Treatment Sequencing Strategies in Relapsed and Refractory Multiple Myeloma

In this segment, Dr. Ajay Nooka asks Dr. Surbhi Sidana to discuss how she approaches treatment sequencing in relapsed and refractory multiple myeloma in the context of an expanding therapeutic landscape. Dr. Sidana highlights the growing complexity of decision-making as clinicians now have access to multiple classes of therapies, including cellular therapies, bispecific antibodies, antibody-drug conjugates, and established regimens. She emphasizes that sequencing is highly individualized and depends on several factors, such as prior treatment exposure, depth and duration of response, disease aggressiveness, and patient-specific considerations. The discussion also touches on the lack of a universally defined sequencing algorithm, requiring clinicians to integrate emerging evidence with real-world experience. This segment underscores the importance of strategic planning across lines of therapy to optimize outcomes for patients with multiple myeloma while balancing efficacy, safety, and access considerations.