidomide (Revlimid) and dexamethasone (Dara-Rd), and CEPHEUS (NCT03652064), which evaluated daratumumab plus bortezomib (Velcade), lenalidomide, and dexamethasone (Dara-VRd).

In our exclusive interview, Dr Mian discussed why frailty should be understood as a dynamic, evolving clinical state rather than a fixed baseline characteristic. She highlighted that frailty scores changed meaningfully over time for a substantial proportion of patients in both MAIA and CEPHEUS, emphasizing the need to regularly reassess patient resilience and vulnerability throughout treatment. Dr Mian also reviewed how the addition of daratumumab improved outcomes across all dynamic frailty subgroups—including patients classified as ultra-frail—and described key safety considerations when applying these findings to real-world practice. Finally, she underscored the importance of designing future trials that prospectively incorporate dynamic frailty to better guide treatment selection and supportive care strategies for older adults with myeloma.

That’s all we have for today! Thank you for listening to this episode of OncLive On Air. Check back throughout the week for exclusive interviews with leading experts in the oncology field.

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