Relapsed/Refractory Multiple Myeloma: Shared Decision-Making and Treatment Goals

Dr. Joshua Richter and Dr. Marco Davila discuss the importance of aligning treatment decisions with individual patient goals in relapsed/refractory multiple myeloma (RRMM), particularly among older adults being considered for CAR T-cell therapy. Dr. Davila emphasizes that chronological age alone should not determine treatment eligibility, as patients of similar age may have very different priorities, functional status, and tolerance for potential toxicities. Instead, he advocates for shared decision-making that incorporates patient preferences, desired treatment outcomes, quality of life, and willingness to undergo different therapeutic approaches. He also addresses common misconceptions surrounding CAR T-cell therapy, explaining that advances in toxicity management and outpatient care have substantially improved the treatment experience compared with earlier years. By providing patients with accurate, up-to-date information about expected risks, benefits, and logistics, the faculty highlight how individualized discussions can help patients make informed decisions that best align with their personal goals and optimize outcomes in RRMM.