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Sequencing Challenges Emerge in Myeloma After Recent Approvals

Ellie Leick
Published: Tuesday, Nov 26, 2019

We are seeing a lot of new drugs, new targets, and new combinations, which are exciting. We still see that most patients, unfortunately, relapse eventually and need additional treatment options. We have not yet had a definitely curative treatment in the horizon. One big challenge for relapsed/refractory multiple myeloma is to identify new targets and treatments that might provide durable, long-term remissions.

The second challenge is to come up with optimal regimens that minimize toxicities. Many of our patients live with this disease for several years. As we get better with efficacy for these different regimens, we need to focus on minimizing toxicities and minimizing duration of treatment. For many patients now, maintenance therapy is indefinite. Can we curtail that to 2 years, 3 years, or even 5 years? Using biomarkers, such as MRD assessments, to determine optimal duration of treatment will be another challenge.
Richardson PG, Rocafiguera AO, Beksac M, et al. Pomalidomide (POM), bortezomib, and low‐dose dexamethasone (PVd) vs bortezomib and low-dose dexamethasone (Vd) in lenalidomide (LEN)-exposed patients (pts) with relapsed or refractory multiple myeloma (RRMM): phase 3 OPTIMISMM trial. J Clin Oncol. 2018;36(suppl; abstr 8001). doi: 10.1200/JCO.2018.36.15_suppl.8001.

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