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Expert Evaluates Evolving Options in Newly Diagnosed Myeloma

Caroline Seymour
Published: Monday, Nov 19, 2018

Ravi Vij, MD

Ravi Vij, MD
Transplant remains the standard of care for eligible patients with newly diagnosed multiple myeloma, although the optimal induction regimen and value of consolidation is still debated, explained Ravi Vij, MD.

on Hematologic Malignancies, Vij, professor of Medicine, Division of Oncology, Section of Bone Marrow Transplant, Washington University School of Medicine in St. Louis, Siteman Cancer Center, discussed emerging treatment options for patients with newly diagnosed multiple myeloma.

OncLive®: Can you provide an overview of newly diagnosed multiple myeloma treatment?

Vij: We've made tremendous strides in the treatment of patients with multiple myeloma. The paradigm that has evolved for multiple myeloma is one of continuous therapy. [First, we need to] determine whether a patient is transplant eligible or not. Stem cell transplant remains the standard of care for eligible patients. Most institutions would deem a stem cell transplant to be part of their initial therapy given the superior PFS that continues to be demonstrated. The paradigm for transplant-eligible patients is to give an induction period of treatment, though the optimal induction regimen is not known. The most popular regimen is VRd, which was shown to be superior to lenalidomide and dexamethasone in a study conducted by the SWOG Cancer Research Network. Though that study was not meant for patients who were proceeding to get transplants, it informed the decision that the use of 3 drugs is better than 2.
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