Treatment Sequencing in Multiple Myeloma

Tanika Pittman, APRN, discusses the evolving role of APPs in helping patients with multiple myeloma navigate increasingly complex treatment sequences across frontline and relapse settings. She describes APPs as a continuity thread throughout the patient’s treatment journey, coordinating appointments, referrals, medications, and communication among members of the multidisciplinary team while maintaining an understanding of the patient’s individual circumstances and goals. Tanika emphasizes that patients often experience multiple myeloma as one continuous journey rather than as distinct lines of therapy, making it important to explain what has changed when disease progresses and why a new treatment is being recommended. She also highlights the need to prepare patients when transitioning to different treatment settings, such as bispecific antibodies or CAR T-cell therapy, and to explain that treatment modifications or dose reductions do not necessarily indicate treatment failure. The discussion then considers how the APP role may evolve from treatment support toward a “clinical integrator” who understands the disease, therapies, patient goals, and operational requirements for safe treatment delivery. Both faculty underscore the importance of long-term relationships between patients and their multiple myeloma care teams as treatment becomes increasingly complex.