Elranatamab reduced the risk of disease progression or death vs standard care in patients with R/R myeloma after prior anti-CD38 therapy and lenalidomide.
|Videos|April 14, 2021
Expert Perspectives on a 75-Year-Old Woman With Triple-Class Refractory Multiple Myeloma
Author(s)Adriana Rossi, MD
Adriana Rossi, MD, describes the treatment approach in caring for a 75-year-old woman with triple-class refractory multiple myeloma [RRMM] while highlighting results from the relevant DREAMM and SOHO studies.
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Case: A 75-Year-Old Woman with Triple-Class Refractory Multiple Myeloma
Initial Presentation
- A 75-year-old woman diagnosed with multiple myeloma 5 years ago returns to the clinic with complaints of extreme fatigue, increased muscle weakness and new bone pain in her right hip, right forearm and low back. She reports that she is currently taking antibiotics for a bacterial infection, her third in the last 12 months.
- Treatment history:
- Initially treated with DRd; CR lasting 20 months
- Switched to VRd, stable disease lasting 16 months
- Subsequently switched to KPd, achieved a PR lasting 12 months
- Started selinexor; follow up at 9 months showed M protein increase by 0.5 g/dl; patient continued to feel well
- Currently, 3 months after her last visit, she returns to the clinic for follow-up
- PE: new bony tenderness appreciated on right hip, pelvis forearm and lumbar spine; bruising and mild bleeding of the gums
Clinical Workup
- Labs: Hb 6.2 g/dL, calcium 8.4 mg/dL, LDH 160 U/L, creatinine 2.1 mg/dL, albumin 2.7 g/dL, b2 microgloblulin 4.9 mcg/mL, serum M-protein 4.2 g/dL, lambda free light chains 4.1 mg/dL
- HBV negative
- Skeletal survey and MRI revealed lytic bone lesions in the left hip, pelvis and L2 vertebrae and lytic lesions as well as a hairline fracture in the distal radius of the right arm
- Bone marrow shows 62% plasma cells IgG k
- FISH: t(11;14) at diagnosis; new del(17p)
- Diagnosis: R-ISS stage II MM
- ECOG 1
Treatment
- Initiated treatment with belantamab mafodotin
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Related to this article
Etentamig, a BCMAxCD3 bispecific antibody, was submitted for potential FDA approval based on the phase 3 CERVINO trial in relapsed/refractory multiple myeloma.
During a live event, Robert Orlowski, MD, PhD, and participants discussed how access barriers, disease tempo, and bridging choices shape CAR T referral for a patient with early relapsed multiple myeloma.
The phase 3 VERIFY trial found that rusfertide improved clinical response, reduced phlebotomy requirements, and eased symptom burden in patients with polycythemia vera receiving standard-of-care therapy.
During a virtual event, Thomas Martin, MD, and participants considered the use of the on-body injector for subcutaneous isatuximab for a frail patient with transplant-ineligible newly diagnosed myeloma.
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