Multiple Myeloma

The treatment landscape for multiple myeloma continues to evolve.

The phase 3 CEPHEUS trial demonstrated that adding daratumumab (DARA) to the VRd regimen significantly improves minimal residual disease negativity, progression-free survival, and overall response in transplant-ineligible or transplant deferred patients with newly diagnosed multiple myeloma, establishing a new standard of care.

The GMMG-HD7 trial evaluated the addition of isatuximab to standard induction therapy in patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplantation, demonstrating significantly higher rates of minimal residual disease negativity and improved progression-free survival (PFS).

Panelists discuss how bispecific antibody therapies in relapsed/refractory multiple myeloma commonly present with cytokine release syndrome (CRS), immune effector cell–associated neurotoxicity syndrome (ICANS), and increased infection risks, while talquetamab specifically exhibits distinctive adverse events including nail changes, skin reactions, and oral toxicities.

Panelists discuss how infrastructure including specialized staff training, updated protocols, enhanced monitoring systems, and comprehensive educational resources for health care providers is essential for institutions to successfully implement and optimize bispecific antibody therapies while ensuring patient safety and treatment efficacy.

Ira Zackon, MD explains his analysis of bispecific antibody utilizaton for relapsed or refractory multiple myeloma in community oncology centers.

Robert Rifkin, MD, FACP, discusses multiple abstracts featuring drugs demonstrating efficacy in patients with relapsed/refractory multiple myeloma.

The AQUILA study demonstrates that early treatment with daratumumab significantly delays progression to symptomatic multiple myeloma, improves survival outcomes, and offers a well-tolerated alternative to traditional observation.

Rakesh Popat, MBBS, PhD explains the mechanisms of action behind the improvement in minimum residual disease in patients with lenalidomide-refractory multiple myeloma with cilta-cel compared with standard of care.

The therapy has similar benefits for both older and younger patients with multiple myeloma.

AI-powered drug response prediction technology is revolutionizing veterinary and human oncology by enabling personalized treatment plans through live cell testing, machine learning models, and data-driven precision medicine approaches.

Panelists discuss how when selecting between weekly and biweekly dosing schedules for talquetamab and teclistamab in multiple myeloma treatment, health care institutions must carefully weigh factors like patient convenience, monitoring requirements, resource utilization, and total cost of care alongside clinical outcomes to determine optimal treatment pathways for both patient and health system benefits.

Panelists discuss how specific recommended dosing schedules exist for step-up medication administration, and protocols should incorporate flexibility for individualized dose adjustments based on patient response, tolerability, and clinical factors while maintaining systematic documentation of any deviations from standard escalation timelines.

Panelists discuss how advances in bispecific antibodies and CAR T-cell therapies are transforming treatment approaches for relapsed/refractory multiple myeloma, while presenting complex operational challenges that require innovative institutional strategies.

Panelists discuss how bispecific T-cell–engaging therapies targeting BCMA, GPRC5D, and FcRH5 have emerged as novel immunotherapeutic approaches showing meaningful clinical activity for patients with heavily pretreated relapsed/refractory multiple

Belantamab mafodotin demonstrated benefits in overall survival in the phase 3 DREAMM-7 trial.

The panel discussion concludes with final thoughts on the future landscape of newly diagnosed multiple myeloma.

Outpatient models are emerging as feasible alternatives to traditional inpatient care, offering potential benefits such as reduced hospitalization, improved social well-being, and cost savings.

Panelists discuss how pharmacists can address remaining unmet needs and challenges in optimizing frontline therapy for patients with transplant-eligible newly diagnosed multiple myeloma (NDMM), including areas such as managing complex drug interactions, improving medication adherence, mitigating treatment-related toxicities, streamlining transitions of care, and enhancing patient education and support throughout the treatment journey.

Panelists discuss how they navigate challenges with payer coverage for quadruplet regimens in multiple myeloma treatment, including strategies they employ to address insurance denials or restrictions, such as providing clinical justification, leveraging recent trial data, and collaborating with financial assistance programs to ensure patients can access optimal therapy despite potential coverage difficulties.

LBL-034 could be best in class in treating individuals with multiple myeloma.

If accepted, daratumumab would be the first approved treatment for smoldering multiple myeloma.

Panelists discuss how treatment regimens for multiple myeloma patients can be personalized to improve adherence and quality of life by considering factors such as dosing schedules and routes of administration while emphasizing the role of pharmacists in providing resources and support to keep patients informed, engaged, and compliant with their individualized treatment plans.

Panelists discuss how pharmacists actively engage in educating and coordinating with nurses, oncologists, and other health care providers by conducting in-service trainings, participating in multidisciplinary team meetings, and collaborating on the development and implementation of formularies, order sets, and treatment protocols to ensure optimal patient care in multiple myeloma management.

Increased bone marrow adiposity is associated with progression of monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma.

In the results, 31% of patients maintained undetectable measurable residual disease 4 years after treatment.

Panelists discuss how pharmacists play a crucial role throughout the multiple myeloma patient journey, from diagnosis to treatment, by contributing to medication management, patient education, adverse effect monitoring, and the development and implementation of order sets and clinical pathways within electronic medical record systems, thereby enhancing treatment efficacy and patient safety.

Panelists discuss how subcutaneous (SC) administration of drugs like daratumumab offers advantages over intravenous (IV) administration in terms of reduced health care resource utilization, improved patient convenience, and potentially better treatment adherence, while also considering potential drawbacks such as injection site reactions and the need for proper training in SC administration techniques.

Panelists discuss how the FDA approval of daratumumab and hyaluronidase-fihj combined with VRd (bortezomib, lenalidomide, and dexamethasone) for induction and consolidation in transplant-eligible newly diagnosed multiple myeloma patients is changing treatment approaches while also considering how recent evidence suggesting reduced observation time for subcutaneous (SC) daratumumab administration may streamline patient care and improve treatment efficiency.

Panelists discuss how recent phase 3 trial data from PERSEUS, IsKia, and GMMG HD7 are shaping their approach to induction and consolidation therapy in transplant-eligible newly diagnosed multiple myeloma (NDMM) patients, particularly focusing on the incorporation of CD38 antibodies into upfront treatment regimens and the potential shift from triplet to quadruplet therapies based on these pivotal trial findings.