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Highlighting the Current Treatment Strategies for Patients With Multiple Myeloma

Noopur Raje, MD
Published Online:1:49 PM, Tue May 21, 2019

Noopur Raje, MD, professor of medicine at Harvard Medical School and director of the Center for Multiple Myeloma at Massachusetts General Hospital Cancer Center, discusses the current treatment options for patients diagnosed with multiple myeloma. At this time, a number of FDA-approved drugs and different combinations are available.

In the frontline setting, majority of physicians are moving toward triplet regimens followed by maintenance therapy in patients who received a transplant. Four-drug regimens are also making their way into the upfront setting with the goal of getting to and maintaining a minimal residual disease-negative state, says Raje.

The curves have also shifted in that patients tend to relapse after 3.5 to 4 years after initial diagnosis; there are more data investigating triplet regimens in this setting, according to Raje. Treatment after relapse is often dictated by the prior therapies a patient has received, the nature of their relapse, and the risk associated with the relapse. Typically, physicians use a triplet regimen.

Majority of patients in the United States are progression after receiving a lenalidomide (Revlimid) maintenance approach. In these patients, physicians are leaning toward a pomalidomide (Pomalyst)-based approach, including either daratumumab (Darzalex), carfilzomib (Kyprolis), or some other agent.
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